Sunday, 6 November 2011

• Privatising the NHS? It's already happened…

Along with all the other joyous changes that the current government is making the public services, one of the most strongly for figure being the privatisation of the NHS.

But one of the most important parts of the NHS was actually privatised years ago, barely making it into the public sector before it was swallowed up by big companies. Swallowed being the apposite word here, as that sector is the pharmaceutical business. The pharmaceutical business and the NHS have had an uneasy relationship with each other. The pharms have the money to do the expensive research and equally expensive rigourous testing required for a drug to be accepted by NICE. This works well in theory for the cash-strapped NHS, who end up being able to take advantage of medicines without having to outweigh the cost of creating themselves.

And perhaps in the short term (which is pretty much the only place that politics ever exists) that is a positive thing. But in the long term it's creating huge financial and health problems for the people of Britain because the pharmaceutical companies can hold the NHS to ransom, for whatever price they wish to put on their products. And while part of the high costs of some medicines are because you're not just paying for the medicine but for the research and testing behind it, part of it is just greedy profit. There has been a lot of discussion about companies creating generic brands of for example HIV and malarial drugs so that people in the poorest countries can be treated for these illnesses, but in this country are NHS is struggling to pay the high prices the pharmaceutical company demands.

And yet in an age where resources are stretched, and GPs are only allowed 10 min with their patient, there is a heavy reliance on medicines as the first port of call of treatment. Doctors place great trust in these medicines, but are often unaware of the long-term effects, the side-effects, or how different medicines interact with each other.

But drug companies are made for profit, not for the advancement of human health or knowledge, or enabling people to be treated effectively and in the most cost efficient way possible. I realised this the other week when I went to pick up my prescription of melatonin. Melatonin is a hormone which helps regulate your sleep pattern (something I have a lot of trouble with). It's available on the Internet for around £10, but when I look to my prescription someone had written a note saying that it costs roughly £60 for the same thing. The melatonin on the Internet is generic, just as paracetamol and ibuprofen are, and so it costs much less. But the NHS cannot use the generic brand because it hasn't been tested. And it cannot be tested because the generic brands do not have the money to do so, and without that testing they cannot be prescribed.

It also means that chemical medicines dominates treatment plans, even when there are non-chemical, equally good ones that are less invasive and have less side effects. For example in fibromyalgia there is a machine called the Alpha-Stim thats uses electromagnetic pulses to interrupts the pain signals, and actually rewire how the nerves work. It's been found in their studies to work for over 50% of fibromyalgia sufferers, it is non-invasive, it has no side effects. But it also doesn't have the funding for the publicity and the expensive research and testing needed to be able to be used on the NHS. It is also, in the short-term, more expensive because it requires an initial outlay and the funding is always so tight in the NHS that such things that group could provide long-term benefits, are passed over the things that are less expensive in the short run. But in the long term when you add up pain medication, incapacity benefit, Disability Living Allowance, and personal care for years and years, an initial outlay of £550.00 now is nothing.

So I feel that firstly, treatment costs and benefits should be measured over years, not weeks of months and weighed against the long term cost to the government in benefits and care, and of human suffering, not just what is cheapest in the short term. And secondly, I feel that instead of further privatising the NHS, it would be beneficial to the NHS to de-privatise, or at least better regulate, the pharmaceutical companies. Because they are entirely controlling the direction in which medicine is taking this country, and creating huge profits themselves at the expense of people's health.

It makes me remember that next time I see a local health authority being criticised for not spending money on a particularly expensive drug, that the reason the drug is so expensive is in large part due to the power the pharmaceutical companies have to set the prices of the drugs they sell, and it is at their door that the blame, ultimately, should be laid.

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