NHS Reform Problem

In the previous article on this blog (refer Categories/Chairman?s Blog/Constitutional Reform in the right-hand index column), we quoted the point made by Bill Emmott , writing in The Times, that before proposing a solution first define the problem that must be solved. The reform of the NHS (see also Categories/Chairmans Blog/NHS Reforms in the right-hand index column) proposed by the government is another case and point.
Polls show that satisfaction levels with the NHS amongst those who use it are currently the highest they have been in recent times. This makes it difficult for people to understand the actual problem that requires this government reform as a solution. It is also a matter of people in general being resistant to change preferring instead e.g. to be grateful to wait in the queue for health care available to all, rather than taking a risk on a change for the worse. This is despite the World Health Organisation (WHO) concluding that France and Holland offer a much better health service through a mixed system of public, private and charitable funding.
The non-profit-making, health insurance companies (Mutuelles) in France, provide insurance complementary to that of the State social security and are often are set up for particular professions e.g. students, teachers etc. Since they then cater for a much larger segment of the population over which to spread their risk than the private insurance schemes of the UK, their charges are proportionally lower and more widely affordable. Private sector competition in the NHS is not necessarily by definition then a change for the worse. Nor should there be necessarily a great fear encouraged by political opportunists, of ending up with something akin to the American health system which supposedly would refuse to treat someone too poor to pay for life saving treatment. President Obama has also already used up a lot of political capital to ensure improved access to health insurance for poorer people.
The Prime Minister has added authority from his successful No campaign in the Referendum on The Alternative Vote (AV) but here it was easier to lobby against change, and indeed also essential if reports are true that the Conservatives had concluded that they would lose out under a system of AV, with significantly more Liberal Democrats likely to give their second preference vote to Labour than to the Conservative party. He now has to convince the public that not only is the NHS safe under a Conservative?led government but that improvements are also necessary and can be implemented while still ring-fencing its finances against the current budget cuts. As it is, with professional staff associations and unions accusing the Health Secretary of trying to destroy the NHS or privatize the NHS, his reform bill has been halted and a consultation process is underway to find allies in the medical profession but likely to result in heavily diluted legislation (as also was the case with President Obama who finally had to compromise).
Yesterday, the Prime Minister was already making the case that modernization was crucial to save the NHS from rising costs that pointed to a £20 billion funding gap by 2015. The only option as he put it, is to change and modernize the NHS, to make it more efficient and more effective, and to focus more on prevention, on health, not just sickness. These are fine words but there are still quite raw memories passed down of what it was like before the advent of the NHS for those who could not afford to pay for treatment and this fuels fears of a similar outcome in the future. However, there are still major problems to be resolved such as the increasing costs of treating the elderly as this proportion of the population continues to expand with improving life expectancy. It is also not acceptable in a developed country in Europe that people are forced to pay privately just to get an appointment with a GP or a dentist within a reasonable time or that for non-emergency treatment they can wait months to see a specialist, for the results of medical tests or for a follow-up operation, indeed for the latter in the past sometimes years.

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