UK News
Insights from the UK and beyond
from The Great Debate UK:
The NHS: Back on the operating table
-Laurence Copeland is a professor of finance at Cardiff Business School. The opinions expressed are his own.-
“The NHS – the envy of the world”. This is one of the Great British Myths to rank alongside “A-level standards haven’t fallen”.
It makes you wonder why all those rich well-organised Europeans are looking longingly at Britain – it’s not as though they can’t afford their own NHS. The truth of course is that they take one look and say “thanks, but no thanks”, and you can’t really blame them.
By most indicators, the NHS produces outcomes that are very unimpressive compared to our European neighbours and are in many cases inferior to those achieved in far poorer countries.
The fundamental problems of the NHS can be seen by simply examining the boasts of its defenders. One oft-repeated claim is that it is the second-biggest employer in Europe (or is it the world?), behind only................the Red Army! What this tells you loud and clear, apart from plenty about the speaker’s role-models, is that the NHS is simply far too big and far too complex an organisation for anyone to manage properly.
That the problems are managerial is confirmed indirectly by another frequently-heard boast.
Do you believe homeopathic treatments work?
A panel of scientists and doctors has told MPs that treating patients with homeopathy on the NHS is unethical and a dubious use of public money, arguing that there is insufficient clinical evidence to support such treatments.
“If the NHS commitment to evidence-based medicine is more than a lip service, then money has to be spent on treatments that are evidence-based, and homeopathy isn’t,” said Edzard Ernst, a professor of complementary medicine at the Peninsula medical school in Exeter, quoted in the Guardian.
Homeopathy is based on the principle of “like cures like” – in other words, a substance taken in small amounts will cure the same symptoms it causes if it was taken in large amounts.
Homeopathic medicines are manufactured by repeatedly diluting and succussing (shaking) a preparation of the original substance, mainly plants and minerals, in water and alcohol. After dilution the medicine is added to lactose tablets or pillules, according to the Faculty of Homeopathy, a regulatory body established by parliament in 1950.
The NHS spends about 4 million pounds a year on homeopathy, the group says. There are four NHS homeopathic hospitals, which treat 55,000 patients a year, referred by GPs and NHS specialists.
More than 400 GPs treat 200,000 NHS patients a year with homeopathy.
While conventional drugs must undergo testing to prove their effectiveness, homeopathic remedies can be sold without being proven to work in clinical trials. They can be marketed for mild conditions if homeopathics agree on their effectiveness.
It’s hardly a question of belief. The BBC sponsored a pretty conclusive double-blind test for Horizon some years ago.On the other hand, spending vast sums of public money on the placebo effect would not be the dumbest thing society has ever done. Most of these patients would probably claim that conventional medicines weren’t doing them any good, so the placebo may in fact be the cheapest option.
Do you love the NHS?
The National Health Service (NHS) has endured a barrage of criticism from opponents of Barack Obama’s plans to push through a healthcare bill that would rein in costs, place constraints on insurance companies and expand health cover to 46 million uninsured Americans.
Stateside critics of the U.S. President’s plans — including former Republican vice-presidential candidate Sarah Palin — have branded the NHS “evil and Orwellian” and said it allowed “death panels” to decide levels of care for the elderly. They see it as an overly bureaucratic, “socialised” system of healthcare and the proposals have prompted angry scenes at town halls across America.
Conservative MEP Daniel Hannan stirred up further controversy by describing the NHS on a U.S. TV show as a “60 year mistake” and as a service he “wouldn’t wish on anybody”.
Political leaders in the UK have been united in their defence of the NHS following the onslaught. Gordon Brown used micro-blogging site Twitter to voice his support, saying: “The NHS often makes the difference between pain and comfort, despair and hope, life and death. Thanks for always being there.”
A campaign supporting the health service on Twitter, called welovetheNHS, has received tens of thousands of messages.
David Cameron, leader of the Conservatives, was quick to distance himself and his party from Hannan’s remarks. “Just look at all the support which the NHS has received on Twitter over the last couple of days. It is a reminder — if one were needed — of how proud we in Britain are of the NHS,” he said in a statement.
What do you think of the National Health Service? Do you agree with our country’s politicians that it is a system we should be proud of? What are your views on healthcare in the U.S?
The NHS is extremely good, but variablle in both location and care. Some parts such as surgery are excellent, some such as mental illness inadequate. The staff are, apart from the odd person, devoted, caring and considerate, but they are overworked. Medicine and nursing are always developing and making continual study for staff to keep pace.
There are far too many managers who do not have training in health care, and heath care is neither a busines or an office job.
The population has increased enormously and become more multi-ethnic, which can pose problems particularly of communication between professionals and patients,
A great deal has been spent on I.T. which soon becomes out dated, and personal face to face contact needs more time than is available.
Where would you cut public spending?
Vows by Labour and the Conservatives to protect the NHS from spending cuts will require tax hikes or cuts to other areas, a new report shows.
Promises to “ring-fence” health spending in the lead-up to the next election — to be held before June — might lead to cuts of about 8 percent in other departments over the next six years, say researchers at the King’s Fund and the Institute for Fiscal Studies.
Alternatively, sizeable tax hikes could be in store as the next government tries to tackle the largest public deficit since the Second World War.
The deficit, forecast to rise to 175 billion pounds this year, has put public spending at the forefront of political debate.
In its equation, researchers posit that the government would have to raise the equivalent of 340 pounds for each family in the country if it were to restrict spending cuts to other departments to 2 percent, while freezing the NHS budget.
Despite being in the midst of a deep recession, the two main political parties have said they will “ring-fence” most spending.
Does this make sense in the current economic climate? From which departmental budget would you cut public spending?
Cut back on politicians salarys and expenses. that should be good for a few hundred mill
Down’s Syndrome numbers don’t add up
Are more women choosing to have a Down’s Syndrome baby despite learning from a prenatal scan they are carrying a child with the condition?
The Down’s Syndrome Association charity believes this is the case. Its conclusion has been widely followed in press reports, including in the Daily Mail, Independent and the Times.
But research data published in response by the National Down Syndrome Cytogenetic Register (NDSCR) in London suggests otherwise. It says that the rate of terminations of unborn Down’s Syndrome babies has remained constant since prenatal screening became widely available in 1989.
The Down’s Syndrome Association says its help desk has been receiving an average of two calls a week from expectant mothers who have received a positive scan for the condition who say they are continuing their pregnancy, a much higher rate than two to three years ago.
And it points to figures from the NDSCR showing that more Down’s Syndrome babies are now being born in England and Wales than before the start of widespread prenatal screening — there were 749 births in 2006, the latest year figures are available, compared to 717 in 1989 and a low of 563 in 1995.
The number of Down’s Syndrome births as a proportion of all live births has also increased by around 15 percent since 2000.
I am interested to see the NDSCR figures produced in response to this highly publicised DSA survey.A further element that particularly concerns me is the figure, variously reported online as ´almost a fifth´ or ´almost a half´ of those questioned who cited ´thinking that the baby was not going to have Down syndrome´ as a reason to continue with the pregnancy. Whilst this many be a manifestion of denial, which may be a potent component of coping with such a situation, surely this raises a major question about the degree/effectiveness of counselling that these women and their partners received?For pregnancies that had had cytogenetic confirmation of trisomy 21 (by amniocentesis, for example), the chances of the baby not having trisomy 21, i.e. Down syndrome, were exceptionally small indeed. (In contrast, in the case of people who chose not to have any invasive prenatal testing, where the likelihood of Down syndrome was suggested on scan findings only, there would indeed still have been significant uncertainty.)Down syndrome conception rates are higher as more women over the age of 35 are having children. These higher numbers of people requiring counselling in a pregnancy likely to be affected by Down syndrome must be addressed at a population level.The DSA´s view that Down syndrome is not an indication for termination of pregnancy is entirely in keeping with their purpose of promoting the rights and aspirations of people with Down syndrome and their families. Lobbying for appropriate counselling to be available for every pregnancy in which Down syndrome is suspected is compatible with this, and therefore it seems that this should be a priority area.
Ban smoking in cars?
Anti-smoking group Action on Smoking and Health (ASH) says serious thought should be given to a ban on smoking in cars.
In a report which says smoking costs the NHS 2.7 billion pounds a year, the lobby group argues that millions of children and young people are exposed to second-hand smoke in vehicles every day.
Similar bans are in place elsewhere in the world and a poll shows that the British public also supports such action.
Pro-smoking groups say such suggestions are just an attempt to stigmatise smokers and bully them into quitting. Lobby group Forest says such moves are an attack on the freedoms of adult smokers.
What do you think? Send us your comments
I think cars exhaust fumes are more dangerous than second hand smoke. How would you like to be told when to drive or who or what you can drive near, should we stop driving near schools. Alcohol makes certain people violent, causes death, should we have a drinking ban too. Where should we stop. All wrapped up in cotton wool..
Family doctors dislike government medicine
A simmering row between family doctors and the government has erupted after Health Minister Ben Bradshaw accused GPs of stifling competition by operating “gentlemen’s agreements” not to poach each others’ patients.
Laurence Buckman, chair of the British Medical Association’s GP Committee, told the BBC the claim was “absolute nonsense”, but then rather undermined his own argument by adding:
“Nor are we going to compete for patients, that is not the way general practice works.”
But that is precisely the way the government wants general practice in England to work in future. It wants to improve patient access to family doctors and believes offering the public a choice of GP surgeries will be a popular and vital element of its plan.
It has already arm-twisted doctors into agreeing to offer extra evening and weekend appointments and is building 150 polyclinics — now referred to as “GP-led health centres” — open early till late, seven days a week, where patients can get seen without needing to register.
“My view is you can compete and collaborate at the same time,” David Colin-Thorne, the government’s national clinical director for patient care, told a media briefing. “Patients need choice to drive up quality and for flexibility.”
Mayur Lakhani, a former chairman of the Royal College of General Practitioners, told the same briefing that his research into the medical experience of black and minority ethnic people had found they were afraid they would be struck off their surgery’s register if they complained about their GP.
Of course they dislike goverment medicine! Because they used to earn money with the help of private practice!
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The Wall
