Wednesday, March 28, 2012

NHS & Genuine Medicine: End of an ERA?

©2010 Am Ang Zhang

It is still fresh in most of the ordinary citizens’ minds that market forces were the main driver behind “dis-genuine mortgages” that eventually led to the near total collapse of the first world’s financial system.  In the meantime, our government is considering the use of market forces to keep the cost of health care funding in check.

The HSCB is now HSC Act and my reading is that medicine in England will change and it is now too late for us to do much. One day, the ordinary citizens of the land will realise that they have lost what was once a very genuine style of medicine. Sad, very sad.

Allowing private providers into a relaxed competitive market funded by the tax-payers is likely to lead to escalating costs and “dis-genuine medicine” being practised.  Private companies need to make profits, and if set up as non profit making, need to pay their CEOs huge salaries.  Where is all that money going to come from?

Some years ago (in fact nearly 30 years ago) I was faced with caring for a highly disruptive manic adolescent at home, as none of our psychiatric units (adolescent or adult) had room for such a patient. With only a very junior social worker in attendance, I had to sedate the boy at home with injections of major tranquillizers.  Our hospital secretary, having heard of my heroic attempt to manage the patient at home, decided that he should be admitted into a private psychiatric hospital. The hospital concerned was agreeable as long as I remained his consultant. They would provide the nursing and junior doctor support.

My daily visits took the better part of half a day in those days. Before then, I had never set foot in a private psychiatric hospital. When we had some spare time, the junior doctor took me round the complex. I was suitably impressed with the buildings, the décor and the apparent pleasantness of the whole milieu. Then I passed a ward where quite a number of patients were on drips and each with a nurse in attendance.


"No, modified narcosis! They came from all over the world, 30 days at a time."

What, this was the late 70s and I have only read about this treatment method in ancient text books!

"What do you use?"

"Barbiturates mainly!!!"

This was well before Michael Jackson’s era.

“You can join us if you like. We are short on Child Psychiatrists and there is a huge demand in areas of anorexia nervosa. You will earn three times, if not more, than what you do now!”

Soon after, I talked to a friend and my patient was transferred to the Maudsley, where he stayed for another 9 months.

I preferred to practise “genuine medicine” in the NHS.

News came of a doctor in America giving unnecessary stent operations to patients.

Abbott Laboratories hired a Baltimore-area cardiologist as a sales consultant after he was barred from practicing at a local hospital last year for allegedly putting heart stents in hundreds of patients who didn't need them, say Senate investigators probing the medical-device industry.
Their report, to be released Monday, shines a light on one of the most lucrative procedures for hospitals and medical-device makers, at a time of spiraling health-care costs. Medicare paid some $25.7 billion for stent surgery in the six years through 2009, according to the report.

This is the danger.  When doctors are paid for on a case by case basis by private health providers, they will find it hard to practise “genuine medicine”.

No wonder doctors are paid salaries at Mayo Clinic, Cleveland Clinic and Johns Hopkins Hospital: some of the most respected names in American Medicine.

Christmas came and went: 50% discount at the stores is now followed by 75% discount.

Would one of the private providers be offering: have one hip replacement, get the other one free!  Two cataracts for the price of one etc.


We check the prices of other insurers and we will match them!

Is that what the government think will keep health care cost down?

Spring Rationing: Hospital Avoidance


Nurse and Hospital Stories said...

Is that what the government think will keep health care cost down?

Ah, they are not thinking I guess, maybe they just feel that a certain method or law is the best to keep the cost of health care low. What an irony to the real practice. :)

Peny@mens scrubs

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