Can Britain Fix Its National Health Service?

 The NYT has the story

A National Treasure, Tarnished: Can Britain Fix Its Health Service? As it turns 75, the N.H.S., a proud symbol of Britain’s welfare state, is in the deepest crisis of its history. By Mark Landler

"As it turns 75 this month, the N.H.S., a proud symbol of Britain’s welfare state, is in the deepest crisis of its history: flooded by aging, enfeebled patients; starved of investment in equipment and facilities; and understaffed by doctors and nurses, many of whom are so burned out that they are either joining strikes or leaving for jobs abroad.

...

"More than 7.4 million people in England are waiting for medical procedures, everything from hip replacements to cancer surgery. That is up from 4.1 million before the coronavirus pandemic began in 2020.

"Mortality data, exacerbated by long wait times, paints a bleak picture. In 2022, the number of excess deaths rose to one of the highest levels in the last 50 years, and those numbers have kept rising, even as the pandemic has ebbed.

"In the first quarter of 2023, more than half of excess deaths — that is, deaths above the five-year average mortality rate, before the pandemic — were caused by something other than Covid-19. Cardiovascular-related fatalities, which can be linked to delays in treatment, were up particularly sharply

...

"Seeking to solve the problem, Prime Minister Rishi Sunak last month announced a 15-year plan to recruit and train 300,000 nurses and doctors, budgeting 2.4 billion pounds (about $3 billion) for the first five years. But critics point out that the plan does not fund wage increases, the only surefire way to prevent workers from leaving.

...

"No mainstream politician proposes to privatize the N.H.S.: The specter of the inequitable U.S. health system still horrifies many Britons. And in some ways, the service remains a marvel, one of the world’s most comprehensive, taxpayer-funded health care providers — “free at the point of delivery,” in the words of its utopian motto. It still offers annual physical exams, mammograms, vaccinations and other services at a level that visiting Americans find impressive."

Sex for the disabled and healthcare

The London Times asks: Is sex for the disabled the last taboo?
"The sexual feelings of disabled people have long been ignored. Now the medical profession is debating the issue"

The issue is not sex, so much as sex workers as a part of health care, and the role that the health care system should play, particularly for the most severely disabled patients who may need logistical support from health care workers .

The report is in connection with a conference called " “Disability: sex, relationships and pleasure”, which is being hosted by the Royal Society of Medicine in Central London. It aims to educate carers about the sexual needs of patients and to introduce disabled people to available support networks. It is backed by the Sexual Health and Disability Alliance (SHADA) and the Tender Loving Care Trust (TLC), which help to put disabled people in touch with appropriate sexual and therapeutic services, and offer confidential support and advice on sexual matters.
Tuppy Owens, the founder of the TLC, campaigns for the sexual needs of disabled people to be recognised by care workers. “Sex is right at the bottom of the list when it comes to their care requirements,” she says. “But they have a right to enjoy all elements of life just like everyone else. It is also important that they have access to sex workers because they don’t have the same opportunities as the average person to explore their bodies."
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"The Sexual Offences Act allows care workers to help disabled patients to book sex workers over the telephone, provided they do not become involved in the negotiation of fees. But there have been many reported cases of authorities stepping in to stop the practice.
“The problem is that many health professionals think it is illegal,” says Owens. “The TLC has had calls from carers who say that they have even considered giving in their notice out of frustration that they are unable to help patients seeking a sexual service that could make them happier.”
Many high-profile names have backed the TLC’s cause, including Lord Faulkner of Worcester, Baroness Miller of Chilthorne Domer and the philosopher and author A. C. Grayling, but no one has gone so far as to suggest that sex workers should be paid for by the NHS. "

Britain's National Health Service and private medicine

Up until now, Britain's NHS has insisted that patients either accept the NHS's formulary which does not cover some expensive drugs, or give up all access to NHS care; i.e. patients who pay for some of their own drugs have been required to pay for all of their drugs and treatment, even those that would have been free to other British citizens. Now, the Telegraph reports:
"NHS patients will be allowed to pay for private 'top up' care: Patients will be allowed to pay privately for drugs and still receive NHS treatment under plans to be announced by the Government in the next fortnight. "

"Under current rules, hospitals may withdraw treatment from patients who want to use their own money to buy drugs not available on the health service.
But Alan Johnson, the Health Secretary, is preparing to announce that so-called top-up payments will be allowed. "
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"Concerns have been raised that such a move would create a two-tier health service where wealthy patients buy life saving treatments denied to those who cannot afford them.
...The Government ordered a review into top-up payments earlier in the year. There has been a public outcry after some NHS hospitals refused to treat those paying for their own drugs or other treatments."

Incentives in (British) medicine

The Telegraph reports on the Annual Congress of the British Orthopaedic Association: Severely injured patients are being delayed specialist care because Government targets mean hospitals are encouraged to operate on routine cases first, experts have warned.

"Routine cases such as hip and knee replacements have to be carried out within Government waiting time targets meaning urgent trauma cases are delayed which can jeopardise their recovery."