The president of the BMA has described a third of health care delivered by the NHS as similar to medicine in the third world.
Giving his inaugural address to the BMA's annual meeting last week, Sir Anthony Grabham emphasised that he was giving his personal view. With 50 years' experience of the NHS, 30 years as a consultant surgeon in Kettering, Sir Anthony said that a third of NHS medicine was of the highest quality and a third was satisfactory and adequate. It was the other third that gave him cause for concern.
He said that he found it totally unacceptable that thousands of patients, many of them suffering, had to wait weeks and months for initial consultations followed by further waits of weeks and months for necessary investigations. It was unacceptable that anxious patients should wait for hours in crowded accident and emergency departments. It was unacceptable that elderly patients had to use their limited savings to pay for operations in the private sector.
It was these scenarios, the president said, that had led him to the conclusion 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.”
It was not only patients who were suffering but doctors as well, and Sir Anthony said that he had the impression that “all over the country there are doctors who are anxious, stressed, overworked, and demoralised because they can't look after their patients properly.”
He welcomed the chancellor's promise to correct the underfunding in the NHS by increasing the budget from £65bn ($99bn; €102bn) to £105bn by 2007-8. But he remained sceptical about the value of such political promises and suggested that some time in the future a different model of healthcare provision might have to be looked at— “possibly along continental lines of social insurance.” He appreciated that an alternative system was not supported in society or by the BMA. The association's policy is that the NHS should continue to be funded from central taxation.
Not all the representatives at the BMA meeting were happy that the new president had strayed into the political debate. Dr Jonathan Fielden, a consultant anaesthetist in Berkshire, said that the presidency was a ceremonial post and the incumbent should “keep out of politics.”
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NICK SINCLAIR
Sir Anthony Grabham