The long read: Even those at the top admit the NHS can’t do what is being asked of it today. But it is far from unsalvageable – we just need serious politicians who will commit to funding it
Even those at the top admit the NHS can’t do what is being asked of it today. But it is far from unsalvageable – we just need serious politicians who will commit to funding itn an ordinary Tuesday morning I arrived at my GP practice for a day’s work. It was 8.30am, and the receptionist on duty was a colleague named Nicola. “Any dramas?” I asked her as I approached the desk. “Not yet, but it’s early,” she said with a wry laugh.
There were two letters with handwritten Post-it notes laid over my computer keyboard – urgent messages left by colleagues for me to action today. Modern healthcare is so complicated that no one case or story could capture all the problems of today’s NHS, but these two letters, left out for my urgent attention, illustrate some of the pressures on the health service today.
When there is adequate time in the day, I enjoy going through these letters, reports and results: they tell me whether the working diagnoses I made were correct, and where a test or scan result is unexpected, they offer learning points. Specialist letters help me to plan my next encounters with each patient, and unanticipated results feel like puzzles to be solved, rather than unwelcome irritations.
There was a letter from the chief medical officer reminding me that the NHS should not be providing any pre- or post-operative care for people seeking private surgery abroad. The diminution and degradation of the NHS means that health tourism is booming – but so is the cost of fixing foreign hospitals’ mistakes. The NHS doesn’t have any reliable mechanisms to bill overseas private providers for the follow-up required when British people fly abroad for procedures that go wrong.
The current algorithms used by NHS Direct trigger about double the number of ambulance call-outs as GPs do when taking the same call – computers don’t make good doctors. Another reason the ambulance service is overwhelmed is to do with patient expectations of what is a real emergency: one paramedic I know told me recently he was called out for a “bleeding wound” that when he arrived on the scene proved to be a paper cut.Service is an amazing institution.
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