AS an unemployed senior consultant surgeon, I share Unison’s Adrian O’Malley’s frustration (Jobs axe to save £24m – Express April 6) but we need to consider the facts.
The NHS has always subcontracted for services and products from the private sector especially in drug research, development, testing and clinical trials which are hugely expensive, industrial manufacture of pharmaceuticals and dispensation of drugs through pharmacies which are privately-owned businesses.
Also, medical devices ranging from tongue depressors, spectacle lenses and dental fillings to ECG machines CAT and MRI scanners and the DaVinci robot used in surgery.
The global market of medical devices reached roughly $209 billion US in 2006 with an average annual growth rate of six to nine per cent.
It is clear that health care systems deliver the healthcare conceived and developed by industry. It needs to be understood that it has never been possible to deliver services without the contribution from private sectors, which must profit to remain financially viable.
Without the contribution of private industry we would have no drugs, from aspirin to antibiotics and cancer drugs. We would have no orthopaedic implants for the management of bone fractures and artificial joint replacement.
We would have no operating instruments with which to place the bone plates joints. We would have no scanners, no renal dialysis nor heart transplants and no robots and other devices.
The NHS manufactures none of these things – it is both purchaser and provider, and as such has to work with the private sector, which invents and supplies the necessary components for modern service delivery.
Historically the NHS has made bad choices along with other government agencies. The huge cost of ineffective IT is just one example.
The NHS does not meet the needs of everyone. Treatment is openly and admittedly rationed. “guidelines” have been successfully formulated for financial reasons and employed to reduce the number of interventions in the guise of “best practice”.
The NHS is not free at the point of delivery for many patients. Prescription charges, dental charges, optician charges refute this concept, but the statement continues to be rolled out especially by politicians.
So how have we come to the current situation? How has the National Health Service, once described as the “Envy of the World” disintegrated?
We were once advised the introduction of NHS trusts which cost the taxpayer £billions would provide the solution.
We were advised the introduction of a contracted managed market would produce greater efficiency through competition.
We are now told that that huge savings are required in a reformed NHS which is facing financial meltdown.
It is very easy to use the global recession as a scapegoat for these problems but we must be mindful that a huge expenditure was required in setting up NHS Trusts in the first place.
The whole process has been at huge cost the taxpayer, which has funded a system that has failed to deliver the service required by the nation.
The current NHS is a product of dysfunctional politics, of successive governments, which reflects on the system and service delivery.
The outcome is that system doesn’t work, cannot work and will never work.
It needs to be stressed that hospital managers are not responsible for the current crisis.
They have no alternative but to accept the “poisoned chalice” and are charged with delivery of HM Government mandates, objectives and targets – no matter how irrelevant, obtuse and unworkable.
The workforce, with a well recognised commitment to patients and unswerving loyalty to socialised medicine, have had all individual responsibility removed. The system has become more important than the patient.
A change in culture is required. We all need to understand the first priority in health care is caring for the patient.
The real problem is many of us have forgotten this principle...if we ever had it in the first place.