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We won't need a PC World NHS if more of us go private We won't need a PC World NHS if more of us go private
(about 2 months later)
If you have ever queued up at the helpdesk of an electrical superstore with a broken laptop, you will not be totally convinced by the declaration of Britain's top doctor that the National Health Service should become more like PC World.If you have ever queued up at the helpdesk of an electrical superstore with a broken laptop, you will not be totally convinced by the declaration of Britain's top doctor that the National Health Service should become more like PC World.
Sir Bruce Keogh, medical director of the NHS, has said that the organisation should copy high-volume retailers such as the Dixons chain, which manages to drive down prices while churning out ever-more sophisticated products for a mass market. Although I am firmly in the camp that says that the NHS must change or perish, and I do believe the private sector has a role to play in healthcare provision, I'm always uneasy when retail giants are held up as exemplars of customer satisfaction.Sir Bruce Keogh, medical director of the NHS, has said that the organisation should copy high-volume retailers such as the Dixons chain, which manages to drive down prices while churning out ever-more sophisticated products for a mass market. Although I am firmly in the camp that says that the NHS must change or perish, and I do believe the private sector has a role to play in healthcare provision, I'm always uneasy when retail giants are held up as exemplars of customer satisfaction.
Let us consider PC World and Dixons, for a start, seeing as that is the example Sir Bruce singled out in an interview this week. On a good day, when the queue is not very long, and the staff happen to be in a good mood, you will receive excellent service at these outlets. At the Knowhow desk, your computer might well be fixed within minutes by cheerful boffins in smart uniforms.Let us consider PC World and Dixons, for a start, seeing as that is the example Sir Bruce singled out in an interview this week. On a good day, when the queue is not very long, and the staff happen to be in a good mood, you will receive excellent service at these outlets. At the Knowhow desk, your computer might well be fixed within minutes by cheerful boffins in smart uniforms.
On a bad day, when there are dozens of flustered, angry customers panicking about lost data, and when the staff appear to have all gone on a break, or become monosyllabic and rude, it really wouldn't cross your mind that if the NHS were more like this, you would happily leave your granny here to have her cataracts done.On a bad day, when there are dozens of flustered, angry customers panicking about lost data, and when the staff appear to have all gone on a break, or become monosyllabic and rude, it really wouldn't cross your mind that if the NHS were more like this, you would happily leave your granny here to have her cataracts done.
To say that the NHS should be like PC World on a good day is fair enough. But you need to look at what happens in the private sector on a bad day and then ask yourself if you want to model the health service on sulky cashiers, disappearing branches and Kafkaesque 0800 numbers (the new NHS 111 line is a case in point).To say that the NHS should be like PC World on a good day is fair enough. But you need to look at what happens in the private sector on a bad day and then ask yourself if you want to model the health service on sulky cashiers, disappearing branches and Kafkaesque 0800 numbers (the new NHS 111 line is a case in point).
It is incontrovertibly true that increasing numbers of us have come up against unfeeling bureaucracy in the health service. Presenting at my local accident and emergency department once with my palms covered in blisters, I was told to go home because "dermatology is not an emergency at weekends".It is incontrovertibly true that increasing numbers of us have come up against unfeeling bureaucracy in the health service. Presenting at my local accident and emergency department once with my palms covered in blisters, I was told to go home because "dermatology is not an emergency at weekends".
But sometimes, the sensitivity you receive from the privatised utility companies is no better. In that sector we were told that competition would drive down gas and electricity prices, putting the customer in charge. The reality is that the big energy firms appear to have found a way to stick together so you cannot seem to shave a pound off your bill, no matter how much you switch provider. One wonders if the "branches" of a privatised NHS would find a similar way to collude to ensure they all churned out exactly the same bad service at the same high cost.But sometimes, the sensitivity you receive from the privatised utility companies is no better. In that sector we were told that competition would drive down gas and electricity prices, putting the customer in charge. The reality is that the big energy firms appear to have found a way to stick together so you cannot seem to shave a pound off your bill, no matter how much you switch provider. One wonders if the "branches" of a privatised NHS would find a similar way to collude to ensure they all churned out exactly the same bad service at the same high cost.
Perhaps we should ask how the founders of the NHS would respond to the fact that the service has deteriorated to a point where making it "more like PC World" seems, to its current director, a reasonable ambition. Certainly, the original aims of the Beveridge report make fascinating reading in the current context of a worsening service under increasing strain.Perhaps we should ask how the founders of the NHS would respond to the fact that the service has deteriorated to a point where making it "more like PC World" seems, to its current director, a reasonable ambition. Certainly, the original aims of the Beveridge report make fascinating reading in the current context of a worsening service under increasing strain.
Sir William Beveridge said that: "The state, in organising security, should not stifle incentive, opportunity, responsibility; in establishing a national minimum, it should leave room and encouragement for voluntary action by each individual to provide more than that minimum for himself and his family." Specifically, he felt that state provision should not take the burden off personal insurance.Sir William Beveridge said that: "The state, in organising security, should not stifle incentive, opportunity, responsibility; in establishing a national minimum, it should leave room and encouragement for voluntary action by each individual to provide more than that minimum for himself and his family." Specifically, he felt that state provision should not take the burden off personal insurance.
In other words, you could argue that those of us who pay for private medical care are the ones being true to the original aims of Beveridge, while those who say we are undermining the NHS by "running it down", are the ones who are missing the point. Those who aspire to instant, tailor-made or niche medical services – the ultimate in consumer care – should be congratulated for paying for them and taking the weight off the state system.In other words, you could argue that those of us who pay for private medical care are the ones being true to the original aims of Beveridge, while those who say we are undermining the NHS by "running it down", are the ones who are missing the point. Those who aspire to instant, tailor-made or niche medical services – the ultimate in consumer care – should be congratulated for paying for them and taking the weight off the state system.
The notion that we must all be cured alongside each other, just as we must be educated in comprehensive harmony, for the sake of national cohesion, is ludicrous. And while I used to think there was an argument for a "comprehensive" health system because demanding middle-class patients would drive up standards, that clearly hasn't happened.The notion that we must all be cured alongside each other, just as we must be educated in comprehensive harmony, for the sake of national cohesion, is ludicrous. And while I used to think there was an argument for a "comprehensive" health system because demanding middle-class patients would drive up standards, that clearly hasn't happened.
When the welfare state was founded, benefits were meant to be of "subsistence" level and free healthcare was meant to save your life. The idea was that the NHS provided a good, basic service which individuals "may build upon". One suspects that if Beveridge were addressing today's situation, he would try to find polite words to say that if you want a tattoo removed, a gastric band or a second child but you've left it too late, then you are going to have to get your head around the idea of contributing to the costs. And he would congratulate those responsible enough to set aside their hard-earned money to make provision for themselves.When the welfare state was founded, benefits were meant to be of "subsistence" level and free healthcare was meant to save your life. The idea was that the NHS provided a good, basic service which individuals "may build upon". One suspects that if Beveridge were addressing today's situation, he would try to find polite words to say that if you want a tattoo removed, a gastric band or a second child but you've left it too late, then you are going to have to get your head around the idea of contributing to the costs. And he would congratulate those responsible enough to set aside their hard-earned money to make provision for themselves.
Private healthcare should be as valid an aspiration as wanting a car so you don't have to rely on public transport. To encourage more such aspiration, there should be tax relief on private medical insurance. We should incentivise those who want instant referrals to fit in with their work schedule, fancy add-ons like cosmetic surgery, or the latest fertility techniques, to aspire to provide it for themselves.Private healthcare should be as valid an aspiration as wanting a car so you don't have to rely on public transport. To encourage more such aspiration, there should be tax relief on private medical insurance. We should incentivise those who want instant referrals to fit in with their work schedule, fancy add-ons like cosmetic surgery, or the latest fertility techniques, to aspire to provide it for themselves.
After all, if we reduced demand on the NHS, we might find there would be no need to turn it into Healthcare World.After all, if we reduced demand on the NHS, we might find there would be no need to turn it into Healthcare World.
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