Whose NHS is it?

Yesterday I signed the most recent NHS petition by the highly-organised campaign group 38Degrees against limiting access to GP appointments, joining 189,206 others (at the time of writing).  The proposal in question is one which (as reported in The Independent) was circulating last week in the TorySphere as part of a ‘discussion brief’ on healthcare for Conservative activists. Today, Jeremy Hunt, the Secretary of State for Health, has been forced to state that limiting appointments will never become Conservative policy.

I can’t help wondering whether it was proposed to deflect attention from other more complex proposals, or to make people feel relieved when proposals that would otherwise have been unconscionable are put forward. But supposing it was a serious proposal, it shows little understanding of how or why people use the NHS.  Whilst it’s certainly true that the sharp-elbowed are more likely to ‘get their taxes’ worth’ out of their GP than those who are vulnerable, it’s also true that people who are ill visit their GP. Some people are isolated, anxious and depressed, and the GP may not be able to address all of their concerns. But people don’t visit their GP for pleasure: reducing access to GPs could only result in more people turning up at A&E, which would surely be a political own-goal for Mr Hunt!

Whatever else Mr Hunt proposes for the NHS, he’s got the service at a bit of a crossroads at the moment. During May, as reported in The Guardian, BUPA and other private health firms were granted access to patient-identifiable information for a (relatively small) fee.  Yet since the Health and Social Care Act came into effect in April this year, commissioning groups – public sector organisations whose job is to ensure that the public has access to effective and efficient healthcare – have not had access to patient-identifiable data on hospital admissions which would help them monitor and commission care properly.

The Primary Care Trusts, which used to commission healthcare, used to have access to this information, but access now depends on information governance arrangements which have yet to be put in place. BUPA might want this information to ‘support the NHS with services like population health management’, but they will be at an unfair advantage if NHS commissioners can’t access the same information.

What does this mean? Does it matter if private companies deliver more of our healthcare providing it’s still free at the point of delivery? I’d say yes. Not just because I don’t see private healthcare companies queuing up to take on the difficult, expensive, and time-consuming cases; not just because it’s hard not to see private healthcare companies adding in charges and forcing a differentiation between those who can afford to pay that little bit more for a decent meal, and those who can’t.  But also because it goes against what we as a nation want from our NHS.

There has been no better advert for the NHS of late than the BBC series ‘Keeping Britain Alive’. If you haven’t  watched it, please try and catch an episode on iPlayer.  Despite having worked in the NHS for 20 years, I watched the episodes avidly, and I’m missing my regular appointment with BBC2 on Tuesday evenings. The BBC brought us documentaries which clearly highlighted the way in which the NHS responds to real people, all the time, regardless of circumstance, and often regardless of whether our own lifestyles have contributed to ill-health. They showed the breadth of the service, from neuro-surgery to community care for people with learning disabilities. They also showed its expertise, experience, and humanity.

I just hope Mr Hunt – and anyone who might consider voting for him in 2015 – was watching.

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One response to this post.

  1. […] Not just because of the continued sale of the nation’s silver – from Blood Plasma UK to healthcare data to community care services, with much more set to follow as a consequence of the so-called […]

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