Chris Lancelot: The time has come: let's get on with NHS reform

Last week I pointed out how the NHS - the so-called 'envy of the world' - treats patients inequitably.

The GP Record, by Fran Orford
The GP Record, by Fran Orford

'Free at the point of need' - are you sure? There's curtailment of access to the NHS if you choose to go privately; travel immunisation isn't supplied at all; and access to treatment for impotence and varicose veins is severely restricted.

But it doesn't stop there. You have cancer? Your Macmillan nurses aren't supplied by the NHS - it is a charity. You've broken your leg? You won't be able to get an NHS wheelchair for six weeks (even though you need it immediately). Instead you will have to hire one from an external supplier. Your child needs a nebuliser? Too bad: you'll have to purchase one.

Then there is NHS dentistry - well, there would be if only you could find an NHS dentist, which in many areas is difficult if not impossible. Approximately 60 per cent of patients have an NHS dentist. That means 40 per cent don't. And NHS dental treatment is usually not free. Nor is the optician.

What about prescription charges? How often have you wondered whether the patient will be able to afford to get their prescription made up, especially when multiple drugs are involved? Yet if you live in Wales, there are no prescription charges. (There aren't any hospital parking charges, either - another bone of contention in England.)

Not only does the NHS in England not provide all treatment free, you may find you can't even obtain secondary care at all. How many PCTs now operate referral centres to exclude 'inappropriate' referrals, using arbitrary criteria with no firm evidence base? How many patients are subjected to a postcode lottery over access to procedures or drugs - such as rituximab for immune thrombocytopenic purpura?

This is the NHS we are currently saddled with - cumbersome, inequitable, inefficient and anything but available at the point of need. It desperately needs reforming. Yet whenever anyone suggests this might be a good idea, certain groups immediately start raising emotional and paranoid suggestions such as 'privatisation by the back door' or 'selling off the family silver', and so on.

This is all politically-generated rubbish and totally counter-productive. A drastic overhaul of the NHS is long overdue.

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