Our 'free' NHS system is failing - an alternative is needed: Bernard Ingham

It is no use blaming the Covid pandemic. It has not done so for a long time, even though longevity has been rising. Yet we spend more on health than most countries apart from the USA.

After years of procrastination, Therese Coffey, the new Health Minister, has tacitly recognised this and made her first moves to sort things out, with her first target the alarming backlog of testing, diaognosis and hospital bed-

blocking by the vulnerable with nowhere else to go.

But a long and controversial trek is ahead before we can be truly proud of our NHS.

It is prized for being free at the point of delivery. But that it is no longer the case.

You are lucky to find an NHS dentist and more people are resorting to

private medicine because of the difficulty of seeing a GP and the long waiting

lists for examination.

The ambulance service is in dire trouble, mainly because A&E departments are becoming the first resort rather than GPs. We are short of doctors and

nurses while GPs on £100,000 a year are opting for part-time working.

And thanks to our litigiousness the intake of box-ticking bureaucrats has

multiplied with compensation payments for defective treatment.

Following the pandemic it could be argued that we now have two NHSs. One

is a dedicated but grossly overworked hospital system which was recognised

during the pandemic with the award of the George Medal.

The other is the primary care system – i.e. the family doctor.

This system has become a lottery. Those who have a reliable, responsive GP who sees you personally instead of talking over the phone are the fortunate.

I have not seen a doctor from my GP practice for at least three years, even though at the age of 90 I have serious mobility and breathing difficulties.

To be fair they have maintained a respiratory and phlebotomist nursing service and kept me more or less up to date with Covid and flu injections.

Things have not been the same since the Blair/Brown government threw money at them and demanded less work in the bargain. A five-day week

service of sorts now seems the norm. Yet health emergencies are no respecters of week-ends.

My conclusion is that too many GPs have forgotten they signed the Hippocratic oath to protect life at all times, are behaving unprofessionally

and should be ashamed of themselves.

I write as a journalist and Civil Servant who worked his socks off from 1948 well into “retirement” until 2012 and knows a bit about stress, pressure and long days and weekends.

But there is another aspect to the problem in what has become a selfish society. It is said it costs the taxpayer up to £230,000 to train a doctor. Those who find the money are entitled to a service that protects their health rather than as now leaves them at serious risk.

I would also go so far as to say that with millions on the waiting list for testing and diagnosis those doctors who have retired have an obligation to return to help put matters right.

But the Government also has a duty to them to end the pension taxation penalty which encourages some to retire early.

At the same time the world’s largest single employer of 1.3m needs managerial reform. That means reducing it to manageable units, putting the medics in charge – it is, after all, supposed to be a health service – and drastically culling the bureaucracy.

Ms Coffey has made her first moves for reform in what promises to be a radical government. But I must say that her initial demand that GPs should see non-emergency patients within a fortnight, while a step in the right direction, shows how bad things have got. We need a vast improvement in value for our money.

The time is coming when we shall be forced to recognise that a system “free at the point of delivery” is not as efficient as insurance schemes operated

abroad. What is the point of paying through the nose through taxation for a

failing service if by a different method of funding – namely personal

insurance – we can readily access what we need when it is required? What is more, it could be cheaper, given the evidence other countries have to find less for a better service.

Many - and many politicians - may think this is a revolution too far. They had better decide what they want.