So as the Con/Dems continue their march towards entirely privatising the NHS whilst proclaiming loudly that having private companies run big chunks of the NHS is entirely different to privatisation, because it’s still free at the point of use (leaving ‘at the moment’ left distinctly unsaid), I was struck by a brief thought.
When people complain about an experience in private health systems, they tend to say “This doctor (or doctor’s surgery) sucks”, or “this insurance company will rip you off” or “this hospital’s terrible”. The difference I see with the NHS is that people tend to generalise. A bad experience leads to “The NHS is terrible”, and a good one to “The NHS is the best thing ever”. And it’s neither. The NHS is, I think, a fantastic thing. It’s not a perfect thing, not by any means. It’s clunky, and overrun by a plague of managers (bonus points to the Con/Dems for making that vastly worse). It’s bureaucratic, often not even vaguely ‘patient centred’ and sometimes slow to respond to changing demographics or demands.
But it’s a thing with a really good core, and a, and corny I know this sounds, a wonderful core principle. That healthcare should be available to everyone regardless of their ability to pay.
But despite all being one ‘thing’, each hospital has reinvented the wheel so many times. In my agency nurse I see everything from the great to the terrible. I see hospitals where I would take myself and I see places I wouldn’t take a dead dog. I see places that are organised beautifully, and trusts who couldn’t organise the proverbial piss-up. But every place I go, people assume that every other hospital is the same, because people don’t really understand how independent each hospital is. How targets and procedures are tweaked. How the management of each site is completely different.
The NHS is an incredible thing as a whole, but if you have the misfortune to be near a crap GP with a less than great hospital then your only experiences will be terrible; thus the opinion that the NHS sucks. And worse most people won’t change their GP (even if they do suck, unless they really royally upset them), so they just get lousy experiences repeatedly. All of this is incredibly difficult to get over – really the only way is to drag these underperformers up, but I’ve no idea how you do that without throwing money at the problem.
Meh.
