When was the last time you went out for some food? Was it to a restaurant , a take away or just a bakers? The chances are that you entered into a contract with the provider of the food about what you would consume in exchange for a particular amount of money. It’s a standard transaction for a modern economy.
A few weeks ago I had a fantastic Chinese banquet. Choosing the banquet option meant that we had a bigger selection of things to choose from and savour, but this came at the price of committing to buying a bigger quantity of food than we would have consumed with a traditional three course meal.
The NHS National Health Service in the United Kingdom is in a state of transition, and has been for several years. Budgets are being adjusted ( usually downwards ) which means that there is less money to pay for as many things as before. There are increasing pressures on the remaining staff, and increasing expectation from the consumers of health care about what they choi,d be receiving.
Going back to the food model. I’d like to suggest that hospitals and many aspects of Secondary Care are like the a la carte restaurant – dishes are served up with a pre arranged price tag, except in the health scenario the customer is blissfully unaware of the cost of the item or the experience they are receiving.
General Practice , or family medicine, in the UK has more in common with the “eat as much as you like buffet”. Providing you can get through the front door, you can fill your boots with as much health advice and medication as you wish. I have enjoyed some really great buffets in my time, and some not so great ones. You generally get what you pay for – your expectation of the quality of the food inside is influenced by the expected financial cost.
Both extremes of payments for food received have their places in our society. I enjoy the chicken kebab, a la carte, and the buffet in equal measure, but should this model be relevant to health?
If a society wants to offer a 5 star buffet, it needs to pay for a 5 star buffet. If you want your set menu to have duck pancakes, then you need to pay for duck pancakes.
Great healthcare is available and can continue to be delivered in the UK. We have some skilled people working in the the NHS and many patients who value the service and who use the health service wisely.
Their is nothing wrong with choosing the 5* buffet – let’s just hope society doesn’t pay for the 3* and then complain when the duck pancakes don’t arrive.
Ps. I appreciate that this is a gross oversimplification of the way the NHS and primary care is funded.
Pps I would also like to stress that people do , generally speaking, use health care resources sparingly, and do not “abuse” the system.
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