The NHS is broken but who can fix it?

The Good Life Letter 

17th February 2017

  • Find out why this group are not to blame for a failing NHS
  • Three major reasons why we need to think differently
  • A way forward, but maybe not THE way forward?
Iím really not a political man, so I donít want any of you to read anything of that nature into todayís letter, however, I have to approach a subject that has deeply affected me and my family and I need to let off steam.

It is basically this, the situation with our NHS has to change before more and more people undergo unnecessary suffering, worry and frustration.

In the last month, not a day has gone by without some new issue or crisis being flagged up and yet I canít see that there is anything being done about it.

One thing that does worry me, and has begun to play on my dadís mind, is that it is all the fault of one section of the population Ė those who are elderly and in need.

My dear father, who is in need of support and care, is convinced that it is him and his like who are spoiling it for everyone else, that his grandchildren will suffer because he is taking too much resource in his older and frailer years. This is how the media coverage is affecting him.

The cause of the failings in the structure and function of the NHS is constantly being identified as the fault of increased demand from an Ďageing populationí and that this group is accounting for the majority of the expensive treatments being carried out.

Politicians, journalists and media commentators are all trotting out the same line that basically our old folk are putting too much strain on our hospitals.

This is just plain wrong.

So today I want to give three basic reasons why the current crisis has nothing to do with an ageing population, and then offer a solution to how we should be thinking about our healthcare in the next decade.

If the politicians canít do it, then I will Ė even just to stop Dad worrying!

The generation game


This week The Resolution Foundation conveniently published a survey saying that pensioner households were £70 a week better off than those of working families.

I say conveniently because it begins to look like there is a witch hunt against the elderly in this country and I donít like it Ė if you distil the news from the last few weeks we end up with the following headline that I am sure a newspaper editor is dying to publish...

Old Folks Healthcare Is Costing Us A Fortune Even Though They Have The Money To Pay


Iím sorry if that seems harsh but this is the way I am interpreting the sentiment and mood of the public statements being published at the moment.

But I have just three things that I want to say to this:

1)    The current generation of pensioners have paid into the country since they first went to work, without fail. Each pay packet was duly docked the requisite amount of tax and NI (stamp as my dad used to call it). This they were told was to support them in their older age and provide them with a pension to allow them to live comfortably.
During successive governments of all political hues these taxes kept being paid, as well as car tax, VAT and rates. The levels of default were negligible and everyone made a contribution.
How this money was used, squandered and wasted is not the fault of those who paid. Each and every politician should hang their heads in shame that they now are failing the very people who provided for and protected their worthless lives to this point.

2)    An ageing population should not have come as a surprise. Every ten years there is a census which maps the number of people living in every household in the country... and identifies their age. In addition, the government is responsible for administering things like bus passes and pensions which only go to the older generations.
Make no mistake about this, the number, ability and infirmity of every pensioner has been tracked, noted and known about for the last fifty years at least.
If the Whitehall minions, Westminster idiots and NHS tiers of management havenít seen this coming they really must have been at the sherry cupboard for a very long time.

3)    This is the twenty first century, people. In times gone by, say the 1960s, we acted as a society who cared for all its members. Neighbours looked after those less capable in the community and families rallied around those in need Ė because they wanted the best for their relatives rather than just looking for a share of the will.
Is there any evidence that the generation who gave of themselves in these circumstances are getting the same level of respect and support from the world they now find themselves in?

Just when they need the love and care of those around them it is now more likely that they are being fleeced by scumbag conmen on the phone, ignored by corpulent business travellers on the packed trains rather than offered a seat or left alone in their homes not seeing anyone from week to week.

Have sixty years really made the plight of those in need a cause for scorn and vilification?

Is there a way forwards?

Having got all that off my chest I canít say I feel any better but feel that it deserved saying.

Now, how can we fix all this?

Well I fear that we need to think about change first and the cost afterwards. Rather than worrying about the healthcare we can afford, we need to deliver the required service then decide how to fund it.

Let me explain my thinking.

Every one of us deserves a hospital bed when we need one, so that means building more wards and putting more beds and staff in place. This needs more doctors and nurses to be trained or employed from other countries to tide us over.

Next, we need a standard set of health practices available around the country Ė replacement joints, surgery for bowel, lung and heart conditions, maintenance treatments for cancers and kidney conditions Ė that sort of thing, and these should be free at the point of delivery.

The last bit is that we should all have access to aftercare and support that does not demean us, but allows us to heal and restore our spirits as well as our bodies, and maintain our independence for as long as possible before we finally need round-the- clock care in our final days.

None of that is beyond our capabilities as a society, or beyond the logic of being human Ė but I can well imagine that you all think Iím away with the fairies in La La Land (not a bad film actually!) and not seeing the big picture of costs and budgets.

Well, like I said I want to shift this debate to need not afford.

Paying for this is not really the hurdle it is made out to be.

First, get rid of waste in hospitals and the NHS, what I want to see is three tiers of management removed from the service immediately. Every suit and skirt in management/business consultancy/marketing and those not directly involved with patient care should be challenged on the value given.

According to the Kings Fund in 2011 the cost of management in the NHS is a conservative £8bn per year, a report from the Guardian in 2014 says this is more like £15.5bn... I think it is fair to say it is too much whichever figure you take.

Next, stop pharmaceutical companies from profiteering on their drugs. Having a product being used by the NHS should be their golden accolade not a right, they should be paying for the privilege, and those negotiating on behalf of the hospitals and doctors need to sharpen their wits and force better pricing from their suppliers. Currently we spend £15.5bn on drugs for the NHS so a 10% saving would release £1.5bn.

These two initiatives alone would yield somewhere around £5bn a year for the NHS Ė enough to build and staff the wards we have lost in the last two years Ė that has to be a start.

Lastly, we as a nation need to realise that a free service has to have limitations. In this way if you want to see a specific GP at a specific time it might cost you £5, but to see a qualified and capable GP when you need one would be free.

The reality of what I am proposing might mean a scale of charges similar to those operated by dentists under the NHS, where children and the elderly get free basic care, but others pay a small fee.

However, the type of hospital stays and operations I mentioned before would still be free to everyone in need of one.

I realise that I have overstepped the mark of a man interested in natural therapy, and many might say Iím well out of line, but once again I feel some of this needs saying, and we need an educated and reasoned debate.

I throw myself on your tender mercies!

Yours, as always


Ray



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