Last year as I was preparing to embrace some chlorine I heard a TV advert in the locker room. Apparently, one can buy a 'well body CT scan'. It angered my moral conscience to such an extent that I noted it down in my phone to reflect upon it in my portfolio. Sadly, that never quite happened. But something my sister said this afternoon stirred up some those same emotions. It turns out she has been unwell and was talking about her recent experience. She is suffering from what sounds like a horrible sinusitis. And given the fact she has had a few headaches recently she has booked in to see a neurologist, privately. No real quibbles, I am not privy to her past medical history and I know from seeing my fair share of headaches they can be both hideously distressing and have a major impact upon your life.
She managed to get an appointment with a leading neurologist the next week and proceeded to compare this to the NHS. The penny dropped and my ethical training hit overdrive. Naturally, for her this was excellent news as seeing a neurologist on the NHS would have taken twelve weeks!
Frustratingly, this is exactly the type of patient the government seem to be giving precedence to. Young, intelligent, affluent and most importantly, well. I tried to make the case for the NHS, that it is based on need, and that actually she doesn't need urgent appointments for chronic headaches. But when you compare it to the leading excellence rapidly available from the private sector, one can see why it is so appealing. And what is perhaps more galling, is that I can guarantee she will receive at least one scan. Because why not? An extra scan is extra money, and the patient has heard about them so will not be satisfied without one. A wholly different dynamic to the NHS.
So one can see where the Conservative government is coming from, and why shouldn't the NHS be as good as the private sector? The quick access to expert advice is something we should aspire to. And I would heftily wager the driving force behind this reason for change is of their healthcare experience, private of course.
But ultimately the NHS is a socialist model based on need. And as an emergency doctor I believe urgent care should always trump planned care as it is needed, not wanted. This is why I believe parading around the fantasy of seven day elective care that fits around the patient is obscene. The scale of reinforcements and investment needed is unbelievable and definitely unachievable at this time.
So if the government truly wishes to fulfil their manifesto they need to interrogate the public they serve. As far as I can see, there are two choices to achieve the seven day fully elective healthcare system: pay more tax to provide the facilities and staff or pay less tax to provide urgent state funded care and replace elective work with private healthcare. But for me the lingering question remains, does the British public want this change?
In an increasingly capitalist world it is easy to give in to temptation, however, that is neither the ethos nor the mandate of a socialist NHS. Before forcing through change let us talk yet perhaps more importantly; let us listen. Only then we can devise a strategy on how to deliver the future, together.