One of my former MP colleagues once told me a story about his time as a GP. One morning, an elderly gentleman came to his surgery complaining of chest pains. With blue lips, he was displaying all the symptoms of a heart attack. My colleague checked him over and called an ambulance. Whilst they were waiting, my friend asked the profoundly ill man why he was wearing a suit, enquiring if he was on his way to a function. “Of course I’m wearing a suit,” replied the patient. “I’m here to see my doctor.”
The following patient was in their early twenties, dressed in an overcoat pulled over pyjamas. They asked for a sick-note as they fancied a day off work.
All stories use hyperbole to make their point, but my friend was so struck by the juxtaposition of a generation that witnessed the introduction of the NHS, and treats it with respect; and a generation who never knew anything else, and takes it for granted.
It was estimated that around 15 million GP appointments were wasted in 2019. It is an astonishing number of people who just don’t up because they get better, or something else comes up. Not cancelled appointments: just failure to turn up. So, there is no doubt something that is wrong with the way some people treat the NHS.
My colleague Sajid Javid wrote an article for the Times last weekend, talking about the NHS. When former health secretaries make comments about the NHS, they are always worth reading.
In it, he tries to tackle the problem of taking the NHS for granted. He suggests a solution of charging £20 for a GP appointment, and talks about the Irish practice of charging £70 for an A&E visit. With an economic stake in the visit, he suggests, people would not fail to turn up, or think more carefully when booking appointments. It’s a controversial idea, with howls of protest from former PM Gordon Brown, with inevitable suggestions of NHS privatisation.
I don’t think charging for NHS services is the best way forward. Free at the point of delivery for all who need it is a founding principle and should not be abandoned. But Sajid is right to raise these issues. It is clear that a service designed 75 years ago isn’t necessarily in the right shape for the 21st century. But we need an intelligent debate, not tribal mudslinging.