Millions of people aged between 40 and 74 could soon be given the legal right to a health check every five years. By law, the National Health Service would have to offer a barrage of tests to assess our risk of heart disease, stroke, diabetes and kidney disease.
The proposals for this “legal entitlement underpinned by law” form part of an expansion of patients’ rights to be included in the NHS constitution from April. Since January 19, when the constitution became law, all NHS organisations have been legally obliged to take account of its principles, rights and pledges. So far, this means little more than a legal right to NHS services, drugs and treatments approved by NICE, and being treated with dignity and respect.
At present, the pledges that patients will be seen by a consultant within 18 weeks of a GP referral and those with suspected cancer will be seen by a cancer specialist within two weeks of seeing their GP are simply that – pledges, which, according to the constitution are not “legally binding”.
However, this is set to change from April. These pledges, along with the health check promise, will become law. Every primary care trust will have a legal duty to ensure patients don’t wait longer than the law stipulates and that health checks are available and offered to everyone in the relevant age bracket.
It cannot be denied that this Government has made overwhelming improvements in waiting times and should be congratulated for it. Vast amounts of extra money were poured into the health service to achieve it. Year-long waits for treatment, so common under the Tories, now belong to the distant past. It is only right that every patient, wherever they live, should benefit from shorter waiting times.
Whether we need a legal right is a different matter altogether. According to the constitution: “A legal right to treatment within a maximum of 18 weeks from referral and to be seen by a cancer specialist within two weeks would help patients and the public to know what they can expect from the NHS in terms of waiting times.” Don’t most of us know that already? Do we need a law to tell the NHS how to behave?
Won’t it lead to even more pressure on NHS staff if they fear being threatened with legal action if a patient with suspected cancer has to wait three weeks to see a specialist? Won’t it lead to stroppy patients – and there are plenty of them – being abusive and demanding their “legal rights”?
All patients want to be seen and treated as quickly as possible. But do they all want a routine health check? Won’t these just attract the “worried well”, while those who are genuinely at risk will ignore invitations to be screened and tested, just as it is usually the women most at risk who ignore cervical cancer and breast screening invites?
Will those who attend health checks actually take notice of attempts to “reduce their risk through lifestyle changes, such as smoking cessation or weight management”? Surely everyone knows that smoking and obesity increase the risk of heart disease and strokes? Sadly, many ignore the risks and carry on with their unhealthy lifestyle. Is a health check going to make them take notice? I doubt it.
And who is going to pay for these health checks? Where will the primary care trusts find the money to provide the staff, time and the support necessary? By taking it away from other services, no doubt.
Our legal rights as patients won’t end there. The raft of new entitlements the Government is also considering include a legal right to an NHS dentist, a legal right to die at home and a legal right to evening and weekend GP appointments. All very worthy. All very expensive.
Telling patients they have a legal right to these things is hardly worth the paper it’s written on unless funding is increased massively.
But does the NHS really need a legally drawn-up constitution to be able to treat its patients to its best ability? Isn’t that what the NHS has always been about? It has survived more than 60 years without a constitution. Is one really necessary now?
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Why does this Government hate the middle classes? Health is an area where it is beneficial to be middle class. Statistics show you are more likely to be healthier and able to manipulate the choices available in the NHS to your best advantage. Poverty is the greatest form of health inequality.
In education, the use of quotas to dictate admission to leading universities blocks the chances of hard-working children from relatively well-off homes. Rather than finding more ways to engineer admissions, shouldn’t the Government be ensuring the best primary and secondary education is available to all youngsters?
The worst example I have come across of the Government’s disdain for the middle classes has come close to home. A major debate has been raging where I live in Richmond about plans to charge for parking in Richmond Park. Our two local MPs – both Liberal Democrats – are against it, as are the Conservative prospective candidates. Local councils whose boroughs surround the park have protested strongly. But culture minister Margaret Hodge has decided that visitors to the park must now pay for that privilege, because “a disproportionate number of people from higher social groups visit the park in their cars”.
To me, that says it all.
