U.K.: We must rethink NHS, plead senior doctors

The National Health Service is doomed to fail without radical changes in funding and approach, a group of almost 800 senior doctors says today

Doctors for Reform has written to the three main party leaders urging a fresh look at the NHS, pointing out that Britain has European levels of spending on health but still falls short of European standards. The doctors' letter is backed by an opinion poll showing that two thirds of voters believe that in its present form the NHS will never meet public demand, however much is spent on it. More than half of those questioned do not believe that the extra spending has resulted in real improvements to the NHS.

The initiative by Doctors for Reform comes at a critical moment. After huge spending and patchy improvement, large parts of the NHS are in deficit and laying off staff. Andrew Holdenby, director of Reform, the free-market think-tank that backs Doctors for Reform, said: "Now that the big spending increases are coming to an end, the NHS . . . still doesn't fulfil patients' rising expectations. We want to start a serious debate about where to go."

Since its launch two years ago, Doctors for Reform has grown from 500 doctors to almost 800. They come from all three political parties, disproving government claims that they are simply a stalking-horse for Conservative ideas. Professor Karol Sikora, one of the letter's signatories, a cancer specialist, said: "Doctors are apathetic, politically. Few belong to political parties, but they are getting to the end of their tether. The problem for the future is going to be matching the consumerist demand from patients, especially the young, with the social equity of the NHS. The system we have today is heavy on bureaucracy and poor on delivery. "It is doomed to fail, because with a single monolithic employer it cannot adapt to either technical or societal change. Compared to that, what we see in Europe are far more flexible systems that cost no more and deliver much better care."

Christoph Lees, a consultant in obstetrics and a co-signatory, said: "Centrally dictated targets do produce some results but they distort priorities. Those specialties outside the target areas become Cinderellas - mental health and maternity services are examples. The attempts to save money are undermining clinical relationships in an outrageous way. It's a doctor's obligation to act in the patient's best interests, but often we can no longer do that."

David Wrede, a consultant obstetrician and gynaecologist and a former Liberal Democrat parliamentary candidate, said: "Ministers talk the language of choice, but there is less choice now than there was years ago, when we could refer patients to anywhere we wanted," he said.

Doctors for Reform believes that only by opening up the NHS to different sources of financing will it be liberated, allowing "a modern, truly comprehensive system" to emerge. Andrew Holdenby believed that political leaders were reluctant to tamper with the NHS because they were convinced the public was devoted to it, but the Reform poll, carried out at the end of March by ICM, suggests that this is a myth.

More here

***************************

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?

Comments? Email me here. If there are no recent posts here, the mirror site may be more up to date. My Home Page is here or here.

***************************