13th March 2012

Standing on the steps of the crematorium waiting to take my first cremation in 1969 I was told a joke by the Funeral Director.

It was a ploy of course.

Get the new curate chuckling just as the hearse drew up and see if he could contain his laughter long enough to get through the service with due solemnity.

The joke concerned a funeral, the crematorium was at the top of a steep hill and as the hearse slowly climbed the hill the unsecured rear door burst open.

The coffin shot out and careered down the hill.

There was a T junction at the bottom of the hill and a Chemist’s Shop.

The coffin burst through the open door of the Chemist’s, bumped up against the counter where the lid flew up and the body sat up asking, have you anything to stop me coffin?

Of course what is being proposed for the NHS is no joking matter.

The market will rule OK!

At least it will determine some 49% of what will be offered in the form of treatments and services and increasingly it will be cheaper and easier to go to the Chemist, which is what happens in a large part of Europe and in the USA, where self- treatment with proprietary medicines accounts for the largest part of the treatment regime available to the poorest, the elderly and children.

The problem with NHS reforms, as currently proposed, apart from the fact that hardly anyone except the Government wants to see them introduced, the majority of Health Care professionals having argued against them, is that the only beneficiaries will be the private providers.

It doesn’t really matter who decides what treatment is appropriate if the choice they have has been reduced and what is available within the public side of the NHS has been handed over to the private side.

For most people a visit to the Doctor is an occasional, even a rare event.

Increasingly people enjoy better health as a result of improved diets and prophylactic treatments.

But for those who have a chronic condition, however it has been caused, the proposed changes do not look like reforms but deforms.

If you need regular monitoring of blood to check co-agulation or glucose levels, those services and associated costs will not be eagerly assumed by private providers, and so you will slowly drift toward the US system, which at one level is the best health care service in the world, hi tech, deeply sexy and successful in treating difficult critical conditions but much less able to offer the low tech, tedious, but no less crucial monitoring required to keep the chronically ill well and functioning normally.

MS is not a specific condition it is description of symptoms and as the condition progresses sufferers may need to be supported and monitored and that will be costly over the long term.

The funding is never sufficient because it can never be sufficient.

It is this worrying aspect of the proposals that are of concern. There are no guarantees, the McKinsey and KPMG advisers who are actively promoting the privatisation of the NHS are unlikely to have given any thought to access and the need for wheelchairs and other aids and adaptations.

Anyone who suffers from a chronic condition will have to increasingly rely on charitable support as they seek to continue to function within their own home or environment because they will almost certainly fall through the gap that the 49% represents.

No doubt the consultants will be on view in the hospitality rooms at the Para-Olympics patronising the athletes, perhaps they’ll share a few jokes, but I somehow feel that I know who will be having the last laugh …………