The role of the NHS

[Issy]

Is only to keep your walking and keep you at work.

They are not there to make you "well" but only "well enough" for these two things.

Ok - this is my opinion - what's your opinion?

[batgirl]

Thats what it was originally created for helth to keep you working and to keep you healthy.

But it has lost its way since the 1940s.

[debjs]

Hmmm hasn't managed to keep me walking or at work, in fact the opposite!

[Ploggy123]

Yes I sympathise with your view and of course I can see why you would say that in the system we live in. However, I sometimes think we get the NHS service we deserve! We still have a tendency to revere those in positions of power or status and listen to everything they say (even when we think they are wrong, but hey, "you're the Doctor"). I think we all as individuals have a duty to be proactive in our own treatment and most of us nowadays have access to further information. Then we need the confidence to put our case to the Doctor and be firm in our own opinion of what we (me, this particular individual) need to be "Well", not just a low level of functioning to make sure I can get to work each week. I think GP's and Consultants in the NHS are our servants, we pay them, we should not accept poor service. Equally they spend years learning their "trade" and deserve some respect (imagine how they must feel nowadays when every Tom, Dick and Petunia has read whats wrong with them on the net and does their own diagnosing) but they must be our true partners in wellness. The NHS is without a doubt a wonderful concept but we could all do more to make it work better for us.x

[Hidden in reply to Ploggy123]

You make some really valid points. My relationship with my GPs has improved since I didn't accept poor service and let them know in an educated manner. They are now respectful, refrain from making banal comments and ask me what I want of them. The shame is that I had to tackle my medical centre about poor service/poor attitude in the first place, and that I had to do this when I was rather ill. I agree that they must be our true partners, and I wish some of those GPs would take this on board too, without needing anyone to remind them.

Liza

[Ploggy123 in reply to Hidden]

Its amazing how you can get someone to treat you with more respect when you do the work necessary to command it. Really, all power to your elbow that you educated your medical centre especially when you were not at your best. Its all a matter of perspective. In this situation the individuals suffering from hormonal and vitamin deficiencies are the experts. We are the case studies and the theory. We can list and tell the specific symptoms of our particular disorders. Its our job, or even our mission (sounding a bit grand there but what the heck) to educate the generalists and in some cases, the experts e.g. Endocrinologists, Mental Health specialists, etc. We are finding it is not an easy job but the more of us doing it, being consistent (within our, at times, reduced capabilities) the more we can influence the quality of care being provided for everyone. We get battered by the disorders, we get battered by GP's and family, friends not understanding. But take comfort in the fact that we are the vanguard who can change it for the better. You have already proved that. I hope others take on board what you accomplished and do the same in their medical centres. If we were all doing what you did, the NHS would be in good hands and we would all be better acquainted with the concept of wellness (some of the definations provided by NBob below) x

[Hidden in reply to Ploggy123]

Thank you Ploggy!

You are absolutely right and you have described our situation so well.

I'm a teacher (teenagers) and I'm used to standing my ground and being assertive without being confrontational... I believe this background has helped me but it still surprised me when I first came across less than acceptable attitudes from my GPs. The first time it happened I asked myself 'would I accept this attitude from a child?' when the answer was 'no' I realised that it was even less acceptable from a health-care professional.

NBob has posted a great response, very informative.

I don't think 'mission' is too grand a word and the more of us who can make changes for the better, the better the future is for everyone.

x

[Ploggy123 in reply to Hidden]

My daughter is just off the phone telling me how proud she is of herself because she stood up for herself at the GP's this morning and got the referal that she has been asking for. When the GP said (once again) "your results are all normal", my daughter asserted herself and explained to the GP why they were not normal and cited references to support her arguments.Unfortunately it seems that all of the GP's at that practice have the same view (work to be done there too). Another empowered customer walking the streets with their head high and their heart full of hope that the referal will bring good health and wellbeing (I hope she can now learn to be patient).

I tried working with a class of teenagers on my own once. That was it!!! x

[Hidden in reply to Ploggy123]

Great news - well done to your daughter and I'm sure she has been inspired by you... so well done you! It seems as if the GPs are listening - at least to the empowered (difficult?!) customers so there is hope! x

[marram]

When the idea of universal healthcare was first introduced, the average person had not the slightest idea of how their bodies worked, let alone how it can go wrong.

I suspect that in the early days many people were misdiagnosed but they had no way of knowing!

We have the luxury of the Internet and all it entails, good or bad. We are also encouraged to be more active in taking responsibility for our own health. Until we get thyroid problems. Then, for some strange reason (money? Big Pharma?) we are considered incapable of even knowing our own bodies.

My personal view is that Big Pharma has hijacked the NHS and now it's just a huge machine for generating profits for the Pharmaceutical companies. Treatment now seems to bear no relation to the actual condition of the patient. Give him a pill which will 'prevent' a condition he may or may not ever suffer from. Give him another pill to counteract the side effects of the first one. And so on.

Make the patient well? He/she is just a cash cow for Big Pharma.

[Stourie in reply to marram]

Well said, I agree with everything you have said.

Jo xx

[tegz in reply to marram]

I can think back 30+ years when a late-ish appt. at the surgery would usually run one into a smart-ass salesman worming past the reception, to get a sales pitch in to the Dr.

NOW- you NEVER see them -as they are part of the institutional life of Big Med/Pharma and have more than a 'foot' in the door ie: they part own the setup now from college to mortuary with the mindset biased in their favour.

A sort of security blanket that there's pill for everything.

I don't deny that many drugs work well, many doctors and receptionists work very hard etc. [^ and DO get paid for it] -but until, like in nursing, patient rights and care are [truly] put at the front of treatrment again there will be a built in shortfall for our overall long term health.

With that proviso -and modern technology/diagnosis we would all be winners.Hooray!

The other thing rarely mentioned apropro the above post is that when docs could 'get away' with more they didn't rely on insurance against malpractice/incompetence half so much -as though they were pedantic old devils like many still today- did use 'hands-on' much more, & not rely on meds so much. They HAD to be good diagnosticians

How long since a Dr looked at your tongue or pulled down your eyelids- OK there are blood tests that will do better, sure, but T3 ? - that's something else, apparently.

[cein]

I was told by my previous GP of 12 yrs when I questioned why my health had continued to decline during those 12 yrs since all medications I had taken for 35 had been reduced, and wasn't there anything she could do to make me feel better and yes Dr I am aware that you said my blood tests said I was ok but unfortunately that's not how I and my body feel .. her response was '' I am here to treat your symptoms not the cause ! '' says it all really .... needless to say she is no longer my GP.

[Stourie in reply to cein]

My god does she not know that if she treated the cause your symptoms would go.

[cein in reply to Stourie]

She is only interested in going by the book ... I am now under the care of an Endo after my new GP refered me.

[snowstorm]

What is high cholesterol? We are all different therefore, we are not going, naturally, to have the same levels. One level is ok for one person but not the next. Why is more attention not paid to the good cholesterol? More often than not we are not told that. Trying to reduce cholesterol to such a low level is dangerous. It is one of the key life factors.

[NBob]

The NHS was created out of the ideal that good healthcare should be available to all, regardless of wealth. When it was launched by the then minister of health, Aneurin Bevan, on July 5 1948, it was based on three core principles:

that it meet the needs of everyone

that it be free at the point of delivery

that it be based on clinical need, not ability to pay

What was missing in the NHS was a definition of health. The World Health Organisation gave us a definition of health in 1948.- Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

I think this is what doctors should be aiming for. As we know, there are some that just want the patient to shut up. The current principles still do not include the WHO definition of health directly but in and amongst the waffle, it is just about there. the problem we see is that in such a huge organisation the core principles get overlooked.

How we ensure that they aren't overlooked? Complain. eventually thing will get noticed. See the Report into Mid Staffs for evidence of the usefulness/necessity of complaining. Plus there is another report coming regarding how the NHS ACTUALLY dealt with complaints.

The current Principles of the NHS are to be found in the NHS Handbook

Principle 1

The NHS provides a comprehensive service available to all

This principle applies irrespective of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity or marital or civil partnership status. The service is designed to diagnose, treat and improve both physical and mental health. It has a duty to each and every individual that it serves and must respect their human rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society where improvements in health and life expectancy are not keeping pace with the rest of the population.

Principle 3

The NHS aspires to the highest standards of excellence and professionalism

> in the provision of high quality care that is safe, effective and focused on patient experience

> in the people it employs, and in the support, education, training and development they receive in the leadership and management of its organisations

> and through its commitment to innovation and to the promotion, conduct and use of research to improve the current and future health and care of the population.

Respect, dignity, compassion and care should be at the core of how patients and staff are treated not only because that is the right thing to do but because patient safety, experience and outcomes are all improved when staff are valued, empowered and supported.

Principle 4

The NHS aspires to put patients at the heart of everything it does

It should support individuals to promote and manage their own health. NHS services must reflect, and should be coordinated around and tailored to, the needs and preferences of patients, their families and their carers. Patients, with their families and carers, where appropriate, will be involved in and consulted on all decisions about their care and treatment. The NHS will actively encourage feedback from the public, patients and staff, welcome it and use it to improve its services.

Principle 5

The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population.

The NHS is an integrated system of organisations and services bound together by the principles and values reflected in the Constitution. The NHS is committed to working jointly with other local authority services, other public sector organisations and a wide range of private and voluntary sector organisations to provide and deliver improvements in health and wellbeing.

Principle 6

The NHS is committed to providing best value for taxpayers’ money and the most effective, fair and sustainable use of finite resources.

Public funds for healthcare will be devoted solely to the benefit of the people that the NHS serves.

NHS Values

Patients, public and staff have helped develop this expression of values that inspire passion in the NHS and that should underpin everything it does. Individual organisations will develop and build upon these values, tailoring them to their local needs. The NHS values provide common ground for co-operation to achieve shared aspirations, at all levels of the NHS.

Working together for patients

The value of ‘working together for patients’ is a central tenet guiding service provision in the NHS and other organisations providing health services. Patients must come first in everything the NHS does. All parts of the NHS system should act and collaborate in the interests of patients, always putting patient interest before institutional interest, even when that involves admitting mistakes. As well as working with each other, health service organisations and providers should also involve staff, patients, carers, local communities to ensure they are providing services tailored to local needs.

Respect and dignity

Every individual who comes into contact with the NHS and organisations providing health services should always be treated with respect and dignity, regardless of whether they are a patient, carer or member of staff. This value seeks to ensure that organisations value and respect different needs, aspirations and priorities and take them into account when designing and delivering services. The NHS aims to foster a spirit of candour and a culture of humility, openness and honesty, where staff communicate clearly and openly with patients, relatives and carers.

Commitment to quality of care

The NHS aspires to the highest standards of excellence and professionalism in the provision of high quality care that is safe, effective and focused on patient experience. Quality should not be compromised – the relentless pursuit of safe, compassionate care for every person who uses and relies on services is a collective endeavour, requiring collective effort and collaboration at every level of the system. The delivery of high quality care is dependent on feedback: organisations that welcome feedback from patients and staff are able to identify and drive areas for improvement.

Compassion

Compassionate care ties closely with respect and dignity in that individual patients, carers and relatives must be treated with sensitivity and kindness. The business of the NHS extends beyond providing clinical care and includes alleviating pain, distress and making people feel valued and that their concerns are important.

Improving lives

The core function of the NHS is emphasised in this value – the NHS seeks to improve the health and wellbeing of patients, communities and its staff through professionalism, innovation and excellence in care. This value also recognises that to really improve lives the NHS needs to be helping people and their communities take responsibility for living healthier lives.

Everyone counts

We have a responsibility to maximise the benefits we obtain from NHS resources, ensuring they are distributed fairly to those most in need. Nobody should be discriminated or disadvantaged and everyone should be treated with equal respect and importance.

[Hidden in reply to NBob]

Very informative - thank you for posting.