Wednesday, May 22, 2024
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Sunak, slave to the NHS


SUCCESSFUL companies deliver what their customers need at a profit. Those that don’t go bust. Those business leaders who blame their woes on their customers are heading for the Official Receiver.

So when Rishi announced that he would penalise no-shows for GP appointments I got curious. The number being bandied about is 15million missed appointments. That’s a big number, and thus as any behavioural economist will tell you, it’s impressive. But it lacks context.  According to the NHS there are, apparently, some 35,998 GPs in the UK, working a 37.5 hour week. At ten minutes per appointment that comes out at 421million appointment slots per year. Fewer than 3.6 per cent of them are missed. Say one in 30.

Now, how many people find it easy to get an appointment with a GP? Anecdotally, not many in the Time of Covid. One has to take the time that one is given. Fine if you’re not working. If you’re employed, you may well suffer from a volatile diary. Add in the complexities of childcare, traffic and the like and I don’t see it as particularly surprising that one in 30 of people who have a health concern don’t make their appointment. Many people struggle to get to business meetings on time, even if it’s in the same building.  A 2021 report by the British Journal of General Practice lists some reasons for absence, including work, mental health etc. . It also notes that those of lower social economic background are more likely to miss, so Rishi is planning to fine the poor for struggling with the NHS.

This confirms exactly what many of his critics have been saying – he’s been captured by the system that he wants to run on our behalf. And the NHS is utterly useless at booking appointments – as I know from my own experience. The 3.6 per cent no show is their problem, not their customers.

I’m a tad deaf, so I need the odd check-up. I used to get a letter stating that I had an audio appointment at a hospital 20 miles from where I live. I would often get another letter changing it and sometimes when I got there the appointment was cancelled anyway. If it wasn’t, the surly staff (administrative and medical) impressed upon me how fortunate I was to have such a wonderful service.

Then one happy day Specsavers started doing NHS hearing tests. Make an appointment at my local branch online, get a reminder by text, get seen. They’ve even helped when I’ve had a minor problem and walked in off the street. Best of all, I get seen by someone wearing a hearing aid who understands the problems of hearing impairment, like lipreading when people are wearing masks. It’s not just audio, it’s the same for eye-scanning. My dentist (private – NHS dentists round here are rarer than hen’s teeth) is similarly customer-oriented, as are the 29,000 vets, who will come and fix injured livestock in a field in the same day. (There are 22million sheep, 9.5million cows, 42million cats and 12million dogs in the UK, most of which can see a vet within 24 hours or much sooner if necessary). So why can’t our lavishly funded NHS management run a simple booking system?

Any minister who had run a whelk stall would grip the civil servant. Any minister who could count would demand context and do the maths. Sadly the path from Oxford via Harvard to the City seldom involves getting one’s hands dirty. There was a numerate contender in the leadership race, but now we have the choice between the systems captive and one who claims to get things done, although is elusive on what, where and whether it was an improvement (any bloody fool can change things for the worst).

Whichever PM we get, the certainty is that by offering us this pathetic choice the Conservative Party is demonstrating that it’s no more able to govern than Boris Johnson is of telling the truth.

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Patrick Benham-Crosswell
Patrick Benham-Crosswell
Patrick Benham-Crosswell is a former Army officer who has spent the last 30 years in commerce. He is the author of Net Zero: The Challenges, Costs and Consequences of the UK's Zero Emission Ambition. He has a substack here.

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