Leatherhead Matters

The NHS was created 60 years ago to provide comprehensive, high quality health care for all, without regard to means or status, free at the point of delivery. It’s a national treasure and yet after 60 years we are now more aware of its little imperfections. Dr Rant (NHS doctor) delivers a 60th birthday verdict on the current NHS.

The NHS provides great comprehensive coverage unless:-

• It’s a dental problem.
• It’s dementia: your needs are social and not medical you see, and be a good taxpayer and sell your house to fund your nursing home bill.
• Fertility- we’ll pay for contraception and abortion…but we don’t to create new babies.
• It’s a new cancer drug.
• You need rehab rather than curative treatments.
• You need adaptations to your house.
• You don’t want to wait.
• You have a mental health problem.
• You want a permanent and recognisable psychiatrist

 The NHS provides high quality service, except that:-

• It ignores foreign comparisons.
• It actively manages against its staff achieving this.
• It sets targets for quantity not quality, and refuses to admit that there is a trade off to be made here.
• The criteria for high quality are poorly defined.
• Pretends that “excellence comes as standard” which, as any fool (except Alan Johnson, Ed Balls, Darzi, Bradshaw and Donaldson) knows, is an oxymoron.
• Pretends that guideline implementation and measurement and compliance is an assurance of quality.
• Dreams that a computer (or nurse drone) could replace a thinking human being.
• Believes that rationing is merely a technical issue rather than a moral issue.
• NHS direct still exists.

 We love our NHS but it is failing to deliver on:-

• Finance
• Cost control
• Clinical effectiveness
• Accessibility
• Computing and record keeping
• Quality
• Comprehensive coverage
• Relationship based care to patients
• Staff satisfaction

It is delivering on:-

• Corporate bullshit
• Redisorganisations
• Meaningless waffle
• Meaningless meetings
• Visions into vapour
• Squandering money
• Laying up future debts under PFI
• Paying more heed to management consultants than medical consultants
• Staff disengagement
• Bureaucratic processes
• Increasing negligence bills

Read the excellent, complete Dr Rant post in “The NHS at sixty: it’s great, but…”