COLIN CAMPBELL: New signals from NHS that numbers aren't adding up as more people await surgery and can’t afford private treatment alternative
A relative forwarded to me a letter he's received from his GP’s surgery advising him that a particular type of medication he's taking is being changed.
From now on the pills he'll receive on prescription, the letter stated, will cost the NHS 60p to purchase from the manufacturer. The tablets he's been taking up to now are 10 times that amount. “At a time of significant pressure on health care resources it is felt that considering a switch from edoxaban to apixaban is a sensible approach to optimising available budgets,” he was told.
It's the first time I've seen specific costs mentioned in a letter from the NHS, and in recent times I've received quite a few. The recipient of this letter is by now all too well aware of the direct link between money and health. The financial numbers game is becoming much more of a feature of healthcare and treatment, except it's no game.
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As the weeks painfully dragged by in his waiting time for a date for a knee replacement operation, he considered getting it done privately. The relevant number there was £15,000, what the operation would have cost him. His ordeal - akin to that of so many other people - ended after 80 weeks had passed. The day in February he had the operation will remain his most significant dateline number of the year by far.
I had a day case operation done earlier this year. If the letters I'd received had included financial references to that they'd have made me aware of the overall cost of the procedure, which I know from my own checks was quite a substantial amount. I was fortunate in having this done without delay, something for which I was more grateful than I once might have been, in a time when punctual treatment and surgery were pretty much taken for granted.
Not so long ago at Raigmore Hospital a senior nurse was hirpling along in obvious discomfort or pain in the department I was in. I knew what my problem was. What, I asked, was hers. She told me she was in need of a hip replacement. Going private was not a £15,000 option for her. Her daily priority was assisting an endless flow of patients. She herself was prepared for a long and painful wait for surgery and relief.
More people I know are becoming aware of the staggering cost of treatment and operations faced by a health service which, we're increasingly being warned, is "on the brink of collapse". And when you get to my age, and to that of the sender of the letter I received, health awareness and concerns tower in importance over everything else.
There should be some middle ground between getting operations "free" on the NHS after long delays and choosing to go private - as so many are doing - and being forced to shell out thousands of pounds.
The status quo is not going to be sustainable for too much longer. As people live longer the burden on the NHS is going to bear down heavier, waiting times will lengthen and things will get steadily worse. Especially in this region where one in four of the population is over 65, the most daunting and alarming statistic I've seen in years.
Sooner or later I hope we can see a workable and broadly acceptable system which enables people over the age of 50 to pay an extra amount annually which will ease their passage to more timely treatment on the NHS in older age when they are most likely to need it. It may be a Herculean task to put flesh on the bones of any proposal involving significant reform. But the alternative is to sit back and do nothing. Many will know someone - or several people - on long surgery waiting lists, if they’re not in that predicament themselves.
The point where the narrative changes from the NHS being "on the brink of collapse" to actually collapsing may be difficult to define. But as things stand we're surely getting there.
