The Thin End

Private practice directly affects the quality of care that NHS patients receive and doctors should not be allowed to work on both sides of the divide, writes a senior doctor in The BMJ this week. Recently I sat waiting for a urology test. The clinic was already running late.  When I arrived it was running 45 minutes late, but now the 'estimate' had been changed on the white board to 90 minutes.  I sat patiently waiting. It was not unusual. I had come prepared with a newspaper to read.  A woman opposite broke the 'silence'. "I went private last time!" she declared. Some of us looked up, wondering whether this was the solution to waiting. "It was the same doctor!" She declared, and we wondered how a busy consultant could work both for the NHS and have a private clinic.  To whom did he owe his loyalty? It has been an accepted part of the NHS since its foundation.  At the heart of the NHS has always been this conundrum. Does it matter? Is ther...

We know now that the NHS is stretched to breaking point.  The doctors and nurses tell us so.  This is not an organisational issue.  This is an issue of funding.  With increased demands, with flat-line funding year on year for the past five, and fewer nurses, the system is creaking.  This is the reality on the ground. In a pre-election report , the Royal College of Nursing  says that the he fragile frontline also highlights other areas which the next Government must address as a matter of urgency. The community nursing workforce has been cut by over 3,300, despite NHS plans to move care from hospitals to the community. And the recent increases to student nursing places are not enough to make up for previous cuts, increasing demands on an ageing workforce. The report also reveals that last year over 30,000 potential nursing students were turned away as over 50,000 people applied for just 21,205 places. Yet figures from UCAS show that there is no shortag...