NHS: Theory vs. Reality

From the Daily Mail, May 25, 2009:

THE THEORY: Announced to a fanfare of publicity last year, Choose and Book allows you to select the time and place you have specialist treatment rather than having an appointment allotted to you.

THE REALITY: Around 90 per cent of GP surgeries are connected to the service. However, some experts argue that hospital choice is not as important as consultant choice – and that option is offered by only a few hospitals because of the fear of long waiting lists for certain specialists. The computer system is also prone to glitches.

THE THEORY: Since 2000, you have been able go to one of the 93 walk-in centres in England without a prior appointment. Although these tend to be nurse-led, there are usually doctors on hand, too.

THE REALITY: Around three million people use walk-in centres each year. ‘They provide good local care that is easily accessible,’ says Mr Summers.

However, the centres are often not manned by a doctor and so can offer only minimal treatment. As uncovered by a Daily Mail investigation, three doctors resigned from a centre in London’s Canary Wharf in 2006 after fears that nurses were operating without doctors’ supervision and were not always giving appropriate treatment.

THE THEORY: By the end of this year mothers-to-be will be able to choose to give birth either at home with a midwife, at a midwife-run centre or in hospital, the Government has promised.

THE REALITY: Currently, only a third of women are offered the option of a home birth, and with the Royal College of Midwives (RCM) claiming the NHS needs another 5,000 full-time staff to provide safe and good quality care, it seems unlikely pregnant women will get much choice.

THE THEORY: After several well-publicised battles, people who want to fund their own expensive cancer treatments can do so while still being eligible for NHS care.

THE REALITY: It’s still early days, but one concern is that the cost is prohibitive for many patients; Erbitux, for example, costs around £3,700 a month.

‘And even with these new rules people cannot have their drugs administered on an NHS ward — they also have to pay for the tests and scans associated with their treatment,’ says Dr Bill Beeby, chairman of the BMA’s clinical and prescribing sub-committee. ‘So, in effect, they are being denied NHS care.’

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