Choice – you can’t be serious?


Do you really believe you have a choice? Come on, think. Everything has limits and choice is only there as far as what can be provided and your ability to access it. Let’s think of health. In the UK, we have the NHS. It was established as a service to be free at the point of use. The idea was to ensure everyone had access to basic healthcare without the barrier of payment. In the 1940s this was admirable and the film by Ken Loach highlights the sentiment of what the NHS stood and this we need to remember.

Is the NHS fit for purpose in the 21st Century? The variety of services that are provided for mental and physical health have expanded, because as a nation we have become healthier and live longer. The types of illnesses are more complicated. This increases the cost and the demand also increases. It is a circle of increasing need. Medical staff are improving their ability to deal with illness and disease, and I presume this provides a sense of job satisfaction. The staff at the top of the hierarchy are well paid earning salaries around the £100,000 mark. However, what about the lower paid staff, who are these people? The nurses, care workers and cleaners are at the bottom of the hierarchy. They are on paid much lower salaries and also their terms and conditions are worse. For example, care workers are on zero hours contract, with low wages. This was recently highlighted on the Channel 4 news and blogged about . Fiona Phillips has recently proposed the idea of professionalising the role of carer to improve pay and working terms and conditions. She workers with the Dementia Society, as she was effected by the system when both her mother and father died from the disease. Do these low paid carers have a choice in this system?

What other stakeholders are there in the NHS? Us as taxpayers and as patients. Today the language has changed patients are described as consumers in a lot of literature and there is an offer of choice. However, is this a real market? Can a patient walk away from a treatment? Yes sometimes if the disease is not too serious. However, it comes back to the hierarchy of need. If the disease/illness/condition is life threatening then you have no choice. You must trust the health professional will provide care. There have been stories of care not being provided. For example, food and water not provided, people left in their own excrement because of overflowing bed pans. What is happening?

Health professionals can you provide an answer, is it because of your remuneration? Is it because you are not being treated with respect?

How do we create a functioning health service for health professionals, patients and taxpayers?