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The waiting game

Mr Hunt, may your actions speak as loudly as your noble NHS tweets

Dr Kailash Chand

Dr Kailash Chand

Health workers, doctors, nurses, activists and unions all marched with a unified voice in central London on Saturday to protest against government policies that are dismantling the NHS and failing to act to ease the winter crisis.

Meanwhile Donald Trump, who is fighting with democrats to repeal ‘Obamacare’ tweeted: ‘The Democrats are pushing for Universal HealthCare while thousands of people are marching in the UK because their NHS is going broke and not working. Dems want to greatly raise taxes for really bad and non-personal medical care. No thanks!’

Health secretary Jeremy Hunt responded via Twitter by saying that while he disagreed with the opinions of some of Saturday’s marchers, ‘not ONE of them wants to live in a system where 28m people have no cover’.

Labour leader Jeremy Corbyn also denounced Trump’s view: ‘Wrong. People were marching because we love our NHS and hate what the Tories are doing to it. Healthcare is a human right.’

Even under huge pressure, the NHS remains the best, safest and most affordable healthcare system out of 11 countries ranked by experts 

Even when NHS funding is being squeezed by this government and both GP (primary care) and hospital services are coming under huge pressure under Jeremy Hunt’s tenure as secretary of state for health, the NHS remains the best, safest and most affordable healthcare system out of 11 countries analysed and ranked by experts from the influential Commonwealth Fund health think-tank.

The UK came first in four of the 11 categories. It was judged to deliver the safest care, be the best at ‘care processes’, provide the most affordable care and offer the most equity.

For all its problems – an overstretched workforce, increasing waiting times, bureaucracy, poor IT – the health service remains a national treasure. Every day it changes people’s lives. In one day, 1,300 people will die, 2,000 will be born and 1.5 million will be treated by the NHS.

It is worth looking at a comparison of healthcare systems in the UK, and USA. The US (whose healthcare system we risk emulating) has the shortest life expectancy despite spending 17.2% of its GDP on healthcare. The US ranked last on performance overall, and ranked last or near last on access, administrative efficiency, equity, and health care outcomes domains.

Despite putting the most money into health, America denies care to many patients in need because they do not have health insurance; it is also the poorest at saving the lives of people who fall ill.

One reason for this in my view is that only 12.3% of US doctors are GPs. Compare this to the UK, where GPs make up 20% of the NHS physician workforce and provide 90% of the care, enabling it to provide some of the best outcomes while coming out most cost-effective.

But a combination of rising patient demand, staff shortages and falling funding is undermining the very foundations of the NHS, as is constant short-term interference from politicians of all colours.

Ongoing ideological disruption of the world’s most cost efficient health service increases healthcare costs. Administrative costs now account for nearly a quarter of NHS spending. Some of that spending needs to be clawed back and spent on the frontline, particularly, primary care.

Mr Hunt, if you mean what you said in your tweet, an urgent priority now is to support and strengthen GPs and restore primary care funding to at least 11% . Remember, primary care is the backbone of the NHS.

Dr Kailash Chand is a retired GP from Tameside and is honorary vice-president of the BMA






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Readers' comments (5)

  • Council of Despair

    BMA part of the problem not the solution

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  • Vinci Ho

    Well, there are some lateral thinking 🤔for our representatives about this ‘review’:
    (1) Saying that the health secretary’s party is in tatters , is an understatement. The gulf ,created by the split of opinions on Brexit within the Tory party , is deepening. The three hard Brexiteers (not Musketeers), Reese-Mogg/Johnson/Gove axis, are posing clear and present danger to Auntie May’s iron throne.
    As quoted from Andrew Turnbull , their accusations on civil servants of sabotaging Britain’s exit from the EU were adopting dangerous tactics similar to those of rightwing German nationalists between the two world wars.
    The soft Brexit supporters including our beloved Sara Wollaston are branded ‘mutineers’ . This is simply a bloody and egregious civil war . And there is absolutely no analogy to Darkest Hour and Dunkirk where a new rising imperial power called Third Reich was threatening to invade our country. What happens right now with Brexit is self inflicted by the Tories. It is insulting to Churchill comparing him with Auntie May.
    (2) Under such extraordinary political circumstances, we have a health and social care secretary , longest serving historically, carries an equally record-breaking vote of no confidence (220,000 and more votes). The NHS and its gatekeeper is widely publicised as on the verge of destruction. The ideology of relying on private companies to support public sectors was entirely humiliated by the downfall of Carillion bearing in mind ,Capita is also now declaring profit warning to the market . Then you had the most mouthful US President in history wrote on his beloved Twitter account about the state of NHS. Well , a duplicitous health secretary got bullied by a even more duplicitous and despicable president. Of course , Agent Hunt had to defend , not really for NHS , but for his sad , miserable party .
    (3) Then it is all about knowing your enemy well when we come to negotiations. There is no absolute friend or foe and every action carries a motive or intention in politics. Our health secretary appears to have an urge to reinvigorate his party(not really GP partnership)and the authority of his prime minister (never exclude his own ambition to become the next PM!), in face of the threat of the Three Brexiteers axis. He needs ‘allies’ desperately. His rapid reaction(with careful calculations) in Dr HBG’s case is very much telling. Now , we have a review to reinvigorate GP partnership , even in small practices. Good or too good to be true?
    (4) Truth is the devil needs us more than we need him . Drawing more blood against us is politically suicidal . One day of politics is too long .It was then and this is now . Those representing us must have learnt by now a political issue needs a political solution and do not ask the question before you already know the answer . I see this weird situation as an opportunity. We need to stick to our gun getting what we want desperately but might have to give ‘something’ back .Politics is dirty and dark but inevitable right now.
    (5) And if Lenin was right ;There are no morals in politics; there is only expedience. A scoundrel may be of use to us just because he is a scoundrel.
    Agent Hunt is a ‘good’ scoundrel , perhaps.

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  • Couple of points:

    - despite Chand's assertion that NHS spend has fallen, spending is increasing. Total health spending in England is nearly £124 billion in 2017/18 and is expected to rise to over £127 billion by 2020/21, taking inflation into account
    - despite all the evident problems with US healthcare, your chances of surviving cancer are dramatically better in the US than the UK; and better in most of the OECD than the UK.

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  • Council of Despair

    unfortunately the priority of the BMA and Royal Colleges is the survival of the NHS - if that means we are all sacrificed then so be it. The priority of the GMC, CQC, NHSE, DOH, HEE is to support government policy and keep the electorate happy. We do not have any support at all. The BMA and Royal Colleges are not going to declare that the NHS is currently unsafe as they are worried how it will play out politically. In the interim how many doctors are going to be sacrificed to prop up a failing system. And let's be clear it is failing as it can not cope with the demands it has been tasked to do. That means either cut demand or increase resources.

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  • Far be it from me to disagree with Khailash's Dear Leader,but having worked in Primary Care in an inner city part of upstate New York, I can reassure him that all US citizens can get access to healthcare.It may not necessarily be of the same standard, but one can point to the same disparities in our own country.Furthermore, when, as a GP CCG member we were looking for improvements, one of the first places for examples was the US.For instance, no problems with bed blocking when the actual cost of inpatient stay was clear.
    But, hey, lets not allow facts to get in the way of a good rant.

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