EVEN GP AND DENTIST ACCESS IS DUBIOUS IN BRITAIN

A quarter of people are not able to see their GP within two days, contrary to Government claims that the target is met in almost all cases, according to the annual review of the NHS. The State of Healthcare 2005 reveals that though many improvements have been made in health provision, a group of "Cinderella services" is being badly neglected, including dentistry, sexual health and parts of primary care.

The review, carried out by the Healthcare Commission, concludes that the NHS still has a long way to go to achieve a "patient-led" service, a key ambition of the Goverment. While praising the progress made in the treatment of conditions such as cancer and heart disease, the health inspectorate found some areas of the NHS to be severely wanting. In its analysis of primary care, the commission found that access to a GP remained a problem for many people, with around 25 per cent waiting more than 48 hours for an appointment. Ministers have claimed that the problem affects fewer than 2 per cent of surgeries. In London, demand for services is such that four out of five GPs are unable to take on new patients.

The review, which was presented to Parliament yesterday, offers further evidence of the well-documented pressures on NHS dentistry. It said that nearly 60 per cent of NHS dental practices were not taking on new patients - an increase from 40 per cent in 2001 - and in some areas no dentists are taking on new NHS patients.

Poor communication between doctors and patients was identified as another problem, with people left in the dark about the type of medications they were prescribed, their treatment options and the specifics of their conditions. The commission said it was particularly worrying that more than a third of patients were not given information on the side-effects of medicines.

One in seven patients also took issue with surgery receptionists' manner, while up to a quarter of patients in some trusts reported that the staff talked about them "as if they weren't there".

The commission also highlighted poor standards in maternity care, which were documented in its recent report into services at Northwick Park, in north London. Staff were found to be overstretched, working in cramped conditions with inadequate equipment. Poor management was identified as more at fault than lack of money.

The report also reveals the long waits for sexual health services, with 28 per cent of people needing to be seen urgently having to wait more than 48 hours, and 29 per cent of people with symptoms waiting more than two weeks.

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Taxachusetts goes wild: "At a time when other states are kicking people off Medicaid to save money, Massachusetts is headed in the opposite direction. Over the past year, the state has added 50,000 people to its Medicaid program, which provides health insurance for the poor. Enrollment reached 985,000 this spring, and in the coming months, it could top 1 million, an all-time high, according to state officials. There is no single explanation for the surge, say those who follow Medicaid's fortunes, but the most critical one may be a change in the political climate. Governor Mitt Romney has promised to provide health insurance to everyone in Massachusetts, and his administration has concluded that signing more people up for Medicaid is one way to accomplish that goal. ''I'm not a giant fan of the governor's, but I will give him credit for putting his money where his mouth is,' said John E. McDonough, executive director of Health Care For All, an advocacy group based in Boston. Romney insists putting more people on Medicaid is affordable. 'When everyone is insured, care will be better and costs will be lower,' said Romney in a telephone interview."

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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