This is something that comes up a lot at the moment, mostly because of the looming General Election. I don’t really want to get into politics but what I do want to say is that I’ve experienced both the NHS as a free service and a privatised system while living in France. Both have their strong points and weak points as any system does, but the NHS is in this weird half privatised half not state of flux, and that’s what I think is causing the most problems- it’s neither here nor there at the moment. Personally, I think the NHS is great because it provides me with completely free healthcare. If I were to have to pay for it, the drug that keeps me alive costs £90 a packet, and I need a minimum of 4 packets a month (£360 a month). Just to keep alive. Never mind the other 15 items I have on prescription.
To be perfectly honest, the majority of people won’t notice a difference because they’re not a frequent service user. Privatisation of NHS services has proved to be beneficial for me at some points. For example, I had a severe asthma attack once and a private ambulance was dispatched to me within minutes because an NHS one wasn’t available. Or I’ve had scans which have been read in the middle of the night, possibly by someone else who is contracted out. When the NHS couldn’t meet a physio target wait time, I was referred to a private one for a short period. I didn’t have to pay anything for all of those things, so sometimes it works out in favour of the patient. But it still costs the system money.
However, despite the positives to come from it, I’ve had my fair share of problems. Lots of GP practices are now managed by private companies. The staff who work there are bound by that company’s rules and procedures and have to really fight for their patients a lot more than they should have to. I’d like to make the point that this is not a dig at any NHS staff, it’s more to do with the fact that the system isn’t backing them up effectively. This post is based on issues and frustrations they’ve explained to me while trying to help resolve my problems. The problems I mention, and other ones I haven’t, likely happen in different surgeries all over the country, this is just my experience.
1. Appointment times become a random number and every minute counts. Like 16.12pm. Doctors aren’t allowed to round up to quarter past, three minutes is money lost.
2. Staffing changes happen so that there are fewer GPs and ANPs and more appointments available with HCAs and nurses. Which is fine if your problem can be helped by a HCA or practice nurse, but sometimes it can’t, and you need to see the doctor. GPs sometimes have to work across multiple sites, which means it can take longer to see your GP of choice.
3. The computer dictates a lot of your healthcare. Because GP time is now like gold dust, you can’t just ring the surgery and have a quick query answered or sort stuff out without making an appointment. So non clinical staff are left in a horrible position of feeling like they should be making clinical decisions (which they shouldn’t). So ‘the computer says no’ is a phrase which comes up a lot. For example, that drug that keeps me alive? If the computer says I can’t have my repeat, I can’t have it and they can’t override it. But it’s 2 weeks for a routine doctor’s appointment (not with my doctor) to sort the problem, by which point I’d have been dead for 1 week and 6 days.
4. Computer systems don’t match. Hospitals have their own systems which GP surgeries can usually log into. But when private companies take over, they don’t always buy into the systems that ‘talk’ to each other because they cost a lot. So the hospital can put notes on which the GP can’t see, (but the hospital thinks they can) and it can take up to 12 weeks for the patient letter to get posted out, delaying treatment or causing everyone a headache trying to get hold of the information.
5. Everything comes down to money. I’ve been told a couple of times how much some things cost, I imagine because someone somewhere is trying to save money. It’s not the person telling me’s fault, it’s the system that makes them feel like they have to choose between finances and patient care.
6. Referrals and tests aren’t a given. You might not get sent for that scan or test you need if it costs too much money and the GP can’t completely justify it. Which is fine in a lot of cases because they can justify it. But just some food for thought: when I was diagnosed with Adrenal Insufficiency, the doctor ordered the test as a final stab in the dark with little evidence to suggest it was needed- I was in hospital with a respiratory problem and got diagnosed with an endocrine one. If he’d discharged me that day like he had originally planned, I’d have died very quickly soon after. Sometimes doctors need to work creatively and can’t back up their thoughts with clear reasons- that’s why investigations happen in the first place to help them theorise. Preventing doctors from doing that is only going to make patients suffer.
I’d obviously rather see the NHS continue to be free. It can be slow and clunky, but then it’s really outdated and people don’t use it properly but, if you do need urgent treatment, it’s pretty efficient. A lot of people won’t have noticed any difference if their healthcare has been privatised, except maybe on paper. But for people with chronic health problems, privatisation like in America and not being able to get insurance could be a huge problem. My prescriptions alone at cost/retail price would be roughly £1000 a month, never mind anything else care-wise I access every month*. But what’s a healthcare system if it doesn’t treat those who need it the most properly i.e. the chronically sick? Vote for who you think is right for you in the election, but don’t be fooled into thinking that the NHS continuing to be free is a guarantee.
*if you thought ‘well if she didn’t use the NHS it would save it thousands a month’, please don’t bother to comment so. You’re effectively saying that you’d rather see another human die so that your health taxes aren’t ‘wasted’ on a sick person. No one actually expects their health to fail, so hopefully you’ll never have to experience that feeling, but if it does, we live in a society which allows us the opportunity to access help when we need it and contribute towards others’. If you don’t like that ethos and want to pay as you go and ‘save your tax money’, then maybe you would actually be better suited to a completely privatised system where you have to pay for every paper clip that gets used as part of your healthcare 😉