*MASSIVE POST WARNING*
I’m fortunate that through various family members I have a perspective on the NHS that stretches back almost to the very first days in 1948; admittedly mostly a UK perspective.
My Great Uncle qualified as a Doctor in 1949 having taken a few years out to tour North Africa and Europe; he would be very quick to point out whenever the many NHS funding crises were on the news that it has always been underfunded and that the biggest mistake was made when it was initially set up allowing politicians too much influence over what should be clinical decisions; he always maintained that the NHS should have been a sort of Quango; funded by government but run by a non-political executive. He actually tried to develop an NHS management degree in the late sixties but was politely told to bugger off. It's a political ping pong ball that faces massive changes everytime the resident of number ten changes.
I’m related to a couple of GP’s both here, in the UK and further afield. They are overworked to the point of breaking; the main cause of this being appointments for minor ailments that can be easily resolved by a visit to the Pharmacist or even just taking a few days off and riding it out.
People are not prepared to be unwell these days; we have a ‘presentee’ culture where taking time off to get over a bug is frowned upon; employers have a responsibility to instil in their staff that it is OK to take a few days off if your ill.
On top of this we are now pretty much at the point where the pre-NHS system of paying to see the Doctor is falling out of living memory and as many of my NHS working friends and relatives say, and it’s a sentiment I agree with; we live in a society that believes that that which has no cost has no value. As such people will book an appointment for the most minor things as it involves no cash outlay and no effort on their part. This blocks appointments for the genuinely unwell and results in GP’s and their staff working themselves into the ground.
I am a full supporter of the welfare state and believe whole heartedly in free at the point of contact but have got to the point where I think a £5 charge to see the GP and £10 for a missed appointment is the only way to reduce the amount of ‘worried well’ appointment blockers that are the route of the problem in primary care. As another poster stated no medication that can be bought over the counter should be available on prescription regardless of whether you’re entitled to free prescriptions or not. The charges should be taken and retained by the individual practices to make up for the fact the IOM GP’s receive lower per head funding than their UK counterparts.
Nobles is an unusual problem in that we don’t have the population to require full services and as such the per head cost of healthcare will be higher; we will never attract the highest calibre career driven staff as the opportunities elsewhere are far greater. This is not to say that I don’t believe that the majority of staff at Nobles are not first rate; I know many people move here for lifestyle choices as my wife and I did.
I’m afraid we will just have to suck up the extra costs; although putting the staff back on the NHS pension would be a huge boost to recruitment and was the biggest, most short sighted, knowing the price of everything and the value of nothing mistake IOMG has made in regards to healthcare that I can recall.
As an aside I do get a little sick of the ‘civil/public service gravy train rubbish’ I read here every day. I’ve worked in the private sector long enough to know that laziness and incompetence is universal and not dictated by who signs the cheques at the end of the month.