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Independents' Day

I have a dream

Dr Shaba Nabi

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Just three score and 10 years ago, the great Nye Bevan, in whose shadow the NHS stands today, announced the National Health Service Act of 1946. This act was a beacon of light to working people who were too poor to afford health, protecting them from destitution.

But 70 years later, the poor are still sick and needy; 70 years later a life in poverty is crippled by ill health, substance misuse and premature death.

So, we’ve come to our secretary of state to cash a cheque. When Bevan set up the NHS he stated: ‘No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.’

It is obvious today that Jeremy Hunt has defaulted on this obligation to remain a civilised society, as the gap between rich and poor widens.

One day we will live out the true meaning of the NHS – that all are created equal in health

But we refuse to believe the bank of health is bankrupt. We refuse to believe there are insufficient funds in the great vaults of global capitalism. We have come to cash this cheque and claim what is rightfully ours through taxes.

We must come together as a nation to remind the state of the fierce urgency of Now. Now is the time to rise from the dark and desolate valley of privatisation to the sunlit path of nationalisation.

It will be fatal for GPs to overlook the urgency of the moment. The year 2018 cannot be the end – it must be the beginning.

There are those who ask the devotees of the NHS: ‘When will you be satisfied?’

We can never be satisfied until we end the 10-year mortality gap between rich and poor. We cannot be satisfied until all those with mental health issues are seen in a timely way. We are not satisfied until our elders are treated with the dignity and respect they deserve.

I say to you today, even though we face these difficulties, I still have a dream. It is a dream deeply rooted in the great British dream.

I have a dream that one day this nation will rise up and live out the true meaning of the NHS – that all men and women are created equal in health.

I have a dream that one day there will be enough GPs to provide holistic care within 20-minute appointments, to foster personal responsibility in patients.

I have a dream that GPs will be supported by a team of healthcare professionals who work autonomously and carry risk.

I have a dream that vexatious complaints and litigation will be replaced by a no-fault compensation scheme, and doctors will no longer face manslaughter charges.

And if Britain is to be a great nation, this must become true. So let good health ring from the peaks of the Scottish Highlands. Let good health ring from the valleys of Wales. Let good health ring from the rugged coast of Northern Ireland. And let good health ring from each and every muddy field of England.

When this happens and we allow good health to prevail, all doctors, healthcare professionals and patients, rich and poor, can stand together and state: ‘We are equal. We are equal at last.’

Inspired by Martin Luther King’s ‘I have a Dream’ speech

Dr Shaba Nabi is a GP trainer in Bristol


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Readers' comments (14)

  • "We must come together as a nation to remind the state of the fierce urgency of Now. Now is the time to rise from the dark and desolate valley of privatisation to the sunlit path of nationalisation.
    ... 2018 cannot be the end – it must be the beginning."

    Good stuff!

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  • Peter Swinyard

    The reality is that the NHS has replaced religion in the UK for many and become sacrosanct politically. Elections are won and lost on it.
    The N?HS was founded on the false premise that, once the load of untreated illness was dealt with, that the NHS could bumble along just treating new presentations.
    Since then, medical technology has revolutionised care, both pharmacological and surgical. People who would have died of strokes, heart attacks, cancers, TB, have many more years of productive life ahead of them, which is a truly wonderful outcome. Then they inconsiderately live much longer and get multiple morbidities and require a lot of medical and social care.
    There needs to be a new honesty about what the NHS is for.
    What can you reasonably expect from the NHS?
    Piecemeal local rationing, mostly by making GPs' lives harder in the convoluted fund-applications for referrals and the introduction of Referral Avoidance Centres risks deprofessionalising doctors and damaging morale. Stupid rules which prevent those willing and able to co-pay from doing so cost the system in time and money.
    Unless there is a cross-party political will to change, and to be honest with the tax payer about what their tax pound can fund, the NHS is doomed to a terminal decline as a poor-law sickness service by the back door.
    Time definitely for a Royal Commission for the politicians to hide behind. With a very short reporting time framework and the obligation to come up with cost-manageable proposals.

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  • I have a get out of the NHS as soon as I can and be a true professional rather than a worker without employee rights once again, without all the "guidance" and restrictions.

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  • I completely agree with Dr Swinyard. The principles of the NHS that it meet the needs of everyone, that it be free at the point of delivery
    and that it be based on clinical need, not ability to pay were idealistic at the time in 1948 and the politicians were worried then. Expectations of the NHS are unrealistic, and it is about time that it was no longer used as a political football. In addition we should make a distinction between want and need. In no other section of society can we always have what we want. We are victims of our own success. People also need to understand that with rights go responsibilities. Should the tax payer fund self inflicted lifestyle consequences? or at least not without some kind of change? There are many difficult and unpalatable questions which we dodge. In a National Health Service the decisions should be the same everywhere. We all know that the NHS is inefficient - appointments are missed without any consequence (often because the appt has never reached the the patient) and that huge amounts of money are wasted. Politicians can't just pour money into it. So much needs fixing. As far as GP is concerned I still believe that continuity is the jewel in the crown

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