Anthony Grabham: Is the cure in sight for the NHS?

Taken from the inaugural address by the new president of the British Medical Association at the annual meeting in Harrogate

Wednesday 03 July 2002 19:00 EDT
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I note with real sadness that equity of access to care, which was one of the great aims of the NHS, today frequently means equity of access to poor or indifferent services unless, of course, you happen to be one of the growing numbers of private patients.

There is much that is very good in the NHS, but I fear that there is now so much that is so bad and so persistent that one can no longer allow the good to continue to obscure the frankly bad.

I had recently come to the conclusion that if the underfunding of the NHS, with all its problems, had persisted for over 50 years it was unlikely to change now, and I had come to the view that we should be carefully and critically reviewing other healthcare systems – possibly along continental lines of social insurance rather than a tax-based healthcare system.

I know that this view is not widely shared in society or in the BMA, but after 50 years of underfunding it seemed reasonable to at least consider the alternatives – particularly in those countries where the health services clearly work better than the NHS. It did not seem to be too revolutionary a thought. It just seemed to me, that in a civilised society, in a wealthy country in the year 2002, there is something wrong somewhere with the system.

I had come to this view very reluctantly (as a child of the NHS) and I have to confess that I was both surprised and delighted when I learnt of the Chancellor of the Exchequer's statement in his spring Budget. He seemed to be acknowledging, frankly and for the first time, the chronic and severe underfunding of the NHS, and he was proposing to correct that underfunding by a major increase to be in place by the year 2007-8 – increasing from the current £65bn a year to £105bn by 2008.

The question for us all, therefore, is: can we now justifiably begin to feel that the problems of the NHS have been acknowledged and that the "cure" is in sight?

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