Worse than I thought

In the last message posted, - on the NHS, I little dreamt, that within hours the position might appear even worse.

Today, the BBC reports the thoughts of Gill Morgan, the "NHS Confederation Boss", who said she thought that the NHS, while having the same set of values throughout, now has a complete split in philosophy" among the four constituent parts - in England a principle of choice being driven, using outside organisations, in the name of improving service, in Scotland a more "collectivist model", in Northern Ireland more integration between health and social care, and in Wales closer contact between the NHS and local government. All this is because Health and education are the most important devolved powers. Ms. Morgan expects the differences to become greater with time.
The conclusion seems to be that there is no National Health service, but four varieties.

Also this morning, The Daily Telegraph reports some thinking of the Government to save billions of pounds from the budget of the (four?) health services. In some there is perhaps some sense, but there is also great danger. "..instead of going to hospital or consulting a doctor, patients will be encouraged to carry out 'self care', ... to meet Treasury targets to curb spending"

Among other things being considered are

Sufferers from arthritis, asthma and even heart failure will be urged to treat themselves.

Patients will be encouraged to monitor their own heart activity, blood pressure and lung, capacity, using equipment installed in their home.

Medical information to doctors could be by remote means - telephone or computer.

Patients could administer their own drugs to manage pain, and assess the significance of any changes in their condition.

Using relaxation techniques could relieve stress and thus avoid "panic" visits to emergency wards.

This is obviously early "Blue Sky Thinking" (see an earlier message), and good sense will lead them to see that the world is much more complicated, and patients are very different and with many who would be unable to cope with the "Brave New World".

There are problems, with patients abusing the system by not turning up for appointments, fetching a doctor out at night for nothing, and asking for prescriptions for items which they should buy over the counter. These may be difficult to solve, but making doctors even more remote and inaccessible than they are now certainly will not deal with much of this. And there is waste on a truly great scale.

When I was young, you could see your doctor either morning or evening. He would call to see you if you were not able to visit him, and if you were very ill the consultant would visit you in your home. We are a much wealthier country now, especially during the last 10 years according to Government spin. Why are we to be denied to face to face contact with our doctor, valuable even more if he has a good "bedside manner".

When was it "Nulabour" claimed that they should be elected , and that there were just 24 hours to save the NHS? All this is a terrible indictment of their stewardship.