The NHS has long grown fat on restrictive practices. If I want an NHS doctor and need a blood test, I make a separate appointment with a nurse. If I want an NHS specialist, I must see an NHS doctor first for a “referral”. If I have an accident I may have to wait hours to see a doctor, even if a nurse can help me in five minutes. To get a simple medicine, I must go to a doctor, then visit a chemist.
Few of these restrictions apply in the private sector, for the simple reason that most are unnecessary and cost the system, and patients, money. But as long as the NHS is regarded as infallible, no one protests and costs soar. Since there is no way taxes can meet costs, care is rationed by congestion. Doctors are overworked, the referral system is clogged with bureaucracy and the rich flee to private healthcare, where they get an increasingly better service.
At last health professionals are calling for pharmacies to be put into surgeries, again as in private practice, to relieve pressure on GPs. Why has this taken so long? The NHS is like any old-established service institution – the law, academia, the army. It is riddled with restrictions to protect the interests of its elite practitioners, backed by bureaucratic messages to “consult your GP”.
Britain’s cancer detection rates are shocking by international standards. No one dares ask if this has something to do with the laborious referral system, requiring two medical consultations before even a routine colonoscopy. A&E departments are a morass of overlapping jobs. Pharmacies are crammed with branded v generic drugs, largely to line the pockets of big pharma.
Everyone assumes the NHS is in trouble through lack of money. If it were, waiting times and outcomes would be improving with more resources. They have not done so. Internet consultation, self-diagnosis and private testing should be slashing pressure on surgeries. Instead it is increasing.
The future of healthcare should involve a mix of public and private sectors, personal and off-the-peg, free and charging. This is inevitable and sensible. The present rigidly stratified NHS was invented by Aneurin Bevan as a bribe to get the doctors’ leaders to co-operate. That bribe should be over. Risks need to be taken and restrictive practices dismantled. Bring on the pharmacists, now.
