spiked proposals: The NHS

As GPs highlight a 'crisis' in their profession, Dr Michael Fitzpatrick makes some positive suggestions for improving the health service.

Dr Michael Fitzpatrick

7th June 2001
Topics Politics
  • A 10-point programme for the NHS

The NHS provides the framework through which much of the government’s social policy is now delivered. After four years of increasing state intervention in the health service, the way forward lies through the abandonment of many of these initiatives.

Here are 10 straightforward ways to improve primary healthcare, by rolling back the advance of a wide range of intrusive and authoritarian programmes.

  1. Health promotion. As everybody now knows that smoking and drinking excessively are bad for them, and that a balanced diet and exercise are good for them, it is unnecessary – and pompous – for doctors to keep telling them so.


  • Screening tests. Screening tests for cervical and breast cancer are better at provoking anxiety than they are at saving lives; screening for prostate cancer, which is now being piloted, is even more unreliable and of even more questionable preventive value.


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  • Social work. With the demise of local authority social work, doctors’ surgeries are becoming the base for projects dealing with drugs and alcohol, child protection and parenting skills. Doctors’ involvement in these areas inevitably leads them into conflicts with patients, without conferring benefits upon them.


  • Social security. In the attempt to squeeze people off sickness and invalidity benefits, GPs are now expected to assist the government by providing reports. It is time that sickness absence was negotiated by workers, either directly with employers or with the Benefits Agency, thus leaving GPs out of it.


  • Sexual health. Under the Teenage Pregnancy programme, GPs are expected to instruct the youth on matters of sex and relationships, while giving out free condoms. This should stop (see The high price of free condoms).


  • Traditional medicine. Under a scheme promoted by the Department of Health, and supported by numerous organisations, GPs are being encouraged to collaborate with traditional practitioners such as acupuncturists and herbalists, as well as with more modern techniques such as homeopathy and chiropractic. This trend for scientific medicine to embrace representatives of systems which it transcended in the course of its development in the eighteenth and nineteenth centuries marks a troubling regression from rationality to prejudice. (See The rise and rise of CAM, by Bríd Hehir )


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  • Old organs. Following the Alder Hey inquiry, it is now easier to get a dead kidney (or other organ) from a long-deceased relative than it is to get a live kidney for a transplant (see spiked-issue: Body parts)..


  • NHS Direct. The government’s 24-hour nurse-led telephone advice line provides advice and information to the worried well, thus making them even more worried so that they turn up, either at casualty or at their GP’s surgery.


  • Appointments. The government insists that patients should be offered a GP appointment within 24 hours (for an urgent problem) or within 48 hours (nor a non-urgent problem). These demands, which appear to have emerged from a Westminster focus groups, indicate the trend to reorganise the NHS around the needs of those who need it least (the young and fit middle classes), rather than according to the needs of the chronically ill, the elderly, the very young, and so on.


  • Walk-in health clinics. Walk-in clinics offer an alternative to conventional GP surgeries. Another concession to the chattering classes, they also provide a means of undermining conventional (self-employed) GPs and replacing them with salaried employees. While resources are squandered on these high-profile initiatives, patients are queuing up on casualty trolleys awaiting admission, or languishing in dirty hospital wards after months of waiting. The switching of NHS resources away from political stunts towards serious medical care might even improve hospital survival rates.

    • Dr Michael Fitzpatrick is the author of MMR and Autism, Routledge, 2004 (buy this book from Amazon (UK) or Amazon (USA)); and The Tyranny of Health: Doctors and the Regulation of Lifestyle, Routledge, 2000 (buy this book from Amazon UK or Amazon USA). He is also a contributor to Alternative Medicine: Should We Swallow It? Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)).

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