Oh dear. Another article on how to save the NHS (How to save the NHS, according to those in the know, 6 January) that conveniently avoids the basic issues, which are money and how to care for our fellow citizens. Alan Milburn and Jack O’Sullivan (please no charge for seeing a GP) rely on technology. Obviously this has a place, especially in improving patient-centred care, but don’t forget most NHS patients are elderly, frail, may have memory problems, and are not big users of technology. Shirley Cramer advocates greater public health investment which does indeed have many benefits and is relatively cheap, but in essence only moves the goalposts. Ultimately a lot of us will get old and frail and need expensive care and better public health may only increase the numbers!
The divide between medical and social care is very vague. Medical care is available 24 hours a day seven days a week and is free; social care is largely only available 9 to 5, Monday to Friday and is means tested. Breaking up the system through outsourcing and privatisation only complicates matters. Basically both need to be provided by government and be taxpayer-funded. Expensive? Why not have a levy of 5% on all inheritance over £100,000, including trusts. The rich who would benefit most in life would pay more in the end.
Hospital finance would be greatly helped by abolishing the Health and Social Care Act; removing the internal market and bringing an end to PFI, whose profits have rocketed since the drop in corporation tax and the use of tax havens to avoid tax altogether (and quietly rip off the taxpayer). Finally, why do NHS hospitals pay a business rate while private hospitals avoid it by claiming to be charities?
Most importantly, we need to invest in both capacity and people. Outsourcing medical procedures to private companies increases the cost by 10% to 25% and leaves the NHS to deal with the difficult problems and clear up the mess when things go wrong. We need more nurses, doctors, radiographers, physiotherapists, social workers etc. Removing bursaries from nurse training must rank as one of this government’s most stupid actions. Provide free or subsidised education in return for a commitment to work for 10 years in the NHS.
Peter Estcourt
Retired GP, Lewes, East Sussex
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