AA ray of light lasts on the NHS horizon. Labor Shadow Health Secretary, Wes Streeting, clearly hurt by his brush with cancer two years ago, has realized that the problem with the NHS is not just one of cash but of structure. Above all, it lies in the costs and delays of an archaic network of occupational demarcations that seize clinics and hospitals alike.
The pure and heavy immensity of the National Health Service has sent you sliding down the global health services league table. With a third of GPs about to resign and many hospitals in war mode, services are failing and the rich are fleeing to the private sector.
In a remarkable interview in the Times, Streeting shows why Britain’s cancer survival rate is so low. It took him three appointments to get a simple test done. Millions of patients who are denied a GP appointment within a month (cost: £39 per visit) are crowding A&E departments in general hospitals (cost: £359 per visit). There, young doctors can spend 45% of their working day in bureaucracy, also crippled by the failure of a privatized social (and mental) care sector.
For Streeting, health has become “an exasperating merry-go-round” of job creation, selection and waste of time. The reason is the plethora of barriers to patient self-help, with GPs acting as gatekeepers to all referrals. Meanwhile, patients should know that the wealthy and insured benefit from a booming private sector, much of its capacity often unused.
Despite spending billions on digitization, the NHS is in the dark age of the internet, as we saw during Covid. Patients are much better informed about self-diagnosis. There will be exceptions, but the Internet can often guide people to tests, pharmacies, and treatment centers without laborious referrals.
The work, Streeting says, would turn doctors’ offices into health centers. Doctors would no longer rule the roost: GP “partners” now win an average of £109,000 a year. Doctors would revert to salaried NHS employees, working alongside nurses, therapists and technicians, and handling the vast majority of health cases that do not require a hospital visit. The British Medical Association might scream, but patients should be able to refer themselves for check-ups and vaccinations, and seek advice and medication from pharmacists.
Although Streeting doesn’t mention it, there’s no reason why some services shouldn’t be paid for by those who can afford it, as prescriptions already are. This could help blur the line between public and private care. Just as private schools are expected to share facilities with state schools, so should private doctors.
Two Conservative health secretaries, Sajid Javid and Steve Barclay, have hinted that money is no longer the answer. Streeting has now joined them. All agree that an outmoded corporatist model for the nation’s health is no longer adequate for modern purposes. This must indicate an urgent need for bipartisan action on NHS reform.
