What Equality (The NHS vs Private Health Care)

Member Name: milmol

Product:	The NHS vs Private Health Care
Date:	10/06/02 (282 review reads)
Rating:

Advantages: Quality of care should be available to all

Disadvantages: Not everyone can afford private care., Not all services are equal in the NHS

I have worked as a NHS nurse for 22 years, the last 10 in general practice. Im not sure sure if the public realise the skills involved in practice nursing, but basically they are many including knowledge and qualifications in Coronary heart disease, diabetes, asthma, holiday vaccinations, immunisation of children, wound care......and I could go on. Now nurses need specialist skills according to their area of practice if it be in the NHS or the private sector.

When I entered general practice 10 years ago I was fortunate enugh to find 5 Gps who ran a Fund Holding practice. This means basically that they had control over certain parts of their budget and were able to buy services from providers that they chose, based on quality, locality, waiting times and cost. It also meant we were able to have many services brought into the practice. Living in an area of high unemployment and social deprivation this was paramount for the patients as even a bus ride to the nearest general hospital can stretch the funds of many families. Now fundholding was fundamentaly against my principles as I had always believed that patients were entitled to high quality of care regardless of where they lived or who they were registered with. I soon became proud of the service that was offered by my employers though and instead began to think that other practices should higher their standards. Private health care is not an option for many patients, how to survive day to day both mentally, physically and finacially is the most important decision some patients have to make.

Then a change of government, Labour came into power. Now having known nothing but a conservative government all my adult life, and seeing the dessimation of the local mining industry I looked forwad to a brighter future in the NHS, but what do I find. The setting up of Primary Care Groups and then Priary Care Trusts saw many 'pen pushers' with little or no clinical experience whatsoever put into post at
enormous cost. To accomodate these individuals, brand new buildings were built. Amazing job titles seem to occur which left health care professionals thinking 'What the heck does that mean' and meetings were many and frequent. I realise of course that the NHS needs managers, but so many without clinical knowledge?

Now the idea of Primary Care Trusts is supposed to be that patients recieve a high standard of care no matter where they live, what utter rubbish. The reality of what happened is as follows. To bring everone to a certain standard, some practices needed to improve their services, we found that instead of them being brought up to the highest standard available, the services aforementioned that we previously offered were removed and we actually offer a lower service now. The demand for these services as not lessened however, and many of our patients do not have the financial means to look to the private sector.

Now not being one to shy away from a challenge, I belive in having my say (as some may now notice) and was put forward to sit on various groups within the PCG/PCT. I found that these meetings were attended by many, all being paid, all having lunch, and very occasional making worthwhile decisions.People with little or no clinical experience were making decisions that affected patient care based on nothing more than monetary plans. Now I know the NHS is not a bottomless pit, and being involved in Triage I know how to priorotize and direct services to worthwhile causes, baed on clinical need but could not belive the waste of time spent discussing ludicrous subjects.

I also found that at these meetings when bids where invited for posts or equipment, the same practices bid over and over, these were usually the forward thinking and well organised practices. Now unless someone had the common sense to help the struggling practices to make bids, how would equality be achieved. These practices include people primarialy concer
ned with caring who are not aways motivated to undertake formfilling. The aforementioned practices would continue to improve services and the latter would fall even further behinde. When I verbalised this fear I was told 'Well everyone was invited to tender, we cannot make them', granted, but lets show them how.

Another inequlity is the differance between PCTs and the finances available to them. Just a few miles from me, a differant PCT has a pharmacist in every practice and seems to have services far and above the ones that we have. This may be poor management on the part of our PCT but how can this achieve equality for patients across the country, it doesnt, it just provides other inequlaities.

To sum up, the ethos of PCTs is correct, to implement this ethos we need less money spent on creating jobs for penpushers, buildings and unecessary meetings and high standards of care and sevices across the country as a whole. If people want to buy private health care and have the finances to do so I dont have a problem with that, after all it takes a load of the NHS, howver the quality of care should be equal be in private or NHS. The idea of PCTs seem right, but the implementaion has a long way to go.

Summary: