The Doctor’s Surgery Tom Stuttaford
Tom Stuttaford: The Doctor’s Surgery
Pity the Secretaries of State for Health. Whatever they decide, they will be blamed for failing to keep British medicine in the premier division.
In my youth, the Americans lived in the only country that had better doctors than we did in Britain. It was probably as safe to be ill in Britain as in Australia, South Africa, Canada, New Zealand, Scandinavia and Holland. But considerable caution was needed in the selection of a doctor in many European countries, as well as the Third World.
The wise ill traveller at that time was probably well-advised to fly home to Britain as fast as he or she could. Even in Britain, there was wide disparity in the care offered in different parts of the country. But we could still claim that the NHS provided the best overall care that was available to the whole population.
In 1981, when Sir Harold Evans was editor of the Times, he asked me to make contact with medical insurers. They let us know those areas of the world where the medical insurance agencies had found it safer for the patient, and more economical to the insurers, to fly the patients home rather than leave them to suffer in local hands.
Therefore, as late as 1981, Britain still had a medical service that was the envy of most of the world, even if it could not challenge American prowess. The results were so alarming that we never published them in full or, so far as I remember, at all. Recent surveys have shown that all over the world there have been huge advances in medical care. However, in many places these have been greater overseas than in Britain.
Other countries, many of which have not benefited from the good fortune of having a cradle-to-grave NHS, can now offer a better chance of a happy outcome for mother and baby.
At last, British health authorities are admitting that our reputation for safe delivery is now being challenged and bettered by many other European countries. We have now even accepted that some of this loss of reputation can be attributed to the distribution of the responsibility for maternal care between doctors and midwives.
It is also probable, rather than possible, that the reduction in the number of antenatal visits, and therefore the reduction of both medical and midwife supervision, is another important factor. In the league tables, published this year, of safety in labour, Britain, instead of being at the top of the European first division, is now around the bottom and looks to be in danger of relegation.
Just look at the international figures on the chance of survival when ill in old age. More and more of us are likely to reach old age; but now, in Britain, although not in other European countries, the life expectancy of those who have made seventy-five or more is no longer increasing.
I can’t count, or perhaps remember, the number of people of my age who now complain to me that their doctors no longer seem to be interested in their disease or their survival. Every aspect of palliative care – whether the choice of drugs prescribed or the amount of domestic and later nursing care – has been bedevilled by cost cutting.
The latest assault on the quality of medical care, because of its cost and the quality of its administration, is wellexposed by the report of the charity Breast Cancer Now, which was well covered by the Daily Mail.
Breast-screening rates are falling, as breast scanning is in danger of being curtailed by a shortage of radiologists. Delays in introducting new drugs also take a toll. These drugs – tested by scientists at well-established scientific research institutes – have shown to be safe and effective. Baroness Delyth Morgan, chief executive of Breast Cancer Now, is reported as having said this toll is likely to amount to several thousand lives.