Monday, 5 January 2009

NHS General Practice, vets and Darzi centres too

There is a popular myth that if the NHS did not exist and if it were not free at the point of service then the whole population would die a hideous death from undiagnosed and treated illness.

We know this is true as every other nation in the world is swamped with death due to a lack of free healthcare but amazingly “suffers” with better health care systems than the NHS which is dropping year on year in the international rankings.

One of the ND team did have need to consult with a veterinary surgeon this weekend and despite this nation being a nation of dog lovers were amazed to discover that you had to pay to see a vet. Surely not?

Now ND does not disrespect vets as some of the team trained with them and by enlarge they are slightly more intelligent than Drs. What really p**d ND of was the fact that the cost of the consultation was cheaper than an NHS Direct phone call.

Granted the person to whom we spoke was a qualified vet, who took the trouble to listen to us, to examine the dog, the patient, and even more amazingly, we were not sent to A&E or our GP and a computer was not consulted to make the diagnosis.

The appointment system ran at 10 minute intervals throughout the day, a Saturday, and we only had to wait an hour and twenty minutes to get an appointment. In the 20 minutes we were there in the waiting room they took £200 from the paying punters who by and large were happy to part with their cash.

This was a well organized practice who had managed to provide a 10 minute appointment system without a government diktat. It is also a teaching practice.

Whilst the idea of paying for healthcare is heresy in the UK if you want to reduce waits to see a doctor then the idea of a charge for A&E attendance or to see a GP we suspect would reduce waits of weeks down to days or even hours. The thought of having to part with some cash to be told you have a cold or a sore throat, that will get better on its own would, we suspect, put most of the punters off wasting Drs time after a few attendances with life threatening or “emergency” consultations that are not treated but do cost (the taxpayer at present).

Whilst doctors cannot treat animals we believe that vets are able to treat humans. So if you want to be seen quickly by a qualified person you might consider seeing a vet rather than a phone call to NHS Direct. It will be cheaper and you will probably get more out of it although you will have to pay out of your own pocket rather than out of your taxes.

The Party thinks that the private sector (the vets, rather than the GPs) can do things better and they can but, and, there is always a but, in this case a huge but, the public will have to pay for it some how. The apparent move to Darzi centres being provided (possibly and mostly) by private providers will cost us all but not at the point of use which is OK to Joe “the plumber who charges for their service (and it will cost) but expects his health care for free” Public.

Some figures seen by the team on their travels suggest that the cost of a “Darzi” centre could be between £ 900,000 to £ 2 million a year to provide a 3 doctor practice as against a £ 1.2 million a year to provide a “normal” current NHS 8 doctor practice in the same area.

Of course like the vets the Darzi centres will be privately run and like some veterinary practices these are staffed by salaried vets in training who do not earn as much as their owners who will cream off the profits. So if there is a fixed pot to run a Darzi centre you can see what will happen. Staffed by cheap salaried doctors with happy rich owners.

Quality is said to cost. Crap also costs. Will Darzi centres provide the same quality as good vets do?

These are being applied equally across the country regardless of need so may provide a degree of catch up in providing extra doctors in areas of need (if they can be recreated to work in these areas) while providing more doctors in already well doctored (popular areas for GPs to work in) regions. Some may be of use but others will be hugely expensive white elephants unless you are the owner of a Darzi practice. These white elephants will be funded for 5 years and properly earn their owners millions in the process.

Of course there may be large capital start up costs for premises etc but we at ND do wonder if the move towards privatization is actually going to cost more than it can ever save. The team at ND know that if we were greedy then providing less than half the service we do at the moment at twice the costs would mean we could each earn more than the £250,000 that all Northern Docs’ do already (not) earn. And we would have to do none of the medical work to earn these sums the salaried vets would do it all for us!

Praise be to Lord Darzi for helping “improve” primary care and to the Party but at what cost to Joe “the Plumber who charges for their service (and it will cost) but expects his health care for free” Public?

Time will tell if it will be as successful as the Independent Sector Treatment Centers have been.

No comments: