Monday, 9 January 2012

Guest post: silicone implants, the NHS and you

This guest post is written by a very good friend of mine who has worked in the NHS for over 30 years. She began her career in nursing and is now a senior NHS manager. Please take a couple of minutes to read what she has to say.
There has been a lot of coverage in the press about the poor quality silicone implants, which have been used in breast "enhancement" surgery.  This has sparked debate in many quarters on what should be done for the women who've had breast enlargements.  On Mumsnet, for instance, one contributor wrote "let the vain bitches die of cancer", but most were sympathetic, and many thought that treatment, including surgery to remove the implants, should be undertaken by the NHS.  One thing was clear; people trusted that the NHS would do it right.
People tend to feel very strongly about the NHS.  Admittedly there are many negative, some appalling, stories in the press, and perhaps you've even experienced some poor care yourself - but in the perspective of a lifetime most people probably have very good care.   In 1948 when the NHS was created they talked care being provided "cradle to grave", but with advances in technology it became "sperm to worm" and now its "erection to resurrection".
Some of us who work in the NHS understand what the so-called "health service reforms" mean - but it's all so complex, most members of the public don't. So I'll try to break it down to some very clear messages: it is privatisation.  It will take away the duty of the state to "provide" care, the state will just provide the funding, i.e. an insurance system.  This will allow care to be bought from any hospital, clinic, or community service.  The big multinational companies are waiting in the wings, rubbing their hands with glee - a great-untapped market they can make profits from.  They will be outcompeting hospital and community services run by managers who have not come from the world of business.  
This reform is also coming in at time when cuts are being made - oh yeah - they don't call them cuts, but the hospitals have to return "savings" of about 4%.  So the NHS hospitals will be struggling to survive economically, and some will be bought up by private companies.  The companies exist to maximise return for their shareholders, so we have a scenario where cheaper, lower quality products will be used, patient to staff ratios will be increased, and the amount of regulation and scrutiny will be reduced. 
I think the story of the silicone implants should signal a warning about the danger of privatising the NHS. The private company that manufactured the implants has gone out of business.  I don't know what influenced the private clinics' choice of implant - but I suspect cost had something to do with it.  No one is clear where responsibility lies now and the private providers are unable to supply adequate records of what they have been doing and to whom. The same private clinics are charging exorbitant sums to those women seeking information on what happened to them.  
Thankfully we still have the safety net provided by National Health Service for now. Let's hope the House of Lords, which is currently considering the Health and Social Care Bill, will now think twice.  The Bill provides much less protection for patients than is available to people booking package holidays. This cannot be right.  I hope you, like me, are doing all you can to stop the NHS privatisation, by contacting your MP or local Lord and spreading the word.