As a medical editor I often come across tales from patients using the NHS - some positive, others less so. I would not be breaking any news stories by saying that the NHS is without a doubt in trouble but it's interesting to hear the many sides of the NHS debate.
The other day I was sent the link to a passionately scribed story from a patient who had terminal bowel cancer. The gentleman proudly claimed that he had never had a sick day in his past 25 years of work and was seldom heard complaining of any ailment. He had, however, recently noticed serious signs of illness and had promptly taken himself off to the doctor, along with his diagnosis of bowel cancer.
His post is one of the more gut wrenching to come across and despite his prognosis of only a few months he remained positive and was given the best possible treatment and care. He was then determined to write to his local MP to tell them that the problems with the NHS were unfounded and that there was nothing wrong with the system.
I found two major issues with this story. It breaks my heart that this gentleman who was apparently of supreme health has now had his life cut short because he was either poorly informed of the early warning signs of bowel cancer or was too reserved to go to his doctor sooner (or both). These are huge issues in public health and are also part of the increasing burden on the NHS. My second issue came from my disbelief that he had a decent experience with the system. I then discovered he had been treated in Oxfordshire. Here lies another example of huge disparity in the type and accessibility of care across the UK. As a Londoner I'm not surprised that my experience in the NHS has been fraught with problems. While the capital might have access to some of the best equipment and most integrated services, more often than not it is not available due to demand or it is poorly managed. On the other hand, many patients with long-term conditions living outside, or on the fringes of, large cities have limited access to services. Somewhat luckily for this gentleman, he happened to fall somewhere in the middle.
These issues have only been further highlighted by Lord Carter's report that there is huge disparity in how treatments are organised and processed. His research found that if we standardised things like surgical procedures the NHS could be saving close to £5 billion a year. (My question of why surgical procedures are not standardised will have to be answered another time.)
The fact remains that the NHS is disjointed and it's becoming more inaccessible. The next available appointment with my doctor is in 1 month. This means that all appointments are essentially reserved for people with long-term conditions. What does this say about our society? We have more cases of diabetes, liver disease and obesity than ever before yet with more careful monitoring and education, and perhaps standardisation, these could be decreased. We have a system of providing care based on public health priorities--it's great we have a 2-week referral period for people with suspected cancer, but there are still very serious conditions that do not warrant one-month (or longer) waiting periods. Healthcare professionals are overburdened from time restrictions on consultations and lack of funding, and hospitals are bursting at the seams trying to accommodate the overflow of patients.
I am originally from Australia and I have never experienced being unable to get an appointment with a doctor, an ultrasound or an X-ray on the same day, if not the next. It took 6 months of investigations in the UK for a condition I had before I ended up going back to Australia to be seen by a consultant there. I received a diagnosis in a 40-minute consultation and advice on how to manage the condition. At the end of the day I was out of pocket the equivalent of £150 but I was happier knowing what was wrong and what's more, I was able to treat the problem.
The system needs to start working on a principle of functionality for delivering care across all conditions, not what the biggest health concerns are of the moment. Access to investigative procedures should be available to all patients within a few weeks, not just those with suspected cancer, and GP appointments should be available to people within a day or two, not 1 month. While Lord Carter's report is a step in the right direction, his solution only solves a tiny fraction of the £22 billion deficit. His research also cost the government a quarter of a million pounds. We are now simply wasting time and money trying to find a solution that maintains the NHS as free for all. In the meantime, we're also cutting costs from services that might be less common but that are extremely important to an individual with the condition.
We need to make the system accessible for everyone that uses it and I believe this is where privatisation would help. If we are financially able then we should be taking responsibility for paying for our healthcare - ultimately this would reduce the burden, provide funding for better quality care and still support a system whereby people who are on benefits receive free or discounted healthcare.