How can we fix our NHS?
By Dark PolitricksWith the recent sad story of a World War II hero having to sell his medals to pay for his care in his old age I thought I would write about my own experience with the NHS.
Whilst I have found it to be excellent when you are wheeled in unconscious from an ambulance into accident and emergency, if you have a long term health issue or require non emergency treatment I have found it to be slow, unresponsive and at times down right ridiculous.
Labour tried and failed to introduce a multi-billion pound national health database to be used by all hospitals and doctors surgeries that was then scrapped due to technical and userbility failures amongst various other issues.
As a computer programmer myself I know how easy it could have been to write a system that would be secure, allow enough flexibility for doctors to add new information as well as give patients access to their own health records.
I cannot see why an Internet based system could not be created that had a secure log on for doctors and different levels of security to stop the GP secretary from reading your personal health history. All whilst allowing a doctor at the hospital to add notes and upload scans and files one minute and for them to be instantly accessible by your GP the next.
There is nothing more ridiculous in my eyes than having a scan in the ultra sound department at the hospital then being given a scanned copy of the files and told to walk 50 metres down the hall to another department and hand them over to another doctor. All the while computers sit on top of desks. Does every department within a hospital have it's own IT system? It seems that way and if so why?
If you know me, you will know I have had serious health problems over the last few years and it has certainly been an eye opener for me in how the NHS works.
I have to see multiple doctors all at different locations. From my GP at my local surgery, to consultants at the pain management clinic and the hospital and counselors at other locations.
If one of these doctors recommend a course of treatment or a new drug or examination I have to literally wait weeks whilst the doctor in question writes down the details or dictates into a microphone recorder the details which are then copied to paper. The details are then sent in the post - sometimes only hundreds of metres up the road (I kid you not, one place I visit is less than 200 metres from the hospital!) before arriving at my GP's surgery where it sits until a receptionist opens it and transcribes it into their own local computer system.
If I make an appointment for a month from the initial visit I "might" be lucky enough for the details to appear on my doctors own computer system when I finally get an appointment with her and if not I have to wait another week until they do get transcribed and copied onto their own computer system.
It has got to the stage where I frequently demand that they copy the letter out there and then and I take a physical copy by hand to the other doctor in question rather than wait so long.
On one occasion one doctor wanted to prescribe me a stong pain killer for my pain and I took a hand written copy straight to my GP where she read it and prescribed the drug straight away. If I had left it to the normal method I would have had to wait weeks at the very least.
Apparently email is out of the question due to the legal implications of opening the Royal Mail opposed to intercepting electronic communications. The sentence for the crime of opening the Queens mail is seemingly stronger and that is why they use the post and not email! A basic website as I previously mentioned would do the job - I would even write it for them if they wanted and I wouldn't charge £20 billion for doing so!
Now I respect the NHS, unlike the USA we don't let the poor die due to lack of insurance and we don't expect to pay before we are treated.
We also are not faced with huge crowds of people using the local accident and emergency room as a doctors for minor ailments due to laws that state they cannot turn a patient away. We also don't have to take out huge loans or pay massive chunks of our salary towards health insurance that may OR may not cover you for your current problem.
I'm pretty young, yet I already have a pre-existing condition. That would mean I would have to pay lots to get insured and if I didn't work I don't know what I would do. In fact I would probably already be dead if I couldn't get cheap insurance to cover me.
There have been times I have been jobless and broke. I have also had to go to hospital. How I would have paid for insurance or a large hospital bill I have no idea!
It seems the NHS is screwed.
They have separate procurement services - why don't they bulk buy as a national company and get everything cheaply?
Gordon Brown's PPI may have built lots of nice new hospitals but it has also loaded them up (and the country) up with debt and forced hospitals to use private companies for minor maintenance whereas having a full time odd job man on the pay roll would have been much cheaper in the long run. Instead they have to hire specific companies and pay stupid inflated amounts of money just to change light bulbs - £70 is the figure I have heard.
Our policy of adhering to the hippocratic oath is admirable but it also means we have become a target for health tourists who come halfway across the world to claim expensive medical care paid for by my tax money.
Whilst I lie here in severe pain, waiting months for my next appointment to come through the post someone from another country who hasn't paid tax or even worked towards funding the NHS is taking up resources that should be dedicated to the people who pay for it i.e. you and me.
Our parents and grand parents fought two World Wars to get our social safety net that includes a pension, dole money and a health service. We are supposed to pay for it out of our National Insurance contributions but instead the money has been diverted over the years to fund military campaigns and other huge wastes of tax payers money.
Our National Insurance cards should have to be displayed before any social security and health services are delivered. It doesn't mean we are loaded and have paid in more than a certain amount but it does mean we are a tax paying resident citizen of the UK and entitled through our own and our parents contributions to be put ahead of those who are costing the service billions due to over crowding and health tourism.
Stop paying to have NHS and Social Security leaflets printed up in 20+ languages and for interpreters to be present at the cost of cancer medication to a 90 year old UK citizen.
If we are having doctors making life or death decisions due to cost restrictions then UK nationality should be at the top of the list far above factors such as whether you smoke (and pay billions into the NHS), drink (and do the same) or are obese or unfit.
These are all factors which should be combated before a person gets ill from them and pre-emptive health care is always better than fixing a puncture once your lung or heart goes "pop" anyway. Start young, start at school, stop the kids getting fat and ill in the first place by teaching them how to cook healthy tasty food instead of letting them just go down the chippy at lunch.
The same goes for an "integrated" social care policy. Currently because of the lack of any foresight or planning our hospital beds are merry go rounds for OAP's who are sent home before they are ready and then end up back in hospital within the week. Either that of the lack of proper social care in a home means they stay in hospital beds longer than they should be and deny them from people who require them.
The actual implementation of an integrated travel system, where airports, major train stations and roads are all linked instead of being miles apart would help grow our economy and bring people and wealth to all parts of our country. An integrated health and social care system would prevent the mis-use of hospital resources and stop them being used as replacements for proper social care. The same goes for using prisons as storage facilities for the mentally ill, the homeless and the addicted.
Labours and now the Tories ideas of introducing "internal markets" within the health service is just another foolish way to introduce "privatisation" into something that is owned by the people. It is another area where capitalism is not going to work to drive down costs and deliver better services.
Just like trains that cannot physically run on the same tracks and makes a mockery of true competition on the railways where prices rise every single year. A true market cannot be created in our health system due to the nature of the beast. Are you going to ask the ambulance to go to the nearest hospital when you're having a heart attack or stroke or are you going to risk travelling an extra 20 miles just because another hospital has a better survival rate?
Should we turn our hospitals into shops bidding for our business and send bills out for treatment, putting people into debt to pay for them. Or should we try to cut waste, combine resources and limit the users of our service to those who deserve it, saving money and using it more wisely by reducing managers and back office staff many of who's jobs can be automated.
The number of receptionists at various hospital departments that could be automated with touch screen computers that tell the relevant doctor or consultant you have arrived probably runs into the thousands.
The amount of time and money that is wasted by transcribing notes so that they can be posted when they could be spoken directly into a computer system using speech to text technology probably runs into more than a few thousand per month.
And the cost in stamps or pre-paid postage that could be saved by having a simple website that allows all doctors concerned with your case to see your notes, upload digital screenshots of scans and write comments for other doctors to see probably runs into the millions.
Just by limiting the resources of our precious health service to those who actually deserve it and who own a national insurance card would save millions again. We cannot afford to be the preferred free health care destination for the world.
For those people who don't like the idea of turning away illegal immigrants then private charities and religious organisations can combine their resources to pay for their own hospitals that are open to those who are not national insurance contributers.
There are so many things that could be done to cut waste and automate procedures it wouldn't be hard apart from unions kicking off when jobs are lost due to the cut backs.
However I am tired of waiting 3 months just to get an appointment for a pain removal injection and then wait another month until the actual operation.
I am tired of having to convince one doctor to give me a copy of their letter to me so I can personally deliver it to another doctor so I don't have to wait a month to get my presecription.
I am fed up of having X-Rays that show something wrong with me but because my GP is on holiday and the locum doesn't know me I am being told to just wait until she comes back whilst kidney stones are causing me imense pain.
I am pissed off at having to spend an hour in the morning trying to get through to my local GP surgery to find that all the appointment slots for the day have gone and that I cannot book an appointment with my GP until next week.
I am seriously fucked off that I am paying for someone who has never worked a day in their life or who has no right to the NHS to enjoy better health care whilst I have to suffer in pain and still go to work to pay for the National Insurance that pays for their treatment.
Our system is certainly not perfect and when compared to the USA I would pick the NHS any day of the week. However we need to sort out the whole system so that it survives into the future and we don't end up turning to a private insurance based system as some kind of fix.
When 90 year old War hero's are having to sell off their medals then something is seriously wrong with our social care system and we need to fix it fast before Cameron and Co chose another war over looking after their citizens health.
View the original article "What is happening to our NHS" at Dark Poltricks.