Anton Joseph

Health inequalities: time to park the Health Bill

Unless you’ve been hiding under the duvet for the last 18 months, you must be aware of the furore over the Health Bill, which has received a new battering this week from the Health Select Committee.

As a GP friend pointed out during a commissioning meeting, we work in an inner-city area where most residents take home less than the UK median wage (£23,000), and so, under the proposed system,  probably won’t be buying health insurance or ‘top ups‘, or whatever this will be called when the GP commissioners run out of money and decide that they can’t afford to fund procedure X or Y on the NHS. And that therefore if you require an X- or Y-plasty you will have to find alternative funding or just put up with it.

So poverty (or, at least, being unable to afford health insurance) and illness is going to be a bad combination – but if you’re a healthy doctor in the top 5% wage bracket and able to ‘work’ the health system, do you care?

Some do. NHSCA chair Dr Clive Peedell ran six back-to-back marathons this month to draw attention to the dismantling of universal healthcare – that’s what I call putting ‘skin in the game’.

Others, though, are less sympathetic, and take the view that the poor have only themselves to blame. Apparently they should have bothered to get themselves a good education when they were younger, and then they wouldn’t be in this mess. This was my second interesting discussion this week, and came on the back of complaints about our graduated car park charges, whereby a consultant on £90K has to pay about £15 a month more than a support worker on £18K.

“We don’t have to pay more for a pint of milk at Tesco just because we earn more.”  The Tesco argument is one which I’ve heard before, so this is not an isolated view.

I’m no saint when it comes to compassion – I don’t even  buy the Big Issue every week – but where do I start? For one thing, the comparison doesn’t work because, of course, poor people probably do pay less for a pint of milk at Tesco –  they simply avoid the organic or decent locally farmed stuff. Hospital car park charges are quite substantial (I pay over £30 monthly) and a significant burden for low paid workers taking home less than £1,000. Even means tested, it’s still a helluva lot more, proportionately, for them than for us.

My concern with this is that it’s a small step from saying it’s OK to price our poorly paid colleagues out of the car park, to saying that poor people don’t  deserve the same healthcare, because  they obviously didn’t try hard enough at school.

How appropriate that in the bicentenary of Dickens’ birth, we should be hearing about the undeserving poor. Doctors have traditionally stood up for the poor and the sick. As well as getting angry about the theft of our pension funds, we should all be striving to preserve the NHS as a good, universal service for all – even for those who didn’t manage 10 GCSE’s. Please sent an email to your Royal College president asking them to support dropping the Health and Social Care Bill.

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