Thursday, March 14, 2013

Do We Really Value the NHS?

According to one opinion poll after another, one of the things that we British say we value most about living in the United Kingdom is the National Health Service. When defining the word ‘value’, the Oxford English Dictionary speaks of ‘the regard something is held to deserve’, and continues on about an object’s ‘importance’ or ‘worth’. However, therein lays a strange conundrum.

Every year, so many appointments are missed by patients that the cost of the lost time amounts to a staggering £162 million. At the best of times, that is an appalling waste of money; within a harsh economic climate it is nothing short of madness. If a government department was identified as wasting that level of hard-working tax-payers’ money there would be a national outcry, with newspaper headlines baying for blood (think BBC executives’ pay, MPs’ expenses and so on); and yet here we are individually contributing to the monumental wastage of something we steadfastly maintain that we ‘value’.

Separating those appointments out between general practices and hospitals, it is apparent that approximately 1 in 20 GP appointments are lost. In my own practice, around 100 GP appointments are lost every month, and last month an appalling 200 nursing appointments were lost. Like many practices across the country, we are overloaded with work and stretched to the limits in trying to meet the demands thrust upon us. We limit advanced-booking, as it is well known that the more appointments booked in advance, the greater the quantity that is wasted. Yet we are castigated for trying to reduce those wasted appointments by applying such a policy.

The value of each lost GP appointment in the NHS is worth in the region of £20. Now, if you saw a £20 note on the pavement, would you pick it up and consider yourself lucky, or would you walk by and ignore it? I know what I would do. I cannot ignore 1p or 2p pieces, let alone a £20 note, and I suspect that you would do the exactly the same; at least when it comes to the note. So why are we so dismissive of the issue of lost appointments? Is it that we have been lulled into the false sense that the NHS is ‘free’, when it is anything but free?

Items given away are often seen as holding little value. If we lose them or break them, it doesn’t really matter to us as they were free in the first place. It seems that to value something, many of us need to understand the cost. Even more so, that cost needs to be seen as being paid by us. So, how about the introduction of a fine of £20 for every missed GP appointment? Last month my practice alone would have brought in enough money in fines to pay for another full-time GP or a couple of practice nurses to ease the workload. Perhaps fines would start to make us truly value the NHS and reduce the shameful wastage currently taking place.

(First published in the Scunthorpe Telegraph, Thursday 22nd November 2012)

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