The NHS: In Crisis

Whoever investigates the NHS, the outcome is always the same. It is underfunded, understaffed and facing increasing demand. Backlogs and failures are now too numerous attract headlines. Yet as responses to emergencies reveal, it is world class in its skills, dedication and outcomes.

The money issue is solvable. It is a mathematical impossibility to run an infinite service on a finite budget. The solution is to allow the NHS to automatically receive more money the more patients its sees, by operating an insurance based service with the Government the only insurance provider. To do this you reduce income tax and introduce an NHS premium. Everybody pays, subject to normal exemption for low incomes and vulnerability.

The premium relates to income level so the rich pay more. Private insurers cannot be allowed to bid, because a requirement is that everybody is fully covered irrespective of their health or existing conditions and no surcharges are levied. One insurer covers both the sick and the healthy and so has an underwriting profile the same as the national statistics. More than one, and they start to exclude the sick and cover the healthy to boost profits and you end up with US style chaos.

Having organised and income stream, you then have to organise the service. There are about 27 quangos presently engaged in managing the health service and innumerable trusts and boards mixed up with running it. They must all be abolished. A Ministry of Health must be re-established with the minister’s head on the block and a razor sharp axe nearby. They are responsible for every aspect of the NHS, which is run directly by the ministry through Regional, District and Community managers. Doctors treat patients.

Next hospitals run 24/7 on three 8 hour shifts, with no excessive hours for staff and no waiting lists of any kind. You feel unwell, you see your GP today, the consultant tomorrow, you are operated on in the night and you are home for the weekend. It looks more expensive but the true saving across the economy is enormous. Vast armies of bureaucrats collating lists, statistics and car park charges, can retrain as health professionals, making a difference to the needy and and gaining fulfillment  in their lives.

Finally GP’s go back to their main function of diagnosis and co-ordination of their patient’s timely and effective care. They give up on pills which are left to pharmacists. We focus on the causes of illness and disease and find the cure. Drugs are not a cure, they just manage symptoms. That is important but it is a short term help, not a long term answer. For example to lead a life low on exercise and healthy eating and high on junk food, booze and TV, whilst protected from disaster by statins provided at public expense, is a fools game to be brought to an end.

Think about it. The more you do the better it gets.