What you are talking about is the same model as the railways. A national network carved into regions and then run by private contractors for profit. I have always, always been against the privatisation of the railways because it was a public service and profit should not be a consideration. The NHS definitely falls into the same category, it should never be put in private hands, profit should not be part of the financial equation at all, it is a national asset to be cherished, not a financial liability.
The problem is that right now and indeed for some time, the NHS has been seen as nothing but a liability. So the question is why is the NHS is such a state when it has such a huge budget allocation each year, why are we getting less and less and it is costing more and more?
I can't begin to address all the issues that are perhaps dragging the NHS down in a single post so instead I thought I would do a list of things that maybe need to be looked at as part of a hypothetical restructuring to transform the NHS from what it is into what perhaps it should be (as I started the list below I could see how this becomes tricky to separate into essential and non-essential and it became clear why the NHS is now so bloated, it is because they don't know how to or won't say "No" to people). Below that I have also shared some of my own experiences, purely anecdotal but probably some common themes in there. But first the provision of the services below maybe needs to be reviewed:
- Fertility Issues and IVF: In an already over populated country do we need to offer assistance to people who cannot have children as a service on the NHS? IVF is available privately so why do the NHS do it? If you can't afford IVF then you probably shouldn't be thinking of starting a family.
- Sexual Reassignment and Gender Disphoria: Both of these fall into the category of mental illness so perhaps the mental health services side of the NHS should still be involved but definitely no surgical procedures because this is not life saving, the patients are not physically ill, the surgery is elective, let them pay for it.
- Plastic Surgery: Tricky one here but if you have been burned in an accident I think that is something that the NHS should be involved with but not elective cosmetic surgery i.e. boob jobs.... but then women who have had a mastectomy should get reconstruction on the NHS so it depends on the circumstances. Same with nose jobs, it should depend on why.
- Health Tourism: There is no eligibility check at A&E, Anybody can just turn up and get treated. The NHS staff (and I do sympathise with this) do not want to be in the business of turning people away because they cannot pay. However, people who get treated who are not eligible are essentially stealing and we are paying and there will be less money in the pot for when you or I need to call on the NHS. Some will argue that Health Tourism is but a small fraction of the overall budget, I won't dispute that but it all adds up if it is part of a general purge of avoidable costs.
- Obesity: I don't know about you lot but food bills is one of the major weekly outlays from my budget. Food is expensive, junk food is convenient but hardly cheap. Most fat people have paid a good amount of cash to achieve their bulk and so they should now utilise that money to get slim again. I know obesity causes all sorts of health problems that subsequently costs the NHS billions i.e. special lifting equipment and staff training, diabetes, cancer, joint problems, stomach surgeries such as gastric bands, dealing with surplus flesh after dieting (more plastic surgery).
- Please feel free to add more burdens to the NHS that perhaps should be reined in a bit or even curtailed altogether.
Then of course there are the inefficiencies of the NHS, the sitting there wondering to yourself "what the hell are they doing?"
I have sadly experienced the elderly/ageing parents NHS merry-go-round that I think most of us will have to go through at some point. This isn't about elderly care and social care as such but simply to point out that having been through that cycle with Mum and Dad I have spent a fair share of my time in NHS waiting rooms observing the day-to-day operations of a hospital and despite what was about a decade of increasingly frequent hospital visits with my parents, including periods of time when they were in hospital for months at a time, I remain mystified and amazed at how anything gets done at all given the appalling lack of organisation, supervision and direction that seems to be the norm for an NHS Hospital.
I'm sure I am not alone at having sat in a packed waiting room where not one person is called for 30 minutes or more and the nurses station has 4/5 nurses and doctors all sat with their heads down at a computer, what they hell are they doing? and why aren't the queues moving? This is particularly true in A&E and I have been in there too many times, where all the bays are full, the nurses station is packed with staff all at computers and absolutely nobody is being dealt with. It seems to me that the focus on record keeping and paperwork is incorrect and patients are secondary to the process. There was one time when my Mum had a fall and needed an x-ray, after waiting 2 hours for a porter to take her to x-ray I did it myself, I picked up her notes and found a chair and wheeled her through, then I had to lift her and put her on the table for the x-ray and lift her off and take her back because the radiographer said it wasn't his job.
With Dad, he amassed a large medical file in his "Hospital Patient Career" and these were diligently transported with him around the departments. His records were about (and I am not exaggerating) 12" think or the equivalent of about 5 reams of paper or 2500 sheets if you like. It was bloody huge and heavy and it went everywhere with him. Dad remained pin sharp right to the end and he was always amused about his medical records and he told me that he never saw one doctor actually read them, not once. He said that every time he saw a doctor and is was rare that he saw the same doctor twice unless he was on a long stay, they would always ask him directly about his ailments and never read the notes. They would then diligently add their own records to the collection which were then duly ignored by whoever followed. The inefficiency is mind blowing, you simply couldn't run a business like this and as far as I can see there is no need for the NHS (which is not a business) to run like this either.
In summary I think that there is a lot of efficiency to be squeezed out of the NHS that we have already, the management, supervision and direction seem to be "off" and beyond that there are treatments and fields of medicine and existing established practices that maybe should have a place only in the private sector.
Some great points, and although your example of the railways proves your point, telecommunications proves mine. The difference being is that the railways were rubbish before privatisation and are still rubbish now, whereas the telecommunications industry is a 100 times better.
Your right on so many points about the NHS, and that's why it angers me people stand outside on a Thursday night applauding something that is crap. I am glad you brought up IVF. Yes, 67m people and the tax payer is spending money helping people produce more sprogs, that's just bonkers. Sexual realignment for nutcases who want to be another sex. Health tourism encouraged by the fact we have a "treat first ask for money afterwards policy" . Your also right in the fact you can go into any hospital in the country and witness nurses standing around the nurse station discussing what they did at the weekend, and how how underpaid they are. Strangely enough this is less common in a private hospital, and have witnessed this many times. Again, this is NOT about under funding, it's about how the money and resources are used. Opposition parties and Jo Public are looking for a quick fix, and they think more money will achieve this, well sorry guys, it won't !!