How To Cure The NHS In One Day

Vernon Coleman

Thanks to a lethal mixture of lawyers, bureaucrats and politicians Britain's out of hours medical service is now virtually non-existent. It's as bad as the NHS dental service has been for years.

The NHS has been moribund for years; kept alive by the hard work of a relatively small number of genuinely caring staff and by the hopes of millions of trusting patients. But it's now worse than ever. The NHS is dangerous to your health.

The real scandal is that everything that is wrong with the NHS could be cured within hours. Given complete authority for just one day I could eradicate everything which has damaged the quality of health care in Britain.

Throwing money at the NHS won't solve any of its problems. The sick joke is that the NHS already has too much money. What it lacks is leadership. No one in charge seems to know how money and resources should be spent.

Here's what needs to be done:

1. GPs were offered the chance to hand over all their out of hours work to agencies because of EU laws limiting their working hours. The whole traditional basis of general practice is that the family doctor takes full 365 day a year responsibility for his patients. Without that role, GPs have no purpose and could best be replaced by a combination of walk-in clinics (staffed 24 hours a day) and an enhanced ambulance service. But I'd prefer to see GPs brought back into the NHS. They should, however, be given the authority to go with the responsibility.

Solution: Reintroduce 365 day a year, 24 hours a day GP contracts. Fire any GP who doesn't want to sign up.

2. NHS care and private care need to be separated. At the moment NHS consultants are allowed to boost their income by seeing private patients. And NHS hospitals can boost their income by allowing patients who can afford to pay to jump the queues for tests or surgery. NHS consultants, using NHS equipment and staff, earn thousands, while waiting lists for patients who can't afford to pay extra just get longer. Administrators support this abuse because their hospitals are so bloated with expensive bureaucrats that they need the private fees too.

Solution: Ban NHS consultants from doing private work. Ban NHS hospitals from charging patients for tests or treatment.

3. The NHS has become a bonanza for bureaucrats. There are more administrators than nurses or hospital beds. More than 60% of NHS employees are pen pushers. I recently attended a hospital meeting to discuss my 84-year-old mother's health. There were nine people at the meeting. One of them was a doctor. Eight were administrators. The NHS is being destroyed by administrators. In many NHS institutions there are now more bureaucrats than cockroaches. It will, however, be easier to cut down the number of bureaucrats. When I first qualified in medicine, decent sized hospitals were run (very well) by a matron, a hospital secretary, two typists and as many ward clerks as there were wards.

Solution: Sack 90% of NHS administrators. It probably doesn't matter which 90%.

4. The NHS is laden with committees, advisors and quangos. There are thousands of them. The bill for their tea and biscuits alone would pay for a few thousand more nurses. Any business which tried to cope with the input from so many amateurs would be a disaster.

Solution: Get rid of all the committees. Let the people who get paid take all the responsibility.

5. When the NHS buys loo rolls and envelopes it pays more for them than you or I would pay at our local supermarket. When I exposed this a few years ago the NHS immediately set up an inquiry - into how I found out.

Solution: Hire central buyers for all NHS purchases. Sack them all if they pay more for anything than the price in Tesco.

6. It is absurd that NHS money is spent on providing couples with fertility treatment, women with breast enlargement operations or transsexuals with life changing surgery while thousands of patients are dying because they have to wait weeks for essential, simple diagnostic X-rays. In military hospital units doctors operate a simple but effective system whereby those whose need is greatest get seen first. Similarly, the NHS has to get its priorities straight.

Solution: Life saving comes first. Life enhancing should come second.

7. As many people have found, the NHS complaints system is designed to protect members of staff rather than offer apologies or justice to justifiably aggrieved patients. NHS complaints should, from the start, be investigated by entirely independent experts.

Solution: There are thousands of retired doctors and nurses who could do this job brilliantly well.

None of these problems are difficult to cure. All of them could be permanently solved in hours.

But, for pretty obvious reasons, no one working for the NHS is going to recommend any of the obvious solutions. And, without knowing they've got public support, politicians aren't likely to do any of these things either.

If you think these proposals make sense send this page today to your local MP, demanding that he ask the Government to take action immediately. And ask friends to read this page. Only when people know what's wrong - and how easy it is to put things right - will anything change.

Every year, hundreds of thousands of people die because the NHS is a mess. If we don't act the NHS will continue to deteriorate. Things are bad enough today. But they will get much, much worse. You, or a loved one, could be the next one to die unnecessarily.

We need to do what needs to be done now. Tomorrow just isn't soon enough.

Copyright Vernon Coleman 2006

Vernon Coleman's books include the international bestseller How To Stop Your Doctor Killing You.