London. Love it or hate it, there's no denying that it's a magnet which draws people towards it whether they're tourists, students, jobseekers or immigrants looking for a better way of life.
Throughout its long history, things have always been pretty much the same - however now we're seeing an influx which is threatening the capital's ability to cope. Both infrastructure and public services are creaking under the strain and public healthcare is no exception. And while the pressure is on in areas such as transport and education, problems in the NHS could be a matter of life or death.
It goes without saying that more resources are required to look after more people but the pace of change in London means that our health service can't keep up. The effects of this were further brought to light by a recent survey of 2,000 patients which we carried out at Fletchers Solicitors. We asked patients across the country to rate their overall experiences of the NHS and some of the regional differences we uncovered were startling.
Londoners scored the NHS particularly poorly in terms of how satisfied they were with the quality of service they had received, with an average score of 6.43 out of ten, compared to the UK average of 7.09 and a score of 7.54 for South West England, the best performing area. It's clear from this that there's something about London which is having an adverse effect on the general service levels of the NHS there.
So are people complaining about the quality of treatment? Well in London they're more likely to do so than any other area of the UK. Almost a quarter of all patients in the capital had complained formally about how they or their family had been treated by the NHS, which was a third more than the average rate of complaints across the country.
Just as alarming is the number of patients who choose not to complain. I wrote recently about the basic need for the NHS to listen to, acknowledge and take action on complaints, and that a good starting point would be to recognise that it's not giving off good signs when it comes to people speaking out.
While London leads the way when it comes to people complaining about the NHS, at the same time almost twice as many households there haven't done so, despite having good reason to voice their disapproval or displeasure at levels of treatment. The most common reason why people in the capital said nothing was an unwillingness to further trouble overburdened frontline staff - another effect of the crippling pressure being put on healthcare provision for Londoners.
It's worrying to say the least to see the results of our survey and the situation that appears to have developed in London in particular. While the rest of the UK clearly shouldn't be ignored in all this, there are strange, unsettling and perhaps unprecedented circumstances at play in our capital city right now. As the pressure on public services grows, so the battle to maintain standards becomes more and more difficult to fight.
If those standards are not to decline from now on, several changes need to happen. It's going to be very tricky but a great and relatively simple way to starting getting improvements in place would be to get people's voices listened to. We need to encourage people to come forward and say what needs to be done to make the NHS better. There are way more voices to be heard in London than any other city in the country, so there's potential for a lot of listening to take place and a whole lot of action to be taken on the back of that.