When listening makes all the difference

By Dr David Wrigley

As a GP I know how important it is to listen. During a consultation in my surgery a patient will tell me about their symptoms. It is easy to jump straight in and tell my patient what medical problem they have, what pills they need to take to sort it out and send them on their way. Job done. But is it?

All too often there are other concerns and worries a patient may have – are my symptoms serious? Is this a sign of cancer? Who will look after my 6-year-old daughter if I need to go into hospital? – there isn’t anyone else to care for her. Unless I listen to my patient, explore her fears and concerns, delve a bit deeper than the presenting symptoms I will miss these issues and the patient may continue to suffer physically and psychologically.

At the moment the coalition government are ‘listening’ to us all about their proposed health reforms. The Prime Minister has imposed an unprecedented pause in the parliamentary journey of their Health and Social Care Bill – much to the annoyance of Mr Lansley who was keen to push his ideology through parliament as quickly as possible. His explanation of the need for the pause was because he had ‘not explained the reforms clearly enough’ – does that sound like someone in listening mode? I don’t think so.

So why has this pause come about? Well it’s come about precisely because politicians were not listening. For years doctors have warned of the dangers of increasing the use of private companies in healthcare provision. In other countries we see healthcare outcomes worsen when the market is brought in to healthcare. Fragmentation of care occurs with many different providers involved in episodes of care. Costs increase when private companies move into the healthcare market – it isn’t cheaper or more cost effective – it costs the taxpayer more.

Private providers have their eyes on the profitable, easy to perform aspects of healthcare. You could call it ‘drive-through healthcare’. They don’t want to be involved in patients with many illnesses or those who may need extensive postoperative care or even intensive care – that is left for the NHS to sort out. The worry is that cherry picking these ‘straightforward’ aspects of care may destabilise local hospitals and also crucially diminish the opportunity for training our future GPs and consultants.

We hear from politicians that they will ‘never privatise the NHS’. This language is worth exploring further because it is a bold statement to make but it can also be misleading. The Health Bill may not lead to privatisation as we saw, for example, with the railways or water, gas and electricity companies in the 80s and 90s. What the bill does though is open the door to private healthcare providers and allow them massive opportunities to offer their wares under the banner of the NHS. The ability to use the ‘brand’ of the NHS is much sought after. Yes the private providers offered services under the last government but this was on a much smaller scale and the NHS remained the ‘preferred provider’.

So listening is all-important. Listening to patients and doctors. Yes the NHS can and should improve. Yes the NHS can do better in what it provides. What we don’t need is the Health and Social Care Bill and all that it involves and the way it will change the NHS for the worse – possibly forever. I urge you to speak out, support the NHS and oppose this Health Bill. Tell your MP all that is wrong about it and maybe then we can preserve the NHS, improve the NHS and ensure it is there when we need it and when our children’s children need it.

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