Give me a moment to sell you the NHS

Much debate rages over the national health service and many faucets of the care system as a whole. There are two very different camps when it comes to this such debate. There are those who will attack the NHS at every opportunity and advocate for a privatised/consumerist system. The opposing faction in the debate are the hard-line NHS supporters who would support the NHS no matter what and will fully advocate for it. There are indeed many who will have an opinion like this and to a greater or lesser extent exist on differing points on the continuum of opinion.
There are many who have written on why the NHS should be scrapped and replaced with a more privatised system. While the idea of this is not intended to be scoffed at, I wish to examine the NHS first and why there exists a case to support it. Both these debates often descend into personal opinions only. The fact is, that all opinions can only be held on one of two conditions:1. The individual in question does not possess all the facts, details or information on a subject, or;2. The individual is basing an opinion founded upon their personal preferences, likes, dislikes and experiences.When you say you dislike something you are simply stating your own opinion based upon your own personal preferences. Personal preference along with personal anecdotes has no bearing whatsoever on reasoned, logical debate and serves to prove nothing. One mans meat is another mans potato.
Now that being the case I’d like to touch upon individual personal preference and explain why it has no bearing on the NHS (or anywhere else for that matter) suitability as a provider of healthcare
Now person X might ask “but I don’t like it, does this then not make it unsuitable?”
The answer to his question is: no.
Let me explain...
When I say: “The NHS as an institution has been provided in some format since 1st July 1948, ergo its proven existence for such a length of time, coupled with there being no major competitor nationally to its provision of care suggests therefore there are few reasons to claim that the NHS is unsuitable as a basis of inspiration for its own future or as a model of whatever should replace it.” I am making a statement of fact, no less; it is supported by reality, it is purest logic, it proves the NHS's suitability, it is universally binding.
When person X says: “I don’t like the NHS” this by itself achieves nothing more than to state their personal opinion; it is their own personal preference, nothing more and nothing less. It is a statement of opinion relevant only to them.
The fact that the person “does not like the NHS” does not mean that it is therefore unfit for the treating of patients, and conversely nor does it negate the fact that someone else does “like” it. Until the NHS act of 1946 (which came into effect 1st July 1948), the provision of health was from various sources, some under the Public Health act (1929) while some mental health aspects were held under the Lunacy act (1885). Under the NHS act, it should be recalled that this gave all people in the UK the right to free healthcare which was provided free at inception and funded from taxation. The NHS act was considered a nationalised service and was rationed accordingly to ensure that all patients were given the same standard of care. Healthcare provision of General Practioner's Doctors, general and psychiatric hospital service including medical and surgical care as well as out patients were provided. In the new NHS act an ambulance service was provided to many areas for the very first time for the transportation of patients of both emergency/urgent/maternity admissions and for out-patient services under the local council. The conservative opposition of the day opposed the proposal of the then minister for health, Anyuven Bevin of the forming of NHS. There is historical evidence to support the influence that individual preference blocked health provision, and that there were bodies opposed to the providing of healthcare. An ambulance journal cited the work of a Mr Todd who overcame opposition to the providing of an ambulance to the people of Kidderminster in the 1920's. Such was common, though in an opposing view, vulnerable workers such as miners often would have contributed money from their salary toward their healthcare, and for the building of mining hospitals in the 1800's in areas where mining was the main employment e.g. Iron ore mines of the Yorkshire Cleveland district and County Durham coal mining communities was common.
Continuing to grow, the NHS was revised in 1974 and 1992. The services which the NHS provides are for all members of society. The service is not without fault however. There are issues of funding and the "postcode lottery" being experienced for patients. A recent area of controversy was the area of IVF (In vitro fertilisation derived from the Latin Vitro meaning glass). There are differences in the provision for each service, though in a high court ruling in 2005, the judge ruled that while the plaintiff cited the Human rights act article 6 on the right to a family life, this did not extend to the NHS having to provide IVF treatment and the case was thrown out. Professional regulation, statutory acts of Parliament and Department of Health guidelines and evidence based practice are intrinsic to all the NHS care. The ethical issues and the concepts of Deontology and Utilitarianism, Beneficence and non-malificence all play a role in the provision of healthcare as well. These are universally binding and are based in logic. A private firm will be in the business for the money aspect and will be interested in insurance, market shares and the like. In this aspect, the money of the hospital would be a foremost consideration, and not the treating of the patients. In the NHS, thanks to the financial restraints caused by the trust debts, this has been seen with the use of Herceptin. This could be a situation seen many times over in the private medical services if it were to be a national body, and there is the problem of insurance premiums. In the area of the university student nurse is studying, there is a line of poverty stretching down the river. There is a main road on which the main general hospital is located. At the southern end, in the village at the end the health authority figures state a man will live on average to be 79, a woman 83. At the northern end these figures are reduced to 73 for a man and 78 for a woman. This may not seem much, but this is a 3 mile odd stretch of road, not the Kinshasa highway!

One has to wonder that if the main employment within this area is based on national minimum wage working on average 16-20 hours per week, how much insurance premium people would be able to afford. A former editor of a newspaper who student nurse was talking to gave a very good point: They had received £25 000 worth of NHS treatment but they themselves had not paid anything near as much into the NHS in national insurance contributions.
An intrinsic factor to the debate on the NHS and the provision of healthcare is that it is a very emotive subject and one which is a political "Hot potato" for lack of a better word. There has been much political influence which is often done without the full input on the people who are to deliver care. The reliance of targets is a strange one. While there are targets used in the NHS extensively, this is a irregularity from the almost business like model. Having a background as a former business manager, which was my former job before commencing university, I find the fact that targets are insisted on being constantly achieved as a mandatory standard. Odd, usually, a target was set based on the previous year figures, a growth margin of 2%-5% calculated and the new target arrived at by this method. Then, following the review period, the correlation to the planned target and the actual target was correlated against each other and usually after a few months is would be clear if we were within the target, over or under target and the projected outcome based on that. Usually, if the target was exceeded, this then meant that an even bigger growth margin was added in for the next period, and if figures did not meet targets, usually the figure was kept at best static or at worse required a 2% growth on top of the original target. I agree with the idea of the two week rule and the 4 hour wait time, though this seems to be having patients and figures fiddled with to make it seem that this is met rather then aimed for. Yes, none of us would like to have a 4 hour wait in A&E, but anyone who is able to wait four hours is either very much critical and then needs urgent attention or not that ill to wait another 15 minutes. The Abdominal Aortic Aneurysm patient usually is a tad more serious then the persistent "frequent flyer" who is back in again because he got a crick in his neck while eating an undercooked steak and is insisting that he has Kuru despite the fact it was only found in the cannibalistic Foray tribe of the highlands of eastern Papa New Guinea with the last reported case being in 1973...in San Francisco.

Health care has to be rationed to give every patient a fair chance of being seen. There will be no miracle cure for cancer, people will have a chance of surviving cancer if it is detected early enough, but that chance will always be dependant on the fact that there will be some who will die anyway. There are some who be rushed to hospital and be found to have an abdominal aortic aneurysm but unless they walked in to A&E, tripped into an MRI scanner then tumbled out onto an operating table with a vascular surgeon, anaesthetist and a scrub nurse ready to operate, they cannot be salvaged. There is a much less “worst case” situation then this, but the private system also has its ramifications of this system. A private hospital will want only the best surgeon. The mortality rate for these patients will be high if a surgeon or doctor takes these cases on, and is not good for the insurance company. Its then likely that patients will be defined as being defined as a “non candidate” for surgery in the name of profit. Some will say this is not true, but the majority of private clinics/hospitals do operations in what in the main is cosmetic, orthopaedic and some prostate procedures. These are a small cross section. There is indeed the argument this is a faster way of being seen…the refute of private being better is easy: Any hospital with a couple of hundred patients as opposed to over a thousand will always be faster. The important point of good quality care is there being skilled and educated professionals who can provide care to the patients with well equipped wards.

The NHS does provide good care like that. The barrier to the full potential is the reduction of the training and posts for the people who matter the most, the frontline health professionals and their workers. The NHS is a much maligned resource which should not be knocked. The private sector will not magically change the way health is provided. The well off of society may well be able to afford it, but given the population of the under 18’s, students, the elderly and those who are on low incomes or the unemployed, many of these would be priced out of the health market. That’s not a good direction. The NHS needs a good fix, because it can work and as people I know from abroad said “Don’t knock the NHS…the alternative is worse”.
The NHS is not perfect. The private sector is not going to charge to the rescue on a steed… though many seem to think the grass is greener on the other side, student nurse things it will be a case of “Same s**t, different name”.