Tuesday, November 04, 2008

Allowing patients their own drugs ? More lipstick?

Has Alan Johnson no respect? First he allows patients direct access to Physiotherapists and now he is letting them buy their own drugs.

Patients no longer need their General Practitioner's blessing to see a physiotherapist? and if they want "Government Care", they are no longer restricted to drugs prescribed by a "Government Doctor"?

Alan Johnson may be succeeding where others have not. He maybe separating the British Public from their communist aspirations of universal care, free at the point of delivery. The NHS is run on the principles of "Free at the point of delivery", "To each according to their need" "Universal Health Provision". Karl Marx would be proud of this real life example of practical Marxism.

However, just as the Russian ideals fell victim to bureaucracy and corruption, so has the NHS.

For a while in the 50s and 60s, the Soviet Union was a highly innovative and revolutionary society. Its citizens had access to social care at the same time as it was putting the first man in space. The West had every reason to fear the advance of communism. However once the idealism had faded, those with intelligence were sidelined for fear of their ambition, those with integrity were impugned and those with ambition, had ambition only for themselves.

For a while, in the 60s and 70s, the NHS was a highly innovative and revolutionary health care delivery system. It provided universal healthcare to the whole population, equal to the best in the world. However excellence in medicine has become expensive, there is almost no limit on what can be spent to keep a body going. There is no natural line in the sand. Modern communications mean that gaps and postcode lotteries can no longer be fudged in the way they might once have been.

The principles upon which the NHS are inconsistent in the modern age. For example, "Free at the point of delivery" Free to whom? Healthcare tourists, or just the locals? For everyone or just the people who have contributed? Everything free, or just the essentials? and "Free to what standard?" Minimum or optimal care? "To each according to their need" Does that include fat people, unfit people, unhealthy people, smokers, old people? What do people need? an inhaler for their asthma, a kidney transplant, better social benefits? a new life, a job? Disease is as much a social condition as a medical condition. Does "Universal Health Provision" include IVF for the over forties, cosmetic dental work for the permanently insecure, health education in schools, mass vaccinations? Where does prevention fit?

The hallmark of a totalitarian system is control. Access to the NHS is still largely controlled by General Practitioners. Once these were benign, everyone's uncle, best interests at heart, social, generous sorts of chaps. Nowadays they receive ample financial reward, may not know you from Adam, but will generously check your biometric data at every opportunity.

Is Johnson's latest step a move towards a patient-centred service? Or does allowing patients to bring their own drugs into the NHS, paper over the worst and most vocal cracks of a failing system? Is this another example of putting lipstick on a pig, or a genuine move towards allowing patients a wider choice of treatment?

Copyright (c) Dr. Liz Miller


Anonymous said...

I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. I will keep visiting this blog very often.



Dr. Liz Miller said...

Thank you, what a nice comment.

And I like your site on the benefits of treadmills, exercise is good, there should be more of it.

On the other hand, the word treadmills reminds me of the song
"Whirling silently in space
Like the circles that you find
In the treadmills of your mind"
by Dusty Springfield
and the scene from the film Oscar Wilde where Stephen Fry is using one.

Are you sure you have the right name ;-)