Isolate 'care' from 'cure'
This is the first in a short series of posts about the NHS.
As a country, the NHS is the biggest issue we face. If we leave it to the politicians - you know, the people who don't know that invoices for £1.7billion are coming through the door - the NHS could bankrupt us.
Bizarrely, we all know this could happen.
But no one knows what to do about it - or has the guts to take the decisions that need taking.
There are two irreconcilable forces:
'Free at the point of delivery' is economically unaffordable. There is a 'funding gap' which is predicted to rise to £30billion by 2020 and £60billion by 2025.
'Private sector funding' is politically unacceptable. What a furore Farage caused last week by his suggestion that the NHS be managed by a 'US style insurance based system'!
So.
Creative thinking is required.
But, as the most creative country in the world, have we engaged our most talented creative thinkers to develop new ideas to resolve this dilemma?
Er no.
As ever, all manner of 'stakeholders' have had a say but our best creative brains - the people most qualified to crack this problem - are left in the cold.
So, as someone who has become a bit of an expert in the NHS over the last ten years, I am going to apply some 'upstream creative thinking' to all this and sort it out it myself. No, really. Please don't worry. It's no problem. Really it isn't. It's what I do.
First, I must urge the nation to reconsider my posts of 6 June 2011 and 27 February 2012:
These posts show that - if properly thought through - private sector funding could be introduced to the NHS without losing control of quality of service (or, more pertinently to some, without making other people, especially foreigners, rich at the UK taxpayer's expense).
There is no doubt that, like RBS and the NatWest, 'shared ownership' would be a better way.
Let's park that thought.
Why be better when you could be even better?
Is there a yet more radical, more creative, solution?
If so, where to start?
When facing creative challenges like this, the hard work comes at the beginning. It is necessary to ruthlessly examine all the facts, to be objective about all the vested interests and to dig deep, and then deeper still, in search of the truth.
You will find all creative people go through this process - musicians, artists, scientists and, yes, even advertising people. To achieve greatness in their chosen fields, they all need to ruthlessly interrogate the truth they seek in order to present their reinterpretation in an original way.
So what is the truth behind the NHS 'problem'?
How did it get like this?
Well, like all things which are true, once you find the truth, it seems ludicrously simple. You wonder how human beings have allowed things to become so complicated.
Because of this, in the case of the NHS, I do not need to take you though all the boring background arguments, the tedious political posturing.
For you know the truth already.
The truth is that, for the NHS to have survived so long, it has, by definition, been doomed.
Here's how it is:
The more people you 'cure', the more you have to 'care' for.
As medical science has advanced, it follows that people who can now be treated and 'cured' today, would, in previous generations, not have been cured and would not have survived. They would have died. And, because they would have died, they would not need to be cared for.
Thus, to a large extent by its own success, the NHS, which started life as a treatment based 'medical service' for people who are ill, has become an extended 'care service' for people who are not as ill as they were.
Because of medical science, some people who need care need it on a very long term basis. And it is this that the NHS cannot afford.
Thus the creative solution for the NHS is to redefine itself in terms of treatment and care.
This thought may seem simple.
It is also very radical.
Once you have taken it on board, further creative thinking can be developed so that both of these elements of healthcare ('health' and 'care') can be redefined and restructured, medically and financially, to achieve a national health service that works - and that we can afford.
My recommendations on how to achieve this goal will be revealed in my forthcoming posts.