Thursday, August 16, 2007

The Great British Public

… and what they think of NHS “reforms” under the Labour government of our now departed Prime Minister Tony Blair.

Recently the British Medical Association (basically the Doctors’ Union, although it has not been very effective representing trainee doctors during the recent training debacle and who have formed their own organisation RemedyUK) conducted a survey of the public’s reaction to NHS reform.

To summarise, the results reveal that the public still want a basically free national and “socialised” health service paid for out of taxes and national insurance payments.

Let us go into some detail ...

Question 1 (the most crucial): “The NHS should continue to be funded from UK taxes and free at point of use?

Answer: 93% agree

Question 2:The NHS should continue to be funded from UK taxes but, as resources are limited, it should be mostly free at the point of use and a small charge should be made for some services?

Answer: 53% agree.

And BMA policy does not agree with this stating it should be 100 % free. And I know some NHS doctors believe some services should be paid for (albeit with caveats).

So I went to talk to my workplace Cuban doctor about this. Remember that Cuba has one of the best-trained medical services in the world and, quite obviously, well-equipped, in the world. He estimated that a typical general hospital would have 10-15 basic blood analysis machines giving the range of results necessary for a standard assay as Kezia receives. Here, with a national population of 150,000 we have four machines. The cost of the machines is c. USD 15000, £7500, the running costs are minimal. The machine will be replaced every 3-5 years. Lab tech labour costs have to be added as well. He reckoned that if 800 in- and out-patients per month required a standard blood test once a month and were charged for it at a rate of £10 or USD 20, the tests would soon pay for themselves.

So, at a price of £10 a test, the cost of Kezia’s weekly blood test would be £520 a year. We could afford that.

Interpreting services, transportation services etc we certainly could not afford. It is a £50 round-trip taxi fare to the hospital, 14 miles away. So this year, with just one visit per week, that is £2600. When I get back to see them, I arrive in Manchester at 05:00 on a Sunday morning and wait 2 hours in the freezing cold to travel “home” because we cannot afford the £25 taxi charge … and anyway I wouldn’t want to wake them up before 6 on a Sunday morning.

The unemployed, the low incomes etc would need state support for even nominal charges.

Fortunately, for the PCT, Nanda has done away with interpreting services as I don’t imagine they come cheaper than £50 per hour .

The cost of her entire treatment, no. I have vague ideas from conversations with our consultant and our social worker, this will cost £100,000 (USD 200,000) or more.

Interestingly, here in our African country, there are nominal, subsidised charges for basic tests, X-rays etc. The International Dispensary Association Foundation provides the country with many low-cost medicines and medical supplies.

I earn, with a severely depreciating exchange rate, £27,000 per year.

Onwards … I am not going to discuss each questionnaire question in the whole document … read it for yourselves

82% agree that local doctors should have a major say in how NHS money is spent locally.

75% believe that all areas of the country must provide the same set of nationally agreed NHS treatments …

I mention this one because of this BBC report of the ludicrous on Friday whereby neurological patients in north Wales can, currently zap along the motorway for an hour for treatment in Liverpool (England) but it is proposed that they should face a 400 mile trip on A roads to go to Cardiff/Swansea in south Wales … who is going to be happy? The taxi drivers!

The next two sections and five questions broadly concern the role of the private sector. The answers are more ambivalent, but on the whole the majority of the population do not want more private involvement. My take on the BMA’s and the public’s position is that they want the privatisation of medical services to be halted right now, it has gone far enough, whilst Tony Blair and the bitch (whoops Patricia Hewitt) wanted it taken further. We have yet to see how Gordon Brown and Alan Johnson will come out on this one.

To conclude, the BMA survey asks the public whether the Blair Labour government has improved our “socialised” healthcare system. 42% disagree, 34% agree and 24% don’t know..My reactions to this survey ,,,

1) Why is MRSA increasing in hospitals … because cleaning staff are private contractors who employ lowly-paid Philippinos who are overworked by the cheapest private contractor who imports them?

2) Why do we have presumably low-paid agency African nurses doing duty on nights because we don’t train enough UK nurses and because we don’t pay them enough.

3) Why doesn’t the UK pay its NHS nurses more to retain more so that we don’t need agency nurses, and at the same time give more DFID (Department for International Development) aid to pay the African nurses more to stay in their countries and avoid the “brain-drain” out from the developing world to the developed world so widely criticised.

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