The NHS is not safe in anyone’s hands.

by John Darvall

The NHS is in crisis. It’s probably been in crisis since it was founded in July 1948. It will be in crisis no matter how much money you throw at it or who runs it. It doesn’t matter which political party comes up with yet more policy or politics on the NHS or who changes it or who blames the other for what they did. Politics has put the NHS in crisis. They are all at fault. They are all to blame. To blame each other is naive and utterly insulting to us, the voter.

The most naive part of the NHS was the founder himself. Bevan’s devastating mistake was not to have the foresight to factor in the likelihood that medical advances and an ever progressive medical profession would render a health service free at the point of need impossible to deliver. If you marry medical advances and science to an NHS promised in our low taxation economy, as pledged by our two principal political parties, the NHS as promised is, frankly, little more than a big fat lie. It just can’t be done and all political parties should come clean and tell us the hard truth. Neither Labour or the Conservatives will give the NHS the £8bn it has asked for.

Let’s deal with the basic principle of the NHS being free at the point of need. This is a worthy aspiration and it is achievable, if it’s not confused with free at the point of want. ‘Need’ really means this: if you are fat and want a gastric band because you want to be thin then you pay for it. You can be treated for any mental health issues that make you eat excessively so you stop eating so much. But it is for you get off your arse, reduce your food intake and exercise. It’s not the state’s job to make you thin, that is down to you.

An NHS free at the point of need is about the heart attack, the broken leg, a stroke or Ebola. It is not for want as in ‘I want a nicer nose as my nose is to big’. But what about the heart attack due to smoking and drinking or poor diet or lack of exercise? That is why *in a world where the NHS is free at genuine ‘need’* you must pay more tax to fund your *own* failings in you not looking after you. You either pay more tax under they current system or you don’t get anything free at the point of *immediate* need, let alone at the point of want.

What of the future of the NHS? As it is now it can’t survive? There isn’t the money or the resource to deal with an ageing population who can be kept alive thanks to costly medical science and its continued advances. It is medical science that defies nature and keeps us going long after nature should have taken us.

So here is my prescription for an NHS worthy of all.

1. All political parties need to stop blaming each other for the NHS in crisis. They have all caused it and they have failed us by not being honest in what is needed. In simple terms, you and I need to pay more tax for the NHS to work. We need to pay for a GP appointment, much like those who can pay for the dentist and optician now. The same exemptions would be applicable. If we don’t turn up to the appointment we must to be fined £10 before we can see a doctor again. Personal responsibility starts with all of us treating the NHS with respect and responsibility.

2. We need be more responsible for our own health and not expect the NHS to pay for what we knowingly do to harm our health. If you want to smoke, drink to excess, go rock climbing, skiing, caving, ride a horse, surf and so on then you need to take out some insurance to protect you if you come to some harm. Don’t expect us all to pay for your choices.

3. It is a bit late for many of us but our children need to be educated about health and wellbeing at school, as part of physical education. They need to be taught how to exercise throughout life, what to eat, first-aid and life-saving, how the body functions and how to take care of it. In a generation, through education, we may have a healthier society than we have now. *If we achieved that,* they *might even* be fortunate to pay less for an NHS free at the point of need.

4. The current NHS needs to be split into the following basic groups. Acute Care, Chronic Care, Social Care and Elder Care. You will fall into one or more of these categories and will be treated accordingly.

5. Pharmacies need to be empowered to deal with sniffles and basic ailments with the power to prescribe and, if needed, refer accordingly.

6. GP’s need to be open 7 days a week, 9am to 7pm. Outside these times you wait or if it really is an emergency you go to A and E. This is THE last port of call on the NHS not the first stop in our ‘I want it sorted now’ society of today.

7. 111 must be scrapped. Like NHS Direct before it, it is a fundamentally flawed idea, thought up by a bunch of Whitehall wonks who didn’t think it through. If you’re ill you need to speak to someone medically trained, not a call handler.

8. Most importantly, we all need to be educated to take responsibility for our own health. It’s not the government’s job to make you better, it’s your responsibility to do everything you can to keep you well in the first place. If you take risks or make choices that impact on your health then you must be responsible for the consequences, regardless of income or social standing. Being rich or being poor is no excuse for poor health.

Being fit and well is all of our individual responsibility. Paying tax for those who are genuinely unable to be fit and well in our society, so they can be cared for properly, is the mark of a civilised society. Tax is the price of civilisation. We all have a responsibility to do all we should to look after ourselves in the first place so the NHS is only used when we really need it.

Finally, as this is an election year, perhaps our politicians can be honest about the NHS, its cost, its failures and its future rather than blaming each other for their collective failings since its inception back in 1948. That would be start to saving the NHS for all of us.

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