Partha Kar

Consultants are defending the NHS and their contract for the right reasons

How would it actually affect consultants if the NHS ceased to exist?

Let’s say the funding challenges become too much and the NHS moves to a 2-tier system. There’s a basic NHS services that everyone can access, and an NHS Plus which can only be accessed via co-payments or top ups.

The very concept makes many froth at the mouth and their hearts churn but anyone worth their salt knows we are in a situation which is nearly irrecoverable.

The money doesn’t stack up anymore. You may not agree with that but there is also the minor issue of the electorate mandate.

The evangelism of a few, however right at the present, will ironically supply the ammunition to break the back of the NHS finances. How will history judge them? Time will tell.

Today’s patient safety advocates have opted to go for the issues of patient safety first, ask for resources later.

The news regarding NICE’s U-turn on safe staffing levels for emergency departments should come as no surprise – the money simply doesn’t stack up.

Should money matter when patient safety is at hand? Ah, but it does – just ask any trust or CCG finance director. To fund X, they have to cut Y.

To YOU patient safety maybe paramount, but to someone else – say having psychology support for their diabetes patients – may be of a higher priority. In footballing terms, to aspire to win the Champions League is laudable but you need the resources of Barcelona to achieve it. Just talent and willpower on their own rarely cuts it.

So, how would the demise of the NHS as we know it affect those recent pantomime villains called the doctors? Free from the “trappings” of a publicly funded structure or the dreaded efficiency drives, only one thing suffers – healthcare for all irrespective of ability to pay. Doctors would be fine.

So, it is with an incredible dose of irony that doctors trying to resist the slide of the NHS are being cast as the villians. Salaries and perks would get better under a non-tax payer funded system. Their voices could just be about the strongest force trying to raise a united voice against the inexorable slide at hand.

The doctors with entrepreneurial skills would flourish. In an open market, their skills will be unbounded, unfettered. No longer would it be about treaing everyone equally, it would become how much you can earn.

If that sounds like blasphemy, do pay a visit to other countries where concept of ‘free healthcare’ is met with raised eyebrows and genuine surprise.

Some will struggle in isolation, opting to stay true to their ethos of “help others at all costs”, while the majority will fall in line with the new two tier NHS. That’s life, making sure your own family is provided for.

That’s exactly what has happened or is happening in other countries, and the UK will be no different.

I also appreciate that many would believe this to be morally wrong.

However when I raised that argument with a Mexican doctor a few days back, his response was curt, waspish but perhaps true too: “A country which has spent centuries plundering other countries maybe shouldn’t lecture others on morality.” All about your viewpoint, isn’t it?

We need some semblance of unity amongst doctors for starters. Too many divisions exists – on lines of what we do, what CEA awards we have, whether we do private practice or not. Maybe it’s time to try and get a united voice. Then it’s a bigger gathering of like minded voices and that’s everyone who firmly wants the NHS to survive as it is.

Let your passion to improve the present not destroy the future, let your own prejudices towards your colleagues not hamper a united voice. For tomorrow, if the system changes, it’s not the doctors who will suffer – it will be folks not born with the fortune or luck to be able to afford to pay for healthcare.

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One Response to “Consultants are defending the NHS and their contract for the right reasons”

  1. angshub says:

    I completely agree, Partha.
    It is also worth considering that Mr Hunt actions seem to be leading us very deliberately towards such a path (i.e. towards a two tier health service and higher pay for entrepreneurial doctors) This makes me wonder it he does not really have anything against doctors as such; only against NHS doctors and the NHS as a whole.

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