Wednesday, 23 May 2007

My Sweeping NHS Reforms

In the event of waking up one morning and discovering I'm still Minister for Health (sick fantasy I know!), here are my reforms for saving public money by spending the NHS budget more wisely & hopefully breathing new life into our once 'envy-of-the-world';

1. Clean existing hospitals instead of building a new one every time an old one gets dirty! With the money saved, the newly-gleaming hospital could employ enough staff!

2. Bring back Matron and real bedside nursing, including help with eating for the malnourished and soon-to-become malnourished. Preventing MRSA would also save money, lives and su-age.

3. Reinstate in-house nursing, cleaning, maintenance and catering staff and jettison outside and agency contractors (who are never cheaper and invariably don't offer the same loyalty, accountability and continuity of care of direct employees.).

4. Counsel male-to-female transsexuals that there are enough lonely middle-aged women in the world, whereas sensitive men in touch with their feelings who haven't castrated themselves and might prove a positive role model to young fatherless males will always have a USP & plenty of market takers!

5. Issue free non-slip slippers to all over-60's (the clue's in the name!) to prevent up to 40% of trips and falls resulting in broken hips, legs and invariably lengthy, painful and expensive hospital stays.

6. Convert or rebuild the numerous derelict buildings to be found on every hospital site into affordable short-medium term housing for staff, particularly those starting out in their careers.

7. Women seeking NHS abortions and women seeking NHS fertility treatment to share hospital waiting rooms...

8. Issue free multi-vitamins to pensioners and offer free home visits from dieticians to go through their cupboards and advise on diet. Up to 60% of senility is exacerbated by vitamin deficiency owing to a narrowed/restricted diet, such as the unrecommended tea and apple pie diet adopted by my grandmother in her final years.

9. Ensure ALL PATIENTS get the latest drugs and treatments to reduce money lost through re-admission rates and also patients' families suing when a patient has died or their condition worsened by an outmoded drug or treatment. And if a patient has nothing to lose anyway, why not let them try clinically unproven drugs if they wish to, so long as they accept the risks and sign the disclaimers? Seven years development is a long time to wait for each new drug if you haven't got seven years and the new drug in question may be your only ray of hope!

10. Bring back convalescent homes for patients who have completed the high-tech or surgical side of their care and just need several weeks nursing, good diet, physiotherapy etc until fully recovered to go home. Too many re-admissions are caused by premature patient discharge to free essential beds.

11. Make ALL hospitals clean, friendly and competant - people don't want to have to analyse the respective merits of hospital league table results before calling the ambulance in mid-collapse with a heart attack!

12. Give carers all the respite and support they need to carry on caring for the long term sick and disabled in their own homes. Carers are heroes, saving the government countless millions, and will amply reward any money invested in them. In fact why not make personal full-time caring a proper career option with proper pay, holidays etc? This would still be considerably cheaper and better for patients than government nursing care and indeed enable more families to be able to afford to leave their day jobs to look after loved ones and relations at home.

13. Forget about refusing treatment to anyone born pre-1948 founding of the NHS. Everyone born up to 1948 (and probably for some time beyond as well) was PROMISED care 'from the cradle to the grave'. I'm amazed no one's sued via the European Court of Human Rights for breach of promise on this. Rather shabby treatment of a generation who helped win World War II to boot!

14. Nearly £2k per capita is paid into the NHS kitty each year for our healthcare. Every Christmas why not offer £200 per person cashback if they have not needed hospital treatment that year? Great incentive to keep healthy and it would help them recover after Christmas, both financially and emotionally.

15. All staff working in the NHS to speak adequate English and possess reasonable handwriting skills to avoid treatment mistakes.

16. Free life-coaching for any patient who asks re diet, exercise and lifestyle. Lifecoaches also to tour all schools.

17. No hospital doctor to work a shift of longer than 12 hours.

18. All foreign nationals to be charged for healthcare unless they have lived, worked and paid taxes in UK for two years.

19. Audit and defenestrate if necessary, any surplus layers of hospital management.

20. Regular case meetings on patients and their conditions and an automatic right to a second opinion for any patient unhappy with their diagnosis.

NB Unlike some, I have no issue with smokers and drinkers requiring repeat treatment as no matter what state they are in as a result of their own actions, they will have paid this many times over in booze and fag tax. If the government is not re-allocating this tax money to their healthcare, that is something they should address. In addition should fatty foods also be taxed with the taxes being ploughed back into the NHS to treat the obese? The problem of recreational drugs and all their societal fall-out shall be mused at a later date.

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