In 1948, the NHS was born out of the noble ideal that no one should be denied treatment because of their inability to pay for it.
Since then times have changed. The society we live in is very different from that of 1948; we have all become more prosperous (though there is still poverty) and enjoy a far higher standard of living. The NHS, too, has changed; there are many treatments available now that could not have been dreamed of in 1948 – they are effective but expensive!
But there has been a basic problem with the NHS since its birth – demand exceeds supply. This became apparent very soon after its inception and led to the breach of one of its ‘founding principles’ – that it should be “free at the point of delivery” – with the introduction, in 1952, of prescription charges and charges for dentistry and spectacles.
With the increase in population (partly due to increased longevity) and the increase in available treatments (which has accelerated in recent years) the imbalance between demand and supply has widened – in spite of ‘increased resources’ put into it over the years.
If the problem is ‘demand exceeds supply’; there are only two possible solutions – decrease demand or increase supply. Both of these are unpalatable to politicians!
However, these are political (not medical) decisions – and politicians must be encouraged to make them. Some members of the public are beginning to debate the problems. It is the duty of the profession to make sure the debate is ‘informed’ by putting forward the ‘pros and cons’ of the alternatives; and I believe the HCSA can take the lead.
Of one thing I am certain; no doctor, politician or member of the public would wish to go back to the ‘bad old (pre-NHS) days’ when patients “couldn’t afford to see the doctor”.
Read the full article by Malcolm Morrison here.