The free-at-the-point-of-delivery principle of the NHS has been compromised for decades – prescriptions charges, opticians and dental charges, but encouraging patients not to see their GP sounds like a recipe for disaster.
I grew up in the optimistic 1960s when killer diseases were being wiped out. Diphtheria, rickets and smallpox were moving to the history syllabus. Improved housing and public health, together with mass immunisation campaigns had finished them off. I remember the shock of a colleague’s daughter being diagnosed with tuberculosis in the 1980s. I thought it had been eradicated, but poverty was there to bring it back.
Tuberculosis, whilst not common, is now present in every inner city community. I was shocked again when my daughter didn’t go through the adolescent right of passage that is the BCG injection. Surely we need the immunisation programme now more than we did in the 70s when I queued up amongst rumours about how big the needle was.
I’ve come into some money this week. Rather like Monopoly, a savings plan has matured. It’s allowed me to pay back the money for my last dentist bill to the household account and I’ve booked an eye test.
The dentist bill came about from a rather large (free) NHS filling from my youth finally crumbled. I’ve got a fantastic new filling, precision milled ceramic by computer from 3-D images of the cavity. It cost me £300. I’m a private patient because my NHS registration lapsed when I missed too many check ups because there didn’t seem to be anything wrong with my teeth. When I tried to reregister there were no NHS dentists to sign up with.
I started wearing glasses about ten years ago. At first just reading glasses, but then I was told I really needed varifocals. They’re great, but they set me back a few quid. A drop in income has meant that I haven’t been back for an eye test since. I could afford the test, but not necessarily the new glasses.
So, charging for GP appointments. Whenever I go to the doctors, there’s always a notice about how many people haven’t attended their appointment. This has always puzzled me because it’s very difficult to get an appointment. You have to get on the phone at 8:30 and keep hitting redial until you finally get through. Even then you can only make an appointment for that day, so you hardly have time to forget about it.
Adding an extra hurdle of £25 for the visit may, or may not reduce the number of missed appointments, but it will certainly deter people from seeing a doctor.
I don’t think people like Jeremy Hunt, the health minister, understand how much £25 is to plebs like us. I doubt he uses the NHS (except for A&E of course). I remember hearing that arch right winger Roger Scruton on Radio 4 in the 1990s. He was debating dental charges and suggesting that NHS patients should pay something, rather than get free treatment. “We already do!” I (and probably thousands across the country) shouted at the radio. John Humphrys didn’t act like a rottweiller for once – perhaps he didn’t know either. These people are completely isolated from the real world.
So the return of Victorian diseases and fewer people seeing their doctor – it’s a heady mix.
I was struck by a letter in the Guardian yesterday that quoted this story from the pre-NHS days:
And sometimes he (the doctor) would shout at my mother for not having come before, like the time we had to wait for my sister’s sore throat to turn unmistakably into diphtheria before she was pushed off in a pram to his surgery. “Good God woman, why didn’t you bring this child days ago?” And then even he read the silence as the half-crown came out. “Damn the money” he said as he slipped it into his pocket.
The point is that treatment of diseases will be delayed and will have a chance to spread. Areas like south Leeds will suffer first, where is the greatest number of people delaying their treatment (not to mention worse health to start with). But even plebs like us travel, to the city centre, to the railway and coach stations. So there will be plenty of opportunities to spread these diseases to even the most affluent areas.
I’ll be back next week with more of my views from South of the River. If you’re on Twitter, you can follow me: @BeestonJeremy.