BRITISH DOCTORS VOTE WITH THEIR FEET

Hospital consultants are spurning the National Health Service by paying for medical insurance so they can be treated privately if they become ill. A survey of 500 consultants, commissioned by Bupa, the health insurer, found that 41% of senior hospital doctors have invested in private health cover. Doctors are among the 10 occupations most likely to take out personal medical insurance, according to Bupa. More than 90% of the consultants surveyed have posts within the NHS. All of those surveyed also worked in private hospitals.

Dr Sarah Burnett, a consultant radiologist in London who worked in the NHS for 15 years, said she took out private medical insurance while she was employed in the state service because she was unimpressed with the level of care she witnessed first hand. "NHS treatment is not a pleasant experience in any way - from the standard of the food, to ward cleanliness and the chance of catching MRSA," she said. Last year Burnett was diagnosed with breast cancer, detected during a private medical screening. Within two hours of her annual check she underwent an ultrasound examination that showed multiple small tumours. An hour after that Burnett was seen by a surgeon who arranged a skin-sparing mastectomy. A few days later she was recovering from surgery. "I was lucky enough to have exceptionally prompt treatment because I choose to pay for insurance. Under the NHS I would not have been screened until 50 for breast cancer and would not have been able to catch my cancer at such an early stage," said Burnett. "The type of surgery I had is only rarely available on the NHS, depending on the expertise of your local surgeon."

The British Medical Association (BMA) argues that the consultants' wish to take out private medical cover does not demonstrate a lack of commitment to the NHS. They want speedy treatment so they can get back to looking after their NHS patients as soon as possible. Dr Jonathan Fielden, the deputy chairman of the BMA's consultants' committee, said: "Consultants may also like the anonymity of private care. One of the problems of being treated in the NHS is that consultants might find they are in a bed next to one of their patients."

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BRITAIN'S NHS NO GOOD FOR THE ELDERLY

Elderly people are being neglected and poorly treated by England's health system, inspectors say. The joint report by three public sector watchdogs said the NHS and care services treated older people with a lack of dignity and respect. The Audit Commission, Healthcare Commission and Commission for Social Care Inspection said it was being made worse by a lack of consultation. Campaigners said elderly people had become second-class citizens.

The report, which assesses the government's progress half-way through its 10-year plan to improve services for the over 50s, found while some services had improved, progress had been patchy and slow in other areas. David Behan, chief inspector of the Commission for Social Care Inspection, said: "The evidence from this study is that older people are not involved in the design of services and, consequently, services are not tailored to their needs and aspirations. "It is vital to understand and respond to the specific needs of older people." And Anna Walker, chief executive of the Healthcare Commission, said: "Older people are the biggest users of healthcare, occupying almost two thirds of our hospital beds, yet they continue to be a low priority in both the planning and development of our health service."

None of the 10 communities across England, whose public services were scrutinised, had reached all the government-set milestones to enable them to meet the standards in the national service framework. Two areas of concern were the planning of public transport and the low priority given to foot care services.

One of the worst areas, the report found, was mental health care, where older people found services deteriorating as they passed the age of 65. The vast majority of older people surveyed said they had not been asked their views on the NHS or council services in the last year, and 80% did not think they had influenced the planning of services. The report did find that steps had been taken to address age discrimination in public services and more people were being supported to allow them to live at home.

Gordon Lishman, director-general of Age Concern England, said it was "shocking" that so many social services departments were still failing to meet the needs of older people - the main users of these services. He said: "Sadly, too many older people in need of public services are currently treated as second-class citizens." Liberal Democrat health spokesman Steve Webb said: "The needs of older people are not a priority for this government."

But Care Services Minister Liam Byrne insisted that older people's access to care had been "completely transformed" although neglect was still "too big a part of the story". He said plans would be unveiled next month to improve the situation. And Professor Ian Philp, national director for older people's health, added measures had also been taken to tackle discrimination, but there was more work to do to reverse the lack of respect shown to the elderly.

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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. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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