I am fed up to the back teeth with people whingeing and whining about supposed problems with the National Health Service and social care arrangements in this country. There is one problem and one problem only - people want the best and most comprehensive services in the world but don't want to pay for them.
When the NHS was founded, there were crazy notions that, over time, the general health of the nation would improve and the demand for healthcare would decline; how could anyone have been so naïve ? The truth, of course and as anyone with half an eye to the future would have realised, was that it would lead to an ageing population with different health needs, while scientific advances would lead to more treatments of every sort becoming available. An increasing and ageing population plus the identification of 'new' conditions, developments in treatment and new and evermore expensive drugs equals financial demands racing out of control.
As regards social care, in the past the elderly were most often cared for by their families but not so today. Granny and granddad are packed off to some care home as soon as they become a burden meaning that the demand for care home places has skyrocketed. The younger generations, anxious to preserve their anticipated inheritance, don't at all like the idea of anyone but 'the state' paying for this, not actually realising that they are 'the state'. Should the government dare to suggest that taxes might have to rise to pay for the extra demand, all hell will break lose.
The solutions to this apparent conundrum are simple. Firstly, the people have to come to understand that the notion of 'something for nothing' doesn't work; one way or another, additional resources have to be made available. In respect of the NHS people have to stop running to see their GP every time they have a runny nose and have to realize that hospital services, Accident & Emergency in particular, must not be abused. We have to recognize that we can't go on expecting everything to be free; GP services and A & E are essential and should be free, as long as they're not abused, but there is no reason why some other elements should continue to be free. Abortions, vasectomies, fertility treatments and family planning prescriptions are usually lifestyle choices and should be chargeable; it is highly questionable whether cosmetic surgery, except when reconstructive following other surgery or injuries, should be a free service and it is highly debatable whether treatments required as a consequence of an individual's abuse of alcohol, tobacco or drugs, or for other largely self-inflicted injuries, should be free. Other treatments for conditions which are neither life-threatening nor debilitating should all be assessed as to whether it is reasonable for the state to pay out of general taxation. In the end, the NHS should become a service to provide for genuine medical need, while the vast array of peripheral services which have grown up since its inception should be covered by insurance schemes. Such schemes could easily be designed to ensure that those who are unable to pay are not disadvantaged while those with the resources pay their fair share. People would then be free to decide what services they wanted to use and what they were prepared to pay for rather than be taxed to pay for services on which they never make any demand and, sometimes, have never even heard of.
Turning to social care, there is a very simple solution. There is no reason at all why those with property and savings should not be expected to pay for their own care. The idea that 'the family home' is, in some way, sacrosanct is an utter nonsense; younger generations have no right whatever to expect to benefit from their parents' estates and, if a house has to be sold to pay for care home services, so be it. The mechanics of a system would have to be worked out but this is the obvious and simplest answer to an issue which successive governments have so far failed to address; clearly, they've been frightened of the likely political fall out but, sooner or later, the nettle will have to be grasped.
What we need today is a Prime Minister with guts and a Government with vision; we need to stop looking back and start looking forward. We need a genuine restructuring of our state-run services, starting with health and social care. The NHS is dead and it's time to bury it.
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