There are many who see the NHS as a shining example for the rest of the world. It is free at the point of access, a phrase that tells you that nothing is free but at least the recipient doesn't pay. However many decisions seem to be based on finance rather than patient care. My grandmother told me how the local community collected money to build a local hospital. Shortly after the hospital opened it was taken over by the NHS and years later it was closed because it wasn't efficient (she didn't get her money back).
Hospitals need to be large to be efficient. Similarly G.P. surgeries have to be larger and share facilities with other surgeries. On-call is apparently cheaper if it is run by another organisation. Services are open to tender because this is apparently more efficient. Private companies come in to take over shortfalls in waiting lists, so surgeons may be brought in from the other side of the world. At another level ancillary services may go to private companies.
Patients want a local service in which they see doctors and nurses that they know. They don't want to explain their symptoms every time they meet another member of staff. They want continuity of care. They want NHS staff to listen to them.
Last week the local A&E only wanted people to turn up if it was absolutely necessary. The bad weather had caused more car accidents and more people to fall. I say local A&E, but there used to be one a lot closer. Another A&E within this area closed too and the one that remained didn't want anyone (my definition of absolute may be different from theirs).
I get the impression that opposition to NHS reforms is based on GPs having more administrative tasks. The opposition is nothing to do with getting a local service from someone who knows you and someone who will listen.
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