Friday, 14 August 2009

NHS In Free For All?

Poor old NHS, a creaking giant born of good intentions, the saviour of many, the tormentor of some. Say what you will, a service where everyone payed in to provide health care for all seemed to be a good idea at the time. Or was it? According to critics both here and in America, the National Health Service of Great Britain is a disgrace. They say we are subjected to governmental control and tyranny in order to access basic health care for which, they say, we wait and wait for no good reason. And what's more we have awful teeth. Nice. How kind of them to mention it.

I've worked in the NHS all my adult life, and quite frankly despite all the negative press I'm proud of what can be achieved, although I'm the first to agree it isn't all good news. That much is obvious. Since 1969 I've seen many changes, many different incentives and initiatives relentlessly pursued only to be abdandoned and tried again years later with the same disappointing results. I've witnessed the rise and rise of superbugs, the lowering of cleaning standards, the out-sourcing of basic services which are often substandard, the ridiculous obsession with producing statistics rather than genuine improvements in patient care. Whole hospital departments exist merely to collect raw and sometimes inaccurate data, mould it into the required good news format to be used in the never ending game of ping-pong politics in which the NHS has become the continually battered ball. Point scoring results can be manipulated to order, depending on who's asking the question and what they want the answer to convey. Legions of career focused hospital managers now spend their time in meetings about finances, targets and cuts whereas at one time they used to know more about patients' needs, the local population, the value of their staff. Sadly, that's all in the past.

Yes, there's plenty to be negative about if we want to look and look and look for it, but whilst we're having such a close look I'd urge anyone who's at all interested in fair play and a balanced argument to take care not to ignore the tremendous good that is also achieved.

In the years I've worked in the health service, I've seen kids who would never have previously survived into adulthood given transplant surgery which has provided them and their families with a future. There are chronically ill people in the UK who are being kept alive by combinations of drugs/therapy/care, all free at point of delivery. What would happen to them if it wasn't for the NHS? Babies smaller than bags of sugar (much smaller, actually) are now routinely cared for in amazingly expensive high-tech units until they're big enough to go home, when the nursing staff joyfully hand the parents a baby, not a bill. Every day we can freely go to our GP's surgery, or take part in some sort of health screening, or be seen by a consultant without taking a credit card with us (although change for the carpark would be handy), but these treatments come at a cost and these costs come from our contributions, and we who contribute do so on behalf of everyone. I think we can be proud of that.

I'll not try to pretend that there isn't massive room for improvement in the NHS and admit that there are very, very many cash-strapped services which are not up to a good enough standard, and yes, our demands for health services outstrip the available supply because there simply isn't enough to do everything everyone wants, so yes, we sometimes have to wait. And sadly, yes, some people have been very badly let down by the NHS for many different reasons. But please don't forget the millions and millions of people who owe their health and wellbeing to it, who have been treated successfully and well and are living proof that when the National Health Service is allowed to work, it works. It may be a long way from perfect, but at least you can rest assured that the first question a patient is asked before treatment in a British A and E Department is never going to be "who will pay?"

For me, the sight of people in the US with no health insurance queueing up before dawn in order to see a doctor, certainly vindicates our NHS warts and all.

And yes, in this country you can get those treated for free too.


Mimi said...

Hear hear! And very well put.
My only experience of the NHS is through my brother and his family (3 kids) who live in the UK, and it seems good to me.
As you say, some things could be improved, particularly outsourcing of cleaning, but overall it is a good service and care, not money, is the priority.
And good to have you back!

Swearing Mother said...

Thanks Mimi, a bit of a soapbox moment but just felt the need!

Mopsa said...

I knew we could rely on you SM. This bollix about saying negative things about the NHS being unpatriotic makes my blood boil - it misses the point completely. What's important about the NHS is that we all have access to it and as imperfect as it is, we don't have to scratch around to pay for it when we need it. And in all its lovely imperfection it is an extraordinary service, doing amazing things. For that I happily forgo perfect teeth. In fact the world of dentistry is the exact reason why we need the NHS - trying to find an NHS dentist is incredibly hard, and finding one that doesn't treat you like scum because you insist on NHS dentistry to make damn sure that the service doesn't wilt for lack of use, is impossible. I can't imagine what it would be like if I had to go through that with my GP or local hospital.

Maggie May said...

Good to hear from you again SM. I think that was a very good post and I do agree with it wholeheartedly.
I am sure that most of my family would not be here today if it wasn't for the NHS.
It might have its failings but in the end I think we do get a good service.
I have been shocked to hear how many people in America have no health insurance, sometimes through no fault of their own.
I hope Obama will do a good deal for them but HANDS OFF if any one tries to privatise us!

Sarah said...

There are some fantastic people working in the NHS who must find it hard to keep going under all the irresponsible political buck-passing. Bankers barely gat a light spanking for their selfish, childish behaviour. Public sector workers seem constantly under a critical glare.

Anonymous said...

Sadly I've never had a good experience with the NHS. At 16 I suffer from a sprained hip joint. February this year I went to a doctor who referred me to the physio dep. and told me they would get in touch. Instead of waiting I went private and only heard from the NHS in july.

All the same though, it does work - just not for everyone. Good blog and nice to hear from you again!

aims said...

Yes - they're attacking Canada too.

No health system is perfect. Nothing is perfect!

But - to know I can get treated when I am in need without losing my house over it....yes - I can sleep at night.

The pics of the people who couldn't pay being dumped in the street by the hospitals in the US - how can one survive that?

Swearing Mother said...

Hi Mopsa, as always you've hit the nail right on the head, and I totally agree with you on the subject of dentists. What a pain!

Maggie May, nice to talk to you too. I too hope Pres Obama will be able to talk some sense about health care.

Sarah, you're not wrong. I suppose sometimes the NHS is a service a lot of people get angry about, but it's better than nothing.

Hello Pure Poser, I know there's always a wait to see a physio, we need more of them!

Hello Aims, it really shocked me to see those folk just shuffling along in a queue when somebody should be looking after them.

softinthehead said...

WOW you are and on full vent :) It is lovely to hear from you again and hear hear, rather that than what they have to put up with in the US - how dare they point the finger. It is a shame that the NHS has started to become victim to those "bottomline" people - it is not about the money but about what kind of society we want to be!

softinthehead said...

Sorry that should say "you are back and on full vent" LOL

Swearing Mother said...

Hi SITH, nice to read you again too!

The Draughtsman said...

That was a good and timely posting.
How dare the Americans have the temerity to even consider slagging off the British NHS when their own house is far from in order?
If you can afford it, in America, the care can be second to none but for the the hoi-poloi?
I agree the NHS is far from perfect but it is far, far better than having to go private when you simply cannot afford it.

Thumbelina said...

Good to see the SM we know here! I must have read this before because I told dad about it and here he is, commenting before me! I am finding time to read some blogs, but now always comment and definitely not post. Just put the last post up today and probably quitting except for visiting. Not got the time.

Great post btw and I agree - leave our NHS alone. It isn't perfect, but it is better than SOME systems in the world!

Swearing Mother said...

Yes Norman, and we should know shouldn't we? Have sweat blood and tears for the NHS, so feel a bit protective about people with no health care provision at all for those who can't afford it, having a pop at our system. Mind you, there are days when I could kick the lot up in the air........

Thumbelina hi? Have been off the air blog-wise for a bit, you're obviously related to the lovely Norman and Cath?? Lovely to read you and thanks for visiting.

Swearing Mother said...
This comment has been removed by the author.
Pam said...

Great post! I was also a tad disgruntled at the rude teeth jab but please believe me when I tell you that Americans are not generally rude - the media finds one idiot and puts them on tv.
It's not quite clear-cut here. I have very good health insurance, had a baby and the whole deal cost about 20k. My portion was $350. So you would think only rich people have kids? but no, there are millions and gazillions of poor Americans churning out babies they can't afford and it's paid for by Medicare/caid, (something like that). So there is a plan for people with no money to get medical help.
The nightmares seems to be with working class families that have health care but not enough. If a person gets cancer it might cost them 200k, they lose their house and they declare bankruptcy. That's the hearbreaking cases that you read about.
Seems to me that if you're on welfare you're tickety boo (same as the UK!)

Swearing Mother said...

Hi Pam, thanks for that balanced view as always. What a worry it must be for under-insured US citizens to be in such financial trouble at a time of illness, not conducive to a speedy recovery at all.

Agree with what you say re "sound bites" - especially chosen to get those UK teeth gnashing!

Swearing Mother said...
This comment has been removed by the author.
Swearing Mother said...

For some reason everything seems to be published twice, hence the "comment deleted" - what the heck's going on??

Frog in the Field said...

Here here!

The Woman who Can said...

SM, I've returned. Come on over if you fancy joining me again!


MBNAD woman said...

Our NHS is wonderful in the case of emergencies. My delightful daughter is alive with a complete set of working parts thanks to the amazing treatment of ill & premature babies. I'm quite sure that the care that available 28 years ago would be just as wonderful today.

About 4 years ago, I broke my wrist and was in and out of A&E in less than an hour. Thanks heavens for that because I might have had to sell a kidney to pay for the car park if it had been longer. Fabulous and efficient treatment.

But the care available to my dying mother was a clinical and administrative disgrace. In fact it could not be described as "care" in any sense.

So, yes it's great that the NHS is a universal service, free at the point of delivery. And the recent soundbite war has been engendered by people who can speak from no knowledge. But let's not kid ourselves either. The culture of KPIs rather than patient needs, of process rather than care does our NHS and us no favours at all.

Right, I'll get off the soapbox now.


Daisy said...

Very good post! Living in France I'm constantly being told how amazing the French healthcare system is and such good value etc etc but I went home to the UK at the weekend and was able to just walk into a surgery and see a doctor and get a prescription on spec, not pay a penny and not even have any boring paperwork to fill in - just my name and temp address. In France I've been waiting nearly two years for my social security number and in the meantime am shelling out thousands of pounds myself!