Guest editorial - My eye-opening view of biggest health market

We are lucky to have the national health service and my recent fact-finding trip to Chicago confirmed my opinion.

I made the trip (which you'll be reassured to know was self-funded) to see for myself how a market-driven health service affects the patients who use it, and my experience was a reminder of how much we have to be proud of in our own NHS.

Health inequalities in the American system are immense and they are brought about by a patient's inability to pay. If you have the means, then you can access the best healthcare in the world. If you have no money then you go without.

My experience of the world's biggest health market has been eye opening, and given me much food for thought.

My fear is that many of our politicians and policy makers in this country have witnessed managed care and health maintenance organisations (HMOs) in the US and now wish to apply the same logic to England.

The promise of the HMO, however, is not often matched in reality, and the inevitable side-effect of a market-driven health service is profit generation.

While I am confident that we will not see a full adoption in this country of the market-driven health service provided in the US, we must ensure that the NHS remains free at the point of need. It must also provide comprehensive care for geographical populations and remain ultimately accountable to the health secretary.

I want to be clear, the RCGP welcomes GPs being placed at the heart of the health system and recognises good commissioning is part of being a good GP. But we will be doing this against a backdrop of £20 billion efficiency savings and a privatisation agenda about which I have widely expressed concern.

The college remains committed to ensuring that GPs are free to provide the best possible care to patients, whenever they need it. During the political party conference season, I have taken politicians to practices to celebrate the care we provide.

Our patients need and want the NHS. We must make sure that when the Health Bill becomes law, they can still access quality healthcare when they need it and regardless of whether they have the money to pay for it.

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