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“Politicians do not understand how the health service works,” says Joe McGilligan


11 May 2015

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It makes not a blind bit of difference who won the general election because politicians do not understand how the health service works, nor the values or motivation of the staff that work in the NHS. For 67 years successive governments have tried in vain to contain the spend of the health service without realising it was set up with a flawed business model. It is a socialist ideology trying to be delivered by capitalist business models where the patient has no responsibility to utilise the resource responsibly.

It makes not a blind bit of difference who won the general election because politicians do not understand how the health service works, nor the values or motivation of the staff that work in the NHS. For 67 years successive governments have tried in vain to contain the spend of the health service without realising it was set up with a flawed business model. It is a socialist ideology trying to be delivered by capitalist business models where the patient has no responsibility to utilise the resource responsibly.

What needs resolving is the means tested social care and free health care debate. A patient is bounced around the system to pass the cost to the receiving organisation without thought of the harm that is endured.

The allocation system is in desperate need of an overhaul so that the spend per patient is equalised to end the postcode lottery. There needs to be a ramp up of the public health agenda so prevention is prioritised, not in a Big Brother way more a concerned cousin to help guide people to healthier lifestyles. There has to be more joined up thinking on the determinants of health such as employment housing and education rather than the vote catching target driven fixit culture of the NHS.

Modernisation of the way medicine and healthcare is delivered can only happen when those that are delivering the service believe in the changes that are needed. Top down dictats are resisted if imposed, however well meaning their purpose. Throwing money at perennial problems such as winter crisis without understanding why it occurs annually and fixing the cause mystifies me.

Understanding that the NHS is a conglomerate of competing organisations both financially and professionally and not one entity that is controllable centrally would be a step forward. The organic nature of its growth and the complexity of all the interactions and hand off points means that the golden baton of blame can get passed so no-one is truly accountable for any deficiencies.

Now we know it is the Tories in power, and that they have stated GPs are at the corner stone of their vision of the future of the NHS, then hopefully the much-needed investment in primary and community care will be realised. The first white paper on care in the community was presented by Keith Joseph in 1973 and unless we learn from history we will repeat the same mistakes.

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