By way of submitting this bill, Dr Lee was merely taking steps to address the fatal problem of economic blindness in the NHS – and I am not exaggerating when I say it is fatal, as I shall explain in this and later blogs. Rather frustratingly, however, Dr Lee’s bill was rejected on the basis that it was potentially divisive.
In my opinion, by way of voting against Dr Lee’s bill, MPs were effectively painting him out to be some form of Parliamentary Dr Josef Mengele who once the end of the wedge reached the thinnest end, would arrange for the annual buff envelope rebuke from one’s surgery to be replaced by a small padded envelope containing a vial of cyanide and a black-edged post-it note bearing the instruction: ‘just do it’
This scenario couldn’t be further from Dr Lee’s mind, however – his strategy is one of saving lives, not the other way round. And I should know because I lost a friend to the vagaries of the NHS ‘selection system’ which in the 21st Century, shamefully and horrifically casts random death sentences on patients due to lack of financial visibility. In fact, in my opinion, those MPs who rejected the plan are the insidious institutional Angels of Death for obstructing a process which could save MANY lives. In fact, I wouldn’t be surprised if this species of ill-considered obstruction to urgent and Society-enhancing Parliamentary bills will at some point in the future, constitute an act of criminal negligence.
No one is disputing that Dr Lee’s proposal would need some detailed hammering out at the micro level such as formulating a reporting style which didn’t give the impression that it was victimising individuals who through no fault of their own are suffering from chronic or terminal illness and receiving costly treatment. This would not be rocket science, however – it would be a simple process of manipulating the reporting tools within a database to produce a pleasing and friendly style of format. And although I cannot provide a precise percentage, I would imagine a good proportion of patients using a surgery in any given year are presenting with relatively banal complaints and are thus hardly going to be offended if they receive a statement listing the likes of: ‘piles inspection - £10’. Additionally, what would be wrong with your GP including a bit of friendly advice attached to your statement, such as gently pointing out that certain drugs which you’ve consumed throughout the year wouldn’t be required if you were to make various lifestyle changes? And why would the inclusion of such advice be any different from getting your ass kicked by your fitness instructor for your burgeoning cellulite, hey?
Sadly, I believe that Dr Lee’s proposal could have spearheaded a very innovative and refreshing process in how we interact with our local surgeries. In fact, it would not be dissimilar to how the ‘Green’ process began – it was all about creating awareness and empowerment in communities and it gradually caught on.
To put Dr Lee’s plan in actual medical context, I suffered with relentless verrucas for a couple of years and a GP at the local surgery would regularly freeze them off. Eventually I happened to mention my condition to a colleague and she informed me that freezing them off had had no effect on her verrucas and that I should try a certain OTC gel – try it I did and bingo they were gone the next week – literally. Ditto for an eczema problem and ditto for a stomach problem. Then there is the matter of blood pressure checking in the surgery – I am not here to comment on the effectiveness of various machines but as a carer, I was worried about my stress levels, so I tested my blood pressure several times with a home machine and it consistently matched the readings on the Dr’s machine.
After reading these examples from my own personal healthcare history, doesn’t it occur to you how much money is potentially wasted in the NHS in terms of needless visits to the GP, consumption of prescription medication the like of which could be bought cheaply and safely over the counter, and conditions needlessly monitored by the GP which could just as well be tracked with an inexpensive home machine? I am sure many people have had similar experiences, but without statements and the accompanying practical guidance, we are provided with no impetus to systematically work with the GP to save the NHS.
Going back to the process of society turning green – how much is recycled at various centres is often publicised and a community praised accordingly. For our cash-strapped and creaking NHS, shouldn’t we be applying the same process ie proactively generating NHS cost-savings by modifying our health-seeking behaviour then congratulating ourselves with a monthly total savings figure displayed on a board in the Surgery’s reception? And if a community is able to take ownership of its healthcare cost centre in this way, then I believe the correct decisions of allocation will automatically be made. Let’s face it, members of the community come face-to-face with their own sick and needy in their high streets and supermarket every day, so the combination of visibility of finance and patient presence, will be a powerful motivator for the fair allocation of healthcare resources.
As an ex-NHS management accountant I believe that the production and distribution of patient statements is probably one of the most efficient ways of making urgent inroads into the massive problem of NHS waste. The GP surgery is effectively the point of sale after all, so that’s where you should check your receipt and make sure you and everyone else is getting value for money. It is the GP’s job to care for patients, not to play accountant and because we are collectively the providers of capital for the NHS via NI contributions and we are also the end user, then it is our duty to perform the financial analysis at the micro level and act accordingly, because no one else is going to do it for us.
If you are reading this blog and support Dr Lee’s idea, then may I suggest you treat bureaucracy in the way it should be treated ie by pretending that you live in a parallel universe where it doesn’t exist. All it would take to get the ball rolling towards the manifestation of Dr Lee’s plan across the UK is for one small group of intelligent, visionary and compassionate patients who are on the list of a particular surgery to proactively ask for their statements then connect regularly to generate ideas for saving money. With a sustained recruitment drive and a bit of publicity, I am sure this activity would catch on very quickly.
I should also mention here that I recently attended a national healthcare function and chatted about NHS visibility to an individual who is senior and well-known within the financial services industry. He too is a fan of this form of reporting and agreed with me that the additional supply of as much cross-sector financial context as possible would enhance the chances of eliciting the required behaviour modifications in individuals. However, the MPs who rejected Dr Lee’s bill have also reduced the chances of other MPs with similar progressive ideas of getting anything done – no one can provide anyone else with that necessary context because a very dangerous public service evolutionary impasse has been reached.
Finally, I have to admit to being very confused as to why MPs branded Dr Lee’s bill as divisive in the first place because this process is no different from the production and dispatch of bank statements, so the bottom line is you don’t have to open the envelope, do you? In fact, in articles relating to Dr Lee’s bill, I haven’t found any reference to a suggestion that a gun will be held to one’s temple if an envelope containing a patient statement remains unopened. However, everyone knows that we are all like sheep when it comes to trends catching on, so it wouldn’t be long before we were ostracised by our families, friends and colleagues for not taking a peek at the price of that piles ointment. Furthermore, as we are all obsessed with our health and personal finance these days, would we actually be able to stop ourselves? I don’t think so.