Friday, 20 August 2010

Rights and choices.

If you are a GP in the UK you will after a few years begin to recognize that patients will insist on their “rights”. If you are a GP, and especially one with an interest in matters legal, you rapidly recognize that these “rights” are not legal rights they are in fact patient demands.

Although we live in the most affluent and educated parts of Northernshire these “rights” are still demanded often on a daily basis.

One of the most common rights is the “right to have a baby”. This is often from a 20 year old drug addict covered in tattoos with a catalogue of STDs and numerous social and criminal problems. Because of her age and circumstances she is “entitled” under the local Soviet’s protocols for reproduction aka socialized medicine, to have full investigation and 2 cycles of IVF in order to fulfil her wish for a child.

Now “rights” should be universal but consider a middle class professional couple who met late in life and decided they wanted a family when they felt financially secure. Because they are “too old” they do not have the same universal “rights” as the first patient.

There is a difference between patient perceived “rights”, and what is medically appropriate for individual patients and what the Party feels its people are entitled to.

The People feel everything is their right, however medically inappropriate or unnecessary, the doctor often feels that certain requests are medically justified but ultimately the State is the final arbiter.

The patient is the “consumer” in that they ultimately pay the bill but, although Government likes the idea of “free markets”, it nonetheless exerts market control in healthcare via the Party and its local organs.

Can the current Government allow a “free market” in healthcare to succeed in a recession?

We think that the devolution of commissioning is perhaps the biggest restriction of “customer” choice in the history of the NHS. Yet it could be one of the biggest potential liberators of the “customer”.

And who will ultimately restrict the “choice”? Not the Government, now, but the evil GPs.

For it will be GP consortia, rather than the State, that will commission local services.

But will the State allow a free market for local GP consortia?

We doubt it for we suspect that as we write this there will be Whitehall mandarins writing pages and pages of rules as to what can, or cannot, be provided by the NHS internal “market”.

So despite pledges of increasing individual freedoms the new Party will be busy restricting the freedoms of individuals in healthcare via its new organs of control the GP consortia.

Praise be to the Party for allowing the “customer” “free market” choice. The question is how much choice will cost, how much can be afforded and how much will be allowed?

We like “free markets” here at ND Central. Things can only get a) better or b) worse.

1 comment:

Muhammad Shoaib said...

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