Is the NHS still fit for purpose? : BBC


I have just watched The Big Questions – The NHS is it still fit for purpose, in which I was in the audience. This was a debate which was presented by Nicky Campbell from the Manor CE Academy, York.

Many aspects of the NHS were debated, such as, funding from Central Government, should it still be free at point of delivery, privatisation, structure, treatments which should still be provided, end of life care, assisted suicide, etc.

I did respond to the comments made about assisting to end life as this is not straightforward. There are those, due to their conditions who do choose to end their life and there are those that do not. Suicide is not illegal but assisting those to die is (Assisted suicide is prohibited by section 2(1) of the Suicide Act 1961 and voluntary euthanasia is considered murder under UK law.). Many wish a change in the Law to allow, for those that wish it, to end their life with help from another person, which would mean that when this occurs the person helping would not be subject to arrest for providing this help, assuming all the checks and balances created by the Law were adhered to. There are many, especially some with long term disabilities and other life-long health condition who do not wish for this change in the law as they fear their life my be taken when it is against their choice and this choice also needs respecting.

This was just one aspect of the debate there was charging for treatments and visits to the GPs (General Practice Doctors), again an aspect that I disagree with, as we should continue with the original concept of being free from the point of delivery. For just a small charge would be a charge too many and what about the cost of the administration, as was mentioned in the debate. But another reason for this not to occur is, when would this small charge be increased by successive Governments and what about those who could not even afford a small charge.

Here are some of my other views

  • the lack of funding  on Social Care and its impact then on the NHS, which, while not being deprived of funding on the scale of Social Care, the two services run in tandem with each other. Problems with one are bound to affect the other, especially on bed blocking through insufficient access to social care being either home care or residential. The beds are blocked or patients are discharged before a sufficient care package is  effectively put in place and many more. This not only means the patient is not sufficiently supported to carry on with their life, but could mean a re-admission due to the lack of required care. This could cause a safeguarding alert, which could have been easily avoided, with sufficient funding for both the NHS and social care.
  • social care is suffering due to lack of suitable trained staff as is the NHS. None of these services can effectively operate on a ‘shoe-string budget.
  • do the Government have an agenda on the NHS, which their lack of funding of social care is adding to the problem, which could be political to show the status quo is not working and that privatisation could be the answer, hence the requirement for services being required to tender, with the service being allocated to the cheapest bidder, without any sufficient checks being made as to whether the tender is covering all aspects to the specification of the required service. So the privatised services become non-effective and non-efficient, leading to the call for more tendering and creating more privatisation.
  • there is no transparency or accountability, only profit taking from the private sector and it is the population as a whole who suffer both short and long term. Those within the decision process do not care as they have sufficient resources to bypass the NHS and use private health facilities. This creates a growth in private health who then further deplete the staffing resources of the NHS,  Then the cycle goes around again and again and so on.
  • funding is not the only problem, which is a major factor, but the root cause is not being addressed. To me the route cause is too many changes being brought in year on year without thought of the resultant outcomes to improve the facilities
  • also with no accountability and transparency of both the NHS and social care, they can effectively do as they please. The powers that be are always wishing to cover their own backs and therefore whistleblowing is not encouraged and is effectively not at the starting gate. By looking at mistakes and problems, including complaints these should be used as a learning tool to improve for the future.
  • the pay gaps of the frontline to the CEOs and other senior management are too vast and when there is a problem in one authority, the senior staff, if there is any investigation are allowed to resign and then gain similar employment in adjoining  authorities, maybe doing similar roles. Where problems occur there needs to be accountability to stop bad practice being ignored and transferred from one authority to another and then another and so on.

I have a, somewhat, controversial consideration, as we now have a Secretary of Health and Social Care, Jeremy Hunt, whether you agree with his suitability or not, is it not time to have one organisation covering both Health and Social Care. Currently, around the UK, do Health and Social Care really work together and if they do is this sufficient. With one organisation would it not be easier to work as one team for the betterment for all concerned, including the population of the UK. Yes I am well aware that the many areas within the NHS do, now, not work together, but is that down to the various structures, individual management and many other areas. I can well believe that when the frontline personal are involved there is much more team working, if they are allowed to by their respective managements.

In doing this there will be cost savings, especially within senior management as there would be one management structure, instead of the two or possibly more currently in place.

However, funding would still be a major obstacle and each area of the UK would need to expressly calculate their funding requirements and the Government would have to listen

Also I have come across an article from digital health which I have made into a blog post  NHS digital programme to benefit from £760m government funding : digital health, perhaps this is part of the answer to improve what is there.
There is also another article I have come across from Denmark see my blog post Healthcare DENMARK – New inspiring White Paper: Denmark – A Telehealth Nation, could this be a solution
 The NHS is a wonderful concept and should be held as a great asset to the UK, if only the problems could be sorted by persons who care for what they are doing, which in the main is the frontline, whereas the management are only looking after number 1, themselves.

To view the debate Is the NHS still fit for purpose?