Monday, 20 June 2011

The Spruce Goose theory of healthcare.

There have been many theories about flying and most of those that get off the ground do actually work. Some do not and they cost lives. The same applies to healthcare and theories that relate to it.

Politicians love to grandstand and while they cannot control such popular favourites as Manchester United they can tinker with the NHS and, with no experience of it except perhaps as patients, bugger it up some more every five or so years via the process called reform. You would think that with all the political reform the NHS would be something akin to a SR-71 or Concorde both planes developed in the 1960s but not bettered even today. They even flew and cost less than the huge failure that is the non-functioning NHS IT system.

For most people the NHS is a workhorse like the Boeing 747. Not exactly what all those who expect 5 star hotel service would want but it gets most people to their destination for example to Florida and back for less than we pay a GP a week.

The advantage of political power is that with it comes wealth albeit in the form of the taxpayers’ hard earned pounds. In the same way that Howard Hughes had wealth and therefore power he could build a monsterous aircraft called the Spruce Goose which flew only once. Politicians feel they can do the same without the benefit of a pilot’s licence or a mandate for their new reforms.

For the last 20 years politicians of all Parties have been building the Spruce Goose of NHS healthcare aka commissioning and the internal market. It is a monsterous beasty (beaurocracy) that will not fly (or deliver healthcare any better or cheaper) but because all of the political pilots think it is a good idea it must be capable of flying for it is a basic concept of aviation that that the more lift (spin) you have the higher you will fly?

Politicians deal with grand ideas while the aviation industry usually tries to get an aircraft from A to B in one piece at an affordable cost and with a close on a 100% success rate. Doctors usually try to do something similar with patients. We in medicine accept that we do not have a 100% cure rate. In politics anything less than a 100% record is clearly the result of “inefficiencies” that only politicians see hence the need for “reform”.

The NHS has traditionally used the 747 approach cheap reasonably comfortable but consistant unlike the Freddie Laker approach to healthcare that politicians of all persuasions seem to favour at present.

The analogy of aviation may be wasted on some but why after 20 years of costly failure are the 3 main main political parties in alphabetical order the Con Dems and Za Nu Labour trying to shaft the British public into a Spruce Goose as opposed to maintaining a tried and tested 747?

The Spuce Goose only just flew once. Most of the electorate have surpassed that limited expensive triumph via the 747 of healthcare. The same basic model has been updated by Boeing over the years in the same way that medicine updates itself but from the passengers the outside looks essentially the same and it still flies. There are a few changes that some might note like new engines or TV screens in the back of seats rather than cinema style screens but what the patient sees is the NHS 747. They are not looking for Spruce Gooses when they look for healthcare.

How come the politicians of 3 supposedly independent parties are trying to lift the long dead Goose out of the water as opposed to getting a reasonably priced 747 bird to continue to fly? One is expensive and wasteful folly the other just keeps on going with minimal cheap maintence. How come all three political parties are trying to be Howard Hughes in a time of recession?

Praise be the the Party for realizing what we do not that one Spruce Goose with one flight of fancy will care for so many more patients than 40+ years of 747s which fly daily.

The NHS works – without politicians – keep them out of the cockpit and keep the 747s flying. They get you there without the commissioning and internal market crap. The new revised revised revised revised Spruce Goose of healthcare which has just recovered from a near fatal stall is still trying to lift off, for how much longer will it continue to do so before it is confined to history?