Friday, 17 February 2012

Not in the Market for the NHS

In the last year I have realised the importance of the health service, in the early part of last year I had extremely painful Achilles tendons and shin splints, my GP did not refer me to a podiatrist, so I found myself one and paid to get them fixed, thankfully this was successful. Anyone that knows me, knows that since September I have been suffering from exhaustion and not firing on full or even half cylinders, thankfully my GP diagnosed the complaint and now they are trying to get the medication right.

Maybe it's age, but I now know the importance of the National Health Service.

The coalition government are nearing the end of their Health and Social Care Bill, this is an illegitimate piece of legislation, neither the Conservative Party or the liberal democrats promised or mentioned their intention to deliver a top down reorganisation of the NHS. A convenient conclusion from the coalitions discussions.

Health Service provision is a dynamic, health innovation moves at a pace and the NHS has moved and will continue to do so, no one can argue that personalised care in the home and greater specialised services will demand changes in the NHS, but the coalition governments solution of private marketisation seems the wrong treatment and even the wrong diagnosis.

The Commonwealth Fund most recent comparative study of health systems clearly shows that market-based systems, or countries that have a more mixed economy in health, spend more as a proportion of GDP on health than we do on the NHS for a roughly equivalent level of coverage and service quality. This is why the fund regularly judges the NHS to be the most efficient healthcare system in the world.

The reason why the NHS is rated to be efficient is because of careful planning and the collaboration between hospital, doctors and health service professionals. Health cannot be about putting your competitors out of business as capacity is important to deal with the ebbs and flows of disease and health issues.

The NHS is based on the notion that everyone deserves the best medical care, the NHS largely achieves this, in market health services there are greater health inequality of delivery, so the NHS delivers better health care for everyone.

In Shepton under the previous Labour government the private sector opened up a treatment centre, this offered choice for patients, and this was within the planned health provision, the NHS mission should be to continue to show how people can have maximum choice, control and access to responsive services without unpicking the fabric of a planned, national system.

The previous Conservative government privatised the railways and the energy markets, these privatisations failed because these do not offer real choice and the markets are rigged, our NHS cannot be treated in the same way, the coalition governments new duty to promote the "autonomy" of providers breaks that. And in a world where hospitals are fighting for survival, it raises questions about the future of clinical networks and workforce planning.

The NHS enjoys patient satifaction, people reconise the NHS is fair.

The Health and Social Care Bill will deliver a postcode lottery, the service delivered depends on where you live, the government argues the GPs are the best people to judge on their patients health, yet the discussion between doctor and patient are not equal and far from improving patient chances, if implemented, the bill will result in increasing numbers of patients fighting to obtain treatment and care.

There is growing evidence that the NHS are beginning to make cuts to meet the £20billion savings demanded by the government, in Shepton the NHS are reviewing the bed numbers in the community hospital, the town has a fight on our hands to save the in patient service.

So back to where I started, the new commissioning groups, will decide what services they fund, I had to pay £450 to make my legs better, patients will lose choice and the power will be with the GP commisioning groups.

The Health and Social Care bill is a mistake, it replaces collaboration for competition, it could fundlemental change the relationship between doctors and doctors and doctors and patients and it will lead to a worse health service, it's time to Drop the Bill before it's too late.

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