Florida. Atlanta. New York. 3 cities with a difference..3 cities where 2 weeks whizzed by..away from the hustle and bustle of work. Not quite away from the NHS though...Twitter provided a harsh reminder of the emotions and issues always there at the tip of the fingers. The last few weeks have witnessed a storm of opinions, thoughts, blogs, open letters...the views of the medical profession has been there for many to see. Angry, hurt, disappointed...some say out of touch with the public, to some that bit being immaterial.
Taking a pause, how actually does it affect Consultants if the NHS ceases to exist or moves to a 2 tier system….a system let's say which say has an NHS Plus..an NHS you can access only via co-payments or top ups. The very concept makes many froth at the mouth, their heart churn but anyone worth their salt, deep in their hearts knows, financially at the very least, we are in a situation which is nearly irrecoverable. The money doesn't stack up anymore. Yes, you may not agree with that but there is also the minor issue of the electorate mandate.
The evangelism of a few, however right at the present, will ironically, perhaps supply the ammunition to break the back of the NHS finances...how will history judge them? Time will tell. Today's patient safety advocates have opted to go for the issues of patient safety first, ask for resources later. Todays news as regards NICE U turn should come as no surprise- the money simply doesn’t stack up.
Tomorrows ones - hopefully- will be at least bolder - at least raise the issue of prioritization and resources first. Only then maybe, just maybe, we would avoid the issue of better-staffed wards but financial balances in the red. Did you say money shouldn't matter when patient safety is at hand? Ah but it does...ask any Trust or CCGS finance directors. To fund X, they have to cut Y. To YOU patient safety maybe paramount, to someone else, having psychology support for their diabetes maybe of a higher priority. In footballing terms, to aspire to win the Champions league is laudable- maybe you need to have the resources (and talent) like Barcelona to do it. Pure talent or will rarely cuts it- in any sphere of life.
So how would it affect those recent pantomime villains called the doctors? In a business called health, in a world where we are worried about our future, worried about dying, worried about growing old....I will allow you to make your own conclusion to that. Free from the "trappings" of a public funded structure or the "dreaded efficiency", only one thing suffers...healthcare for all irrespective of ability to pay. Thus, it is with a incredible dose of irony one notes doctors trying to resist the slide of the NHS..spun today as the pantomime villains trying to protect their salaries and perks...it could also be about the strongest force trying to raise a united voice against the inexorable slide at hand.
The doctors with their entrepreneurial sides will flourish….as in fact, most of them already do...in an open market, their skills or whatever you want to call it, will be unbounded, unfettered...would you bother about who was suffering due to inability to pay or would you worry about how much you can earn? If that sounds like blasphemy, do pay a visit to other countries where concept of "free health" is met with raised eyebrows and genuine surprise. Some will struggle in isolation, opting to stay true to their ethos of "help others at all costs" while the majority will fall in line with the 2 tier NHS...that's called life, that's called making sure your own family is provided for, that's called reality. Sounds harsh? Maybe YOU won’t do it…believe me…many will. Do patients needs come before your own families needs? Think about that
That's exactly what has happened or is happening in other countries...UK will be no different. I also do appreciate many believing that morally it would be wrong - however when I did raise that argument to Mexican chap a few days back, his response was curt, waspish but perhaps true too…."A country which has spent centuries plundering other countries maybe shouldn't lecture others on morality". All about your viewpoint, isn’t it?
So why do I write this particular blog? Simply to ask one more time for some semblance of unity- amongst doctors for starters. Too many divisions exists- on lines of what we do, what CEA awards we have, whether we do private practice or not...maybe it's time to try and get a united voice. Then it's a bigger gathering of like minded voices...and that's everyone who firmly wants the NHS to survive as it is.
Let your passion to improve the present not destroy the future, let your own prejudices towards your colleagues not hamper a united voice...for tomorrow if the system changes, it's not the doctors who will suffer...it will be many more who will….folks not born with the fortune or luck fate has provided them with. It's a very simple question really...do you believe enough in it? And if so, are you willing to forget your differences?