You don’t know what you’ve got till it’s gone

by Rick Johansen

“Good morning. Melchester health centre. Can I help you?”

“Oh, hello. I’d like to make an appointment to see Dr A, please.”

“Let me just check for you” … short period of silence … yes, she’s available on Friday 7th June. We have appointments at (reads possible times).”

“Can I take 8.30 am, please?”

“Yes, certainly. Let me take your full details …”

You’d need to be quite old to remember that scenario, but trust me, that’s how things used to be. When I was a kid, you didn’t even need to make an appointment, you just turned up at the surgery and waited your turn to be seen. Best of all for me, you could usually choose the GP you preferred to see, something that really matters to those of us with long term conditions who really don’t want to have to go through the hassle of explaining, in my case, over 50 years of mental health issues in a two minute period. As the song goes, you don’t know what you’ve got till it’s gone.

In recent decades, it got a bit harder to see the GP you wanted to see. The gatekeeper receptionist at the surgery, or health centre as it became known, essentially told you who you could see and when. The great unsaid was “You’ve no choice. Like it or lump it.” Mostly, you lumped it. You needed to see a doctor so if it was a different partner from the health centre, or increasingly a locum, “just be grateful”. Compared to today, those seem like the good old days.

Now, you complete an on-line form and someone will ring you back, occasionally a doctor you’ve never met nor indeed heard of, or a nurse practitioner or a prescribing pharmacist. (I had a call back from one of the latter a few weeks ago. Once he’d finished not being able to help me, he said I’d have to speak to a GP to get a prescription. “But aren’t you a prescribing pharmacist?” He did reply, but I’d zoned out by then.) In short, the whole system is nonsense. Like everything else, the system is broken and nothing works.

During a recent mini mental health crisis, it took four weeks for a GP to call me and when he did, he had no idea why he was calling me because no one had left a note. What if I had been suffering from a major health crisis? When I’m having a mini crisis, that’s what I always think and of course I know the answer. (Incidentally, the answer was essentially, “There’s nothing we can do. The NHS doesn’t bother too much with mental health these days.”

If you are in good health, comfortably off, perhaps with some kind of private health provision, you may think, “Well, what the hell has this got to do with me?” You may be like Rishi Sunak who, until recently, paid for the use of a private GP rather than bothering with the NHS. Worth nearly three quarters of a billion quid, why wouldn’t you? Well, I wouldn’t, under any circumstances, but I hope you get the drift. But here’s the thing. The private health sector – or those parasites and vultures who exist in order to make money from people’s medical conditions: ugh – might do your new knee, or help with some physio, but if you have a massive stroke or develop cancer, they might not be quite so keen to see you. The coming election will give us a straight choice between the types of health provision we want. It’s one or the other.

The choice is between a properly resourced service, free at the point of provision. An NHS, funded by all of us collectively through taxation or a US style private system, one in which unless you are wealthy you get ill at your peril, literally. The Labour Party created the NHS despite massive opposition from the then Tory leader Winston Churchill and, I would argue, every Tory leader since. A vote for the Conservatives or, especially, the hard right Reform UK, a business posing as a political party, is a vote to further run down and eventually collapse the NHS. Many of us who have had dealings with the NHS in the last decade or so will know this to be true.

One thing for sure is that we cannot go on like this. And that’s where the choice comes in. Do we elect a government to end the NHS waiting lists – currently eight million and rising – or do we just hand the whole thing over to private businesses?  It’s hard to get exact figures of how much exactly it would cost here’s a very general example from the USA which I’ve cribbed from CNN:

Individuals enrolled in group health plans paid an average annual premium of $8,435 in 2023 (about $703 per month), according to data from independent health and medical research firm KFF. For families, the total annual premium averaged at $23,968 — or about $1,997 per month.”

Obviously, these figures are in dollars and the pound figures would be slightly lower – it’s currently $1.28 to the pound – but it’s still a hefty wedge. Americans pay less in tax than we do, not least because they don’t have an NHS, so if the NHS was scrapped we’d have more cash in our pockets, before paying our health insurance premiums. I’d imagine those of us who take all manner of medication, or use health care a great deal, could end up paying far more, but that’s the deal with full fat private health care. It’s free at the point of delivery or it isn’t.

However, I’d like to see the health service restored to something closer to how it was originally intended to be. In Scotland and Wales, prescriptions are free. Actually, they are free in England – oh yes, they are – but here we pay a prescription tax of £9.90 an item, all of which goes into the tax pot. So I’d abolish the prescription tax. I’d reintroduce free NHS dentistry, too. How would I pay for this? By increasing tax a little bit, that’s how I’d do it. I’d increase taxes to make our NHS the world class service is should be. No major political party is offering this option and of course I understand why, what with the Conservatives having crashed the economy under Liz Truss and now under Rishi Sunak’s chaotic ‘leadership’, and I know we have to restore the economy. This last paragraph has been about me increasing your taxes a bit and why. Sadly, you can’t vote for me!

We the people will choose the direction of the country for the next five years, as we chose (well I didn’t choose) to elect the Conservatives in 2010 (a austerity heavy Tory government in which some Lib Dems took jobs), 2015, 2017 (despite Theresa May running the worst election campaign in history) and 2019, which gave us Boris Johnson, Liz Truss and now the wretched Rishi Sunak. 14 long years of destruction and decay, built on lies and half-truths, government by gaslighting and trolling.

Only Labour and, to be fair to them, the Liberal Democrats are committed to a strong, fully-funded NHS, with waiting lists being axed within five years, so voting on 4th July couldn’t be simpler. In every constituency in the land, vote for whoever of Labour or the Lib Dems has the best chance of winning. Quite apart from being infiltrated by hard left Corbynista cranks, a vote for the middle class luvvies of the Green Party is a wasted vote. A vote for the Conservatives or Reform is a vote either for more of the same or probably much worse.

The 2024 general election isn’t just about the NHS but the only way of guaranteeing the future of the NHS is by voting as suggested above.

I once heard a story, probably apocryphal, where a man collapsed on an American street clutching his chest. Paramedics arrived and opened his jacket. A passer-by asked, “Are you looking for his pulse?” “No”, replied the paramedic. ‘I’m trying to find his credit card.”

20% of all Americans are in medical debt, around 40% of bankruptcies are due to medical bills, which works out at around 500,000 people going bust every year. “It could never happen here!” Do you want a bet? Just about everything else American ends up over here. I don’t bet because you lose in the end. I won’t bet with our NHS, either.

 

 

 

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