Social healthcare and the A & E thing

I should make it clear from the start that while I don't think the NHS is perfect (not to mention the  recent shambolic develpments across the Pond) I am absolutely in favour of social healthcare. I have seen children in shanty towns in Peru with no teeth, where those living in poverty will walk out of a hospital and die two days later from appendicitis because they can't afford to pay for the surgery. But I also know a man in the USA who had a kidney transplant but is no longer in work and can't afford health insurance which means he can't afford the medication he needs to prevent his transplant being rejected. Fortunately, the local transplant patients basically pool their meds so that if one month someone can't afford their tablets, then they will be supplied by someone else; a situation which strikes me as no less tragic (although on the other side, also restores one's faith in humanity). However, one of the biggest problems with free medicine (and the Welfare State in general) is what happens on the receiving end.

 

Research shows that people who get free prescriptions visit their GP when they are suffering from a minor ailment in order to obtain over the counter remedies on prescription rather than paying. This has led to the establishment of minor ailment schemes, whereby those people who are exempt from prescription charges can obtain such remedies free of charge. This frees up GP time and resources for people who have more serious problems.

 

Recently there has been a lot in the news about the pressure which A&E departments are facing this winter, with 40% of those patients seen in A&E not needing to be there: they could have been treated earlier and/or in the community. At the weekends, A&E is often full of alcohol-related (alcohol-fueled) injuries, and sometimes people will end up there because they are seriously ill and it is one of the paths to hospital admission. A while ago I saw an ambulance which bore an explanation of what was meant by a life-threatening emergency. (I was tempted to give my brother a similar list after he woke me up extremely early to ask where Mum was.) Tales of bizarre 999 calls, which often include people who want a lift to a hospital appointment, are frequent and mind-boggling.

 

Often it is the elderly who suffer, whether because they didn't go to their GP in time (couldn't get an appointment or didn't want to bother them), or because nobody took them or even noticed that they were a bit off colour. The point at which someone realises you have a mild case of cystitis shouldn't be when you're admitted to hospital with a broken hip (more common than you might suspect), because if someone is suddenly acting confused (often the first symptom of cystitis in older people) then your neighbour or your friend or your carer or someone should notice. And if someone is calling the ambulance service because they need help bringing the washing in and the path is icy, or they need a lift to the supermarket, then we should be asking ourselves why. Why is it that this person had to call 999 for help with a simple task? And I fear the answer has a lot more to do with individualism, loss of community and the selfish desire not to be burdened with other people and their problems (which some might call freedom) than the fact that our healthcare is free.