11 Dec 2009

Where exactly is the choice in the NHS?

Listening to a discussion on BBC Radio Four this morning between the Labour and Conservative Health Secretaries, I have to note that there appears to be a huge misconception by the government about people's desires for health public services.

Recent prebudget report announcements indicate severe cuts to NHS funding.

The discussion this morning, as ever with a mediocre chairmanship by James Naughtie, surrounded the concepts of choices within the NHS. Blunkett discussed how he considered that choice in the NHS was now a perceived fundamental right of the people.

Is it?

The last time I checked, living in Ashford, in the centre of Kent, I am required to go to Canterbury to get my teeth looks at in an emergency, if I break something I have to go to Ashford to have it operated on, if I need dialysis I have to go to Folkestone, I only have the options of Ashford, Tunbridge Wells and Greater London boroughs for a full A&E service and if I were to be diagnosed with a terminal cancer it is dependent on what part of the body it is in as to what hospital I would need to attend. Having a baby would also be difficult, not to mention locating a GP surgery is actually allowing NHS patients.

As far as I understand, the majority of people require the NHS to be nearby in situations of necessity. If someone breaks a limb, they reasonably expect to be able to access an A&E department where all their needs can be catered for. When a friend of mine broke their leg in Canterbury three years ago, they were rather surprised to be informed that although KCH could take x-rays, they would need to be sent to Ashford to get it reset and then back to Canterbury to have the cast put on.

I am failing to see the choice that we apparently have by right.

I would rather see services in every major town that catered for the majority of health needs such as dialysis, scans, operations, maternity wards and cancer treatments than the current system of pick and choose when you might need medical attention in order to receive the best treatment.

The only choice that I have encountered within the NHS has been when I've required a more detailed scan such as an MRI. I had the choice of Margate, Ashford or Maidstone. However the choice was really based on how soon I could be seen. And, of course, if I could actually get to the location where the scan was available.

A two hour drive to Margate may get me seen six weeks earlier but unless I have the petrol money or someone willing to give me a lift, I am far more likely be seen in 14 weeks in my local town.

Or perhaps, the choice is in fact on how much you pay for the services.

When seeking dental treatment due to an addiction to toffees, I was informed that the only dental surgery accepting NHS patients would not allow instalment payments and all costs had to be paid for before they were down. My only other choice was to go private for the treatment, so I had a choice of locating £400 for NHS treatment or £1700 for private treatment.

Actually, I think here, my choice within whether or not I ate the toffees!

Joking aside, we need a National Health Service with a Bentham approach. Not an 80% administrative force surrounding key performance indicators and quality frameworks that nobody needs or cares about when they are in dire need of medical treatment and informed that they allegedly have "the choice" as to where this treatment is delivered.

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