As this issue goes to press, the main news is that junior doctors have gone on strike, downing tools in all areas for the first time since the NHS began. Despite some media slants suggesting otherwise, the dispute is ‘cash neutral’.
Rather, it is primarily a protest against a heavy-handed approach by current government to impose a contract change which, without any evidence to back up the statistically spurious but sound bite friendly adoption of 24/7 cover, has almost certain consequences on both doctor’s working conditions and, more importantly, quality of NHS care provision.
A country weary of pre-war privilege and class-ridden deference embraced notions such as income-linked national insurance schemes. These promised the delivery of care way beyond the door-to-door ‘how much can you afford?’ service remembered from the post-Victorian era.
Wealth redistribution is a doctrine that divides the UK, and generations tend to vary in their attitudes, see-saw like. The current demographic cannot realistically expect free access to all forms of care but, as with any finite resource, the main arguments always concern where the limits are drawn.
From the introduction of private finance initiatives (now a major contribution to the drain on NHS funds) through to the more recent grab for care provision contracts by private providers (who, it has to be said, do tend to cherry-pick the sexier areas of health care), the challenges to free health provision have been somewhat one-sided.
State-trained doctors can be tempted into the private sector but how much private sector money is ploughed back into their training? Efficiency drives easily mask doctrine change. And many a scandal within the NHS has not helped the cause.
Optometry has been an uneasy balance of commerce and care, but I firmly believe our role in the primary care sector, fully funded, can support not detract from the original NHS vision.
