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4. Free of money: Money is neither an anxiety issue during illness, nor is it thought of during consultations. And for that matter, to the pleasant surprise of the consulting migrants, their innocently offered payments are politely declined by the staff! Thus, while the proliferation of altruistic doctor - patient bond is clear in this, clearer is the freedom from the hassle of finding, contacting and organising an insurance company pay! It is not even thought of. Yes money always talks, but when its exchange is less, research and publications can themselves speak louder. 5. The philosophy offered: There has always been a clash of ideas between the communists/socialists, who focus on the working class and the capitalist thinkers, who focus on the rich and the successful. Each philosophy tracers argue theirs is the best. In trying to prove that, almost like Christian evangelists killing millions to spread the love of Jesus, while the communists have killed millions including their own lot, capitalists have not left many communists alive either. The beauty here, however, is that there is a merger between the two killer philosophies, in which both rich and the poor are taken into consideration. The high tax paying capitalist, for example, who may even go private, knowingly or unknowingly pays for the poor people. Unlike in the US, here both the government and the rich look caring. The poor themselves are able to live blissfully with dignity and free of healthcare pain that too without sloganeering, 'workers of the world unite'. Giving a philosophy that is good for all of mankind, the NHS gives a very important message to the political philosophers of the world. Present state of the NHS: Sadly, today, this institution is helping all, like an ambulance that needs a push to start, is itself sick. It itself is getting poorer, and the professionals themselves are not happy. The phases: The NHS has had two phases: A. The expansion phase: This saw the expansion of NHS with new hospitals emerging in many places. Each hospital had a relatively small medical staffing department, and clinicians had their say on the running of the department. Doctors had to be brought in from different parts of the world to run the hospitals. They were specially treated. B. The contraction phase: This phase in which we are now, began with the beginning of the merger of hospitals, the formation of trusts and the establishment of the managerial system. This system has seen the following problems. 1. The organization: Almost like a big fish or a company engulfing a small fish/company bigger hospitals engulf smaller ones - in this phase. If not, then hospitals are usually brought together under a single trust. No wonder, the term contracting phase for it, is so apt. NHS may be out of money but it is not quite out of politics - on many occasions that is. This is so because trust managers could be easily headed by a political appointee. Also, optimal performance of the hospital would demand a clinician-manager coordination. That, however, is not the usual case scenario as narrated below. 2. The manager-clinician clash: In this, a clash between ones with more brains and less power, and ones with more power and less brains is clearly seen. In this clash between the clinicians and the management, while bringing in new and more colleagues the hospital mergers also brought in disorganisation and disunity for clinicians, it also offered management the power to organise clinician's rota. With this victory in that clash - apart from others - also increasing the list of suspended consultants, a loss in the clash reluctantly became the clinician's desire. And when dictated, the clinician just became a pair of hands. With gravity thus gone down, they remain an unconsulted group in the running of the department or when constructing a new hospital. NEXT BACK

NHS: Why This Globally Best Health Care System is Becoming Sick? Is Privatisation The Solution?

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