Wednesday 2 February 2011

Taking the NHS for granted

It might be true to say that you only really understand the true value of something good when you have to live without it.

Moving to South Africa, we were aware that we would be using a different health care system and that we would be responsible for the costs incurred if we needed to see a doctor or go to hospital. As a requirement for our visas, we needed Medical Aid, which is the South African model for health insurance.

What we didn't realise is that there are lots of hidden charges and squirming ways in which medical aid providers try not to pay up or communicate what they are willing to pay for. Also, we didn't know that hospitals, doctors and other medical services are very unclear on their funding structures.

In fact, the other day a midwife told us "Often it's not until you get the bill that you'll know who is going to pay for what!"

We have had an acute experience of this system moving here right at the time when we are expecting our first baby. In the UK, as tax payers and British citizens, we had no idea how easy we had it. Attending check-ups with the midwife, booking into hospital, having scans, getting prescription drugs and all the other medical services used were all '"FREE". Of course we knew that these costs were covered by our taxes under the National Insurance tax system. But the beauty of the system is the focus: health care first and foremost.

It seems somehow wrong to be given choices, based on healthcare, like you were choosing a hotel room, or a bottle of wine. We have had to make some tough choices on where to give birth, how to give birth (water birth, home birth etc) and pain relief, not based on Becky's well being and future health of her and the baby, but on what we can afford. This makes it clear who has money and who hasn't. What's bizarre is that those with wealth, aren't necessarily given the best choices. Private hospitals in this area encourage those with money and good insurance to opt for a c-section. Why? Because of the safety of the mother/baby? No! Because of fear of litigation, if things in a vaginal birth go wrong. Choices are made, not based on the long-term health and well being of the patient, rather on what will enable the hospital or surgery to reduce the likelyhood of being sued!

We are embracing the life here in South Africa. We have made so many friends from many walks of life who also bemoan the system here. As visitors, we're not inclined to just complain about how 'different' things are here. This is more of a reflection and thanks for the services we received through the NHS.

The very idea of a health system, whatever country you're in, that works for greedy insurance companies and is in constant fear of law suits will never be as good as those that work for the good of the patient. Oh yes, you might get friendly service and a hotel-like environment when you check in, but is that a worthy compromise for behind the scenes decisions made on your behalf? I think that it's is our moral duty to look after the people that surround us and ensure that healthcare provision is based on need and not social status.

For all its faults and difficulties, I love the NHS and I wish that many other countries adopted its model. Never again will I take the services I received from this age-old institution for granted. Thank you NHS!

1 comment:

Kelly said...

Well said Peter! People in the UK definitely take the NHS for granted!