NHS

What is the NHS?

The NHS is a means where everyone in the country can have free healthcare, which is paid for by the state, out of the state coffers, out of tax and national insurance.

What are the best things about the NHS?

The strengths of the NHS are free health care provision. No one's going to ask you "can you afford to pay for your treatment?". In America when you go and you had an accident, someone's going to say, "have you got an insurance?". That does not happen here, if you have an accident you will get cared for. Some times the care is incredibly expensive. also it means you can go and see a GP, family Doctor, you can go and see a consultant in a hospital, you are not going to have to pay for it, the provision is free at the point of delivery.

Where does the future lie for the NHS?

The future for the NHS is really going to be quite difficult. The problem is when it was set up back in 1946, health care wasn't nearly as expensive as it is now. No one could've predicted that people were going to live as long as they do now, that cancer treatments would become so advanced. We now have an aging population who are very expensive to care for and there are a lot of questions being raised of can the NHS actually afford to keep the population healthy? A lot of people think that the NHS will no longer be viable financially in a few years time. We'll wait and see.

How does the publishing of league tables effect your job?

Generally the publishing of league tables does not affect our jobs as G.P's at all. We go more on the consultancy of new person. We go more on the reputation of hospitals in our local area. We are not going to expand the tables. We know though well that principally and absent in emergency problems where they have to have league tables where it helps the patient to see, patient often seen by a nurse it seems they walk in the door so that they can tick the books in terms of being seen as far as the league of the table is concerned and the patient waits for 3 or 4 hours to be seen by the doctor.

What are some of the lesser known services available on the NHS?

Treatments available on the NHS can actually vary quite a lot from region to region, which is a problem in many ways. In some areas, you can get acupuncture on the NHS. In some areas, you can get osteopathy on the NHS. Counseling services, talking therapies, are generally available on the NHS, but again, they vary about how good they are from region to region. In some regions, there is very good access to psychotherapy, to counseling, and cognitive behavior therapy, which some people just don't know about.

What medical procedures aren't available on the NHS?

Unfortunately the age of rationing we are now in means that anything that can be viewed as remotely cosmetic is not available on the NHS. Now that would include lumps and bumps on your face, which you might find quite disfiguring and quite upsetting. It includes varicose veins, you can't get them done on the NHS these days. The other thing that upsets me is treatments for women who have got excess body hair, again it's regarded as cosmetic and therefore that's not available. And increasingly some drug treatments are not available. I think a lot of people have heard about the rouse about cancer treatments and drugs for Alzheimer's disease that are only available to a certain number of patients or not available at all. But there are increasing drugs where general practitioners are being very heavily pressurized not to prescribe them, for instance Viagra, because of the expense.

As a GP what concerns you most about the current state of the NHS?

What concerns me most as a general practitioner is the rationing that is going on, which sometimes seems completely illogical in terms of the treatments that I am available to give patients. I don't mind prescribing conservatively, being told to prescribe a cheaper drug if it works just as well. I do mind being told that I can not prescribe certain drugs because they are just too expensive, and I feel that the way some of the decisions are made about drug treatments are very unfair indeed. For instance, women are told they can't have drugs for osteoporosis unless they've actually broken a bone. That to me is a nonsense. We should be able to give drugs when their bones are becoming thinner, rather than waiting until they've actually broken a bone. It's like closing the gate after the horse has bolted. It's a nonsense.

If someone is going abroad are they still covered by the NHS?

If you go abroad, you are covered for emergencies within the European Union, as long as you are carrying a European Union health card. We used to have forms called E-111, now they're now defunct but a lot of people don't know that, and if you still have a E-111, you need to change it for a European health card. That means you can get treatments for emergencies. However, if you need treatment for pre-existing condition, you may have to pay for it. The other thing is, about treatment within the European Union, if you're carrying the European Union card, you will probably have to pay for it when you go and see the doctor or you go to the hospital and then you have to claim the money back which is a bit of a hassle. Don't expect to get it completely free, expect to have to pay for it and then reclaim the money. If you're going somewhere else like America or outside the European Union, then you will not be covered by the NHS, and you need to take out private health insurance.

Can anyone in Britain receive treatment on the NHS?

Generally, anyone who is in Britain can get treatment for an emergency on the NHS. So, even if you are an illegal immigrant, if you have a nasty road crash, you're not going to be told you can't have treatment. However, if you're coming in from abroad and you're from a country which does not have a reciprocal arrangement with the NHS, you will not be able to receive free treatment for an ongoing medical condition. So, for instance, if you're an American visiting Britain and you've got an ongoing heart problem, you can't expect the NHS to start looking after your heart while you're here.

Does the NHS provide services for recent immigrants to the UK?

Generally if they are coming in from the EU, then you can get treatment on the NHS. If you are coming in from elsewhere abroad, if you're not working here, then you shouldn't be able to get treatment on the NHS, but it seems to be quite a gray area.

If someone opts for private treatment do they give up their right to NHS treatment?

No, you always have a right to NHS treatment even if you are being treated privately and if you go and see a private consultant, and you don't like what you are told, you're entitled to get a second opinion on the NHS. What does seem to be a very odd area and a gray area is if a consultant advices you to have certain treatment, whether you can pay for that treatment yourself and then get it given to you by the NHS. This is recently come to light over cancer treatment where drugs that NICE has said, they shouldn't be available on the NHS. Some doctors are now saying that patients should have the ability to buy the drugs for themselves but have them administered on the NHS and there is no law that says that can't happen.

Is the NHS considered better than private care for some types of treatment?

I certainly think that the NHS can provide extremely good care that sometimes is better than private care. Areas like cancer treatments, cardiac treatments even, quite serious illnesses, and certainly if you had a really serious accident and you need to go to an intensive care unit. If I had the choice I'd want to be on an NHS unit.