NHS - Not a Healthy Service.

I'm a "thick file patient". God was having an off day when s/he created me. I have several chronic conditions which I have had for many years & which affect everything I do in my life every day. Pain & fatigue are constants.

I also work for them as a volunteer in several ways. So, I know about the NHS. If we are to maintain the NHS into the future we all need to participate in a difficult discussion about what we want it to be. What it can & should do.

As a patient I want to be treated as a holistic individual. I am a whole person - a complex inter-related system. The NHS is lots of discreet little empires presided over by consultants who protect their individual territories. From the patient perspective it is a time wasting, repetitive, burocracy which does not communicate effectively in the interests of the patient.

If I have an appointment with a medic, I want to know that I will be seen within a reasonable amount of time of that appointment - say half an hour. Otherwise what is the point of an appointment system? The reality is that all too often I have had to wait for hours in an unappealing waiting room.

Worse still is waiting for hours after a hospital admission or emergency situation. Exactly the same questions are often asked by several different medics within a relatively short space of time.

The obvious solution to this is for the NHS to mount a factfinding piece of research shadowing individual patient real experience & collating the results to find patterns & improve delivery.

We should also be discussing the realities of funding health treatments. What should be funded, what not & why. If I am terminally ill do I have the right to expensive treatment which everyone knows will only prolong my life for a relatively short time? We seem to have reached a point where death is not acceptable, rather than accepting that we are all dying from the moment of birth. The preservation of life at all costs seems to have become a Holy Mantra. This is unbalanced & unsustainable. Why prolong life artificially just because we can & maybe condem to a life that has no real quality?

Why do we not ask patients to pay towards the normal costs of living when they are in hospital and therefore not paying those costs at home? Things like food could quite reasonably be charged to patients or their families. Not only would you save the costs of the raw materials, but also the whole infrastructure. Why do hospital staff get subsidised canteens?

We need a contract between the NHS & the patient with a clear statement of what the roles & responsibilities of each are. If patients are significantly & deliberately contributing to their health problems do they have the same rights as those who are not? Should we all be paying for treatments for those patients, which are doomed to failure, to the detriment of the whole service?

If people chose to participate in dangerous sports or activities why do we not insist that they or their employers have medical insurance for those activities? Why should the taxpayer pay for what is often very expensive, self inflicted risk?

I may not know the answers, but I think we should be having the discussion because the present system is not fit for purpose & is unsustainable. Costs are reaching epidemic proportions, the patient is sick. Most health professionals probably try to do a good job, but there is systemic failure. The prognosis is that the condition will worsen. We have to prescribe the treatment now.