A better future for UK healthcare
To improve health care provision in the United Kingdom it is crucial we restore personal responsibility. Eat too much? Drink too much? Pay.
In the United Kingdom, the NHS is a product of a different time; formed in the years following the Second World War. When the NHS was founded by Bevan, Britain was a markedly different place with limited car ownership and rationing still in effect. In time, our lifestyles have become relatively sedentary.
The NHS is now paying the price for its success in increasing life expectancy, with an aging population adding to the challenges facing the health service in the coming years.
But patients are failed by the NHS because no government has sought to define the extent of services provided. This has led to patients being denied necessary treatment because the service is overwhelmed and attempting too much. In the case of the Mid Staffs scandal, patients were neglected because the hospital trust was largely focused on achieving foundation trust status rather than on patient care.
The National Institute of Health and Care Excellence (NICE) helps determine the treatments available through the NHS, placing cost effectiveness ahead of patient requirements.
Patient care should always be the primary motivation when attempting to restructure health provision. Changes in lifestyle are placing the health service under increased strain both in terms of provision and in terms of cost. Obesity for example is costing the health service a further £5 billion, stretching already stretched resources worse than an obese person’s waist band.
In the 1960’s a mere 1 to 2 per cent of the population were clinically obese. Today, it is over 25 per cent. Obesity is a prefect example as it demonstrates the challenge the NHS is facing in not only providing care but having to procure additional equipment which eats into the NHS cake.
To improve the health care provision in the United Kingdom it is crucial we restore personal responsibility. One possibility would be to introduce health savings accounts. By replicating Singaporean style healthcare provision we would be able to make it an individual's responsibility to look after their own health and well being. This I feel would go some way to addressing issues like obesity and alcohol related conditions both of which place great strain on the already beleaguered NHS.
What form does the Singaporean alternative take? Operating a system of health savings accounts, Singapore places patients in position of authority. Individuals save money in personal healthcare dedicated accounts which coupled with low cost catastrophic insurance coverage eliminate issues such as waiting lists and the rationing of services.
Those who are unable to meet the cost of their health care receive healthcare provided through the government safety net.
The big question would be how would the transformation of the NHS impact upon patient care? In terms of access to emergency services the move to individual health accounts would have no impact as those services would continue to be delivered. The real change would come in allowing the patient to become a consumer receiving care in a manner that they choose. This should promote competition between care providers, such as hospitals, to improve services and improve patient care.
Patient care should be the most important aspect in health care. To accomplish this, patients should be consumers, put in a position to choose the treatment they receive and the facility where treatment is carried out. The Mid Staffs scandal demonstrates the failings of the heavily under-strain NHS where patients were consistently failed.
The health system at present is not fit for service and we need to change the system to provide tailored health care responsive to patients' requirements.
Christopher James Harries is a freelance writer
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