NHS in Wales

Aneurin Bevan

Yesterday, Judith Phillips in the Daily Post was all gloom and doom about the NHS in Wales. She does say and I quote "but it seems we have now reached a crisis point where public confidence in those running the NHS in North Wales is at an all time low."

What utter bullshit - yes complete and utter drivel....

Now what do you mean I hear you ask - well lets start with her conclusion and I quote again "but throwing the responsibility for the level of care given by community hospitals onto families and county council social services departments, is in my opinion going to open up yet another can of worms."

Which does rather show she has no clue what she is talking about, that she does not realise that the family and the local council was an integral part of our care system as envisaged when the NHS was established in the very first place.

We should be proud of the NHS, of what it has achieved, but we need also to recognise that in changing times what was the remedy of yesteryear may not be the best use of the 'limited' resources available to us now.

And in reaching those decision as to the future shape of the NHS within Wales they should be based on clear cut clinical opinion, made in the best interest of all of us. Not may I add the straw sample of a deluded correspondent of the Daily Post.

Take community hospitals....lets be honest they have had their day, they are not really the answer to our needs. Let me go further.....the moment someone comes a patient at a community hospital is in reality a sign of failure somewhere else.

We should be truly proud of the welfare system this country has, think....we are all living longer thanks to welfare, we have less infant deaths thanks to welfare.....and just on the simple fact there are more of us, will mean welfare costs will go up.

Which brings me to being old.

Think about....if put simply you have the countries GDP and from that you need to pay for children, adults and pensioners. Are we really in a society that as children demanded to be feed, then when working moaned that everyone else wanted to be fed and in our retirement demand that we are fed again?

Personal responsibility, the ability to plan and care for oneself - that is the aim we all should have. And the majority of us will live full and independent lives.

But sometime along the road we may need assistance, and sometimes we may need care, and sometimes we might even need acute care as we wait for death. Death is inevitable, but it need not be in pain.

We have plenty of care homes, the private sector in the most provide a very good service, and sometimes for some people whom cannot look after themselves that is the best place for them to be.

However what of those with acute needs - such as dementia or alzheimers, what they need is specialised palliative care in purpose built nursing homes. And that is one thing we lack, sufficient nursing homes to care for those who need specialised care, even if just means providing respite for the caring family.

Nursing homes built with the dignity of the patient in mind, with single rooms and trained staff, where someone comes to die because we cared and not because we pushed them aside.

So here in part is my prescription for the NHS:

• We need local doctor surgeries to be in modern buildings that offer a greater range of services to their patients.
• We need more district nurses.
• We need more paramedics.
• We need more pharmacists, and a consulting room in every pharmacy.
• We need more doctors
• We need more palliative care nurses

Now up to now I hope you will see my list is mostly more people not more buildings, if we get the prevention right we would need less buildings so to speak.

But if we need to decide as to priorities in brick and mortar then that would be the need for more acute care nursing homes, to complement and build on the excellent work done by charities such as Marie Curie.

Now I know it wont be popular, but let's be clear

....no beating about the bush...

......Community Hospitals are not the answer.

.........you know do try an keep up....

NHS - we remember Aneurin Bevan

Listening to David Cameron yesterday, talking about the dismantling of the NHS as we know it, with a top to bottom reform (even though in their manifesto they said they would not) made me question whether the veneer has finally started to crack on that polished image the Conservatives have tried to portray.

Is the nasty ‘Tory’ party back, is it their way or the highway. What happened to constructive dialogue and the big society? - instead it seems we were told anybody that doesn’t agree with the ‘Leader’ needs to grow up - or what we ask, is he going to take his football home?

Luckily for us the Lansley NHS reforms are for England only, or are they – will the Welsh Conservatives follow the lead of their leader?

Anyhow let me remind you of the days when politicians were politicians with this extract from an essay by Aneurin Bevan about the NHS from 1952

"When I was engaged in formulating the main principles of the British Health Service, I had to give careful study to various proposals for financing it, and as this aspect of the scheme is a matter of anxious discussion in many other parts of the world, it may be useful if I set down the main considerations that guided my choice. In the first place, what was to be its financial relationship with national insurance; should the health service be on an insurance basis? I decided against this. It had always seemed to me that a personal contributory basis was peculiarly inappropriate to a national health service. There is, for example, the question of the qualifying period. That is to say, so many contributions for this benefit, and so many more for additional benefits, until enough contributions are eventually paid to qualify the contributor for the full range of benefits.In the case of health treatment this would give rise to endless anomalies, quite apart from the administrative jungle which would pe created. This is already the case in countries where people insure privately for operations as distinct from hospital or vice versa.

Whatever may be said for it in private insurance, it would be out of place in a national scheme. Imagine a patient lying in hospital after an operation and ruefully reflecting that if the operation had been delayed another month he would have qualified for the operation benefit. Limited benefits for limited contributions ignore the overriding consideration that the full range of health machinery must be there in any case, independent of the patient's right of free access to it. Where a patient claimed he could not afford treatment, an investigation would have to be made into his means, with all the personal humiliation and vexation involved. This scarcely provides the relaxed mental condition needed for a quick and full recovery. Of course there is always the right to refuse treatment to a person who cannot afford it. You can always 'pass by on the other side'. That may be sound economics. It could not be worse morals.

Some American friends tried hard to persuade me that one way out of the alleged dilemma of providing free health treatment for people able to afford to pay for it would be to 'fix an income limit below which treatment would be free while those above, must pay. This makes the worst of all worlds. It still involves proof, with disadvantages I have already described. In addition it is exposed to lying and cheating and all sorts of insidious nepotism.

And these are the least of its shortcomings. The really objectionable feature is the creation of a two-standard health service, one below and one above the salt. It is merely the old British Poor Law system over again. Even if the service given is the same in both categories there will always be the suspicion in the mind of the patient that it is not so, and this again is not a healthy mental state.

The essence of a satisfactory health service is that the rich and the poor are treated alike, that poverty is not a disability, and wealth is not advantaged."

The above extract and much more of his words can be found at:
Aneurin Bevan and the foundation of the NHS