10 opinions on the political parties' NHS plans

In response to a previous article written by our Clinical Content Editor Dr Hayley Willacy, this month we asked subscribers to our newsletter for healthcare professionals the following question: What do you think of the political parties' plans for the NHS and do you think any of these promises can save the NHS in the long term? Here are 10 responses we received.

I've worked as a paramedic in the NHS for the last 26 years but I want to leave as there is no future in this career anymore as successive governments have raped the NHS. None of them will save it because it can't possibly stay free for everyone. It's a difficult decision but someone has to step up to the plate. Keith Middleton

Being a typical male I rarely find myself attending an NHS service. But my experience has not been the best either. I have stopped going to the doctor now, as every time that I have needed some help I have phoned or visited the surgery to make an appointment and been told it will be at least a week to see my doctor. Well quite frankly that's not good enough or fit for purpose in my view, so I don't see the point. I am a working person and it's difficult enough to get time off work in the first place so trying to make appointments is just not worth the aggravation. As for hospitals, the hospital in the town where I live is all but reduced to outpatients now, so the nearest main hospital is 33 miles away. In all likelihood if something major happens to me, I will likely be dead before I get there. And in the event that I become seriously ill with a major health failure like cancer I will conceal the fact that I have it until the last minute so that by the time I reveal that I have cancer it will be too late to do anything. At the end of the day I don't agree with trying to treat serious illness in order to prolong life. FACT: some of us are supposed to die. It is not right to try to preserve all lives, especially at the cost of undermining what the NHS was conceived for in the first place.

In my view the NHS was created to improve the health of the nation, not to treat every condition under the sun or to include people from all over the world. It's no wonder that the NHS is struggling to stay afloat. It was never intended for that purpose and it needs to stop now or it will cease to exist in its present form.

On to my next point: the dentist. I have lived in Cornwall for 16 years now. I have applied to join an NHS dentist on numerous occasions and have been put on a waiting list never to be contacted again.

Though I work I do not earn enough to pay for all the work that needs to be done. I have had some work done by private dentists, but the cost is just too much to afford. I have had problems my whole life with my teeth; they are in a terrible state. I have been in pain for years and am often depressed by it. Most of the time I can see no way around it; most of my teeth are rotting in my mouth and all I can afford to do is wait until a tooth is so rotten that all that can be done is to have it pulled out. That way it only costs me around £60 as opposed to £100s to keep having it repaired.

The effect that the poor health of my teeth has had on my overall mental and physical heath in the last thirty five years is immeasurable. It has caused me almost constant pain, terrible bouts of depression and on occasions I have even contemplated taking my own life as a way of stopping the pain.

I really don't know what the answer is to improving the health of our nation and I get the impression that no government knows how to either.

One aspect of change that I think is needed is this: (a) No health service should be completely free to everyone, even a small charge to every user would make a huge difference to the running of the service.

(b) Private companies should not be allowed to serve the NHS unless it can be proven that they can do the same quality of work at a more competitive cost than the state can. This includes having the same accountability for what they do, together with how and under what conditions they employ personnel, as what the state does. There is no point in giving a contract to a private company because it's cheaper only to find that they do a half-ass job and abuse their staff and underpay them at the same time.

(c) Persons who receive training through the NHS should be contracted to work for the NHS for a minimum of ten years post qualification or else pay back the cost of their training. I think that this particular aspect of cost amounts to far more that many people realise and is starting to become a major drain on resources, especially when a person gets fully trained and then leaves after just a couple of years' service. All that cost is down the drain and it also causes a lack of trained staff in some areas of healthcare.

(d) The scope of conditions that are treated needs to be reduced. It is no longer practical to try to treat all known conditions. There has to be a cut-off point. What is the point in trying to treat all conditions and then finding that you are always overstretched as a result?Treat the most common conditions that often affect millions of people and, where cost-effective and not to the detriment of the core services, treat the more uncommon conditions, but that's it. The NHS cannot be all things to all mankind; it's not right and it's not fair to make people think otherwise. John Adkins

With an ever-expanding population, the - laudable in their day - aims of the NHS at its inception in 1948 are no longer sustainable. We have a two-way choice ahead, either: (a) The service is free at the point of delivery to everyone (universal access) BUT there are a restricted number of ailments covered by the service OR (b) All ailments are potentially treatable by the service BUT there are restrictions on access, based on either net income or number of years NI payments etc. In other words we either reduce the number of procedures covered or reduce the number of potential patients or - if severely cash-strapped - both.

These are the ONLY REALISTIC options. The laudable aim of caring for everyone from cradle to grave was possible with a population below the 10 million mark but not with a population approaching 70 million as is the case 67 years later. A sad state of affairs, but inevitable with a massive population explosion in little over half a century. Anna Dyer

I am a retired General Nurse. It became obvious to me in the late 50s and onward that the serious underfunding of a glorious heathcare system would destroy it in the years to come.

The solution is, and always has been, to increase the NI contribution paid by all those who work in the United Kingdom. Consider a five pence increase from all those millions who work and who - along with their families - will need at some time or other help from the NHS. What happened to "From Cradle to Grave"? Is nobody prepared to grasp this nettle before the NHS collapses? Guess who will then fill the gap and develop USA-style of care - equals NO care for very many? Bernard Gilbert

Every political party is using the superb NHS as a political football. The pressure on the NHS is due to some very simple but crucial factors. Firstly, we are an ageing population. As a result, those requiring medical help are bound to increase year-on-year. Secondly, the numbers attending A&E are spiralling upwards because hundreds, perhaps thousands, are doing so, despite their problems being minimal. Thirdly, the public demands the latest medical technology. The result is costs are soaring and will continue to soar. Finally, the NHS is no longer a giant; it is a monster in terms of size.

Put all this together and it is clear that no party can maintain health standards by vague, woolly promises. Hence, it is crucial we filter those arriving at A&E. Those with minor problems should be sent away to see their GP or local pharmacist. We must train more doctors and nurses as soon as possible. Whatever happens we must not compromise standards.

I was once taken ill in the USA. The care was excellent, at a high final cost! Dr Barry Clayton

Anyone voting for the Conservative Party is voting against the NHS. They have done long-term damage in their term in office. I work for the NHS. I can see the damage; it is being hidden from the public until it can be blamed on someone else as usual. GPs' surgeries will not recover unless there is a huge injection of cash and more moves are taken to ensure those people who are not entitled to treatment do not receive it free. At the moment the NHS allows people from other countries to help themselves to our NHS without paying a penny into it. GPs are not allowed to find out if people are genuine visa holders before registering at surgeries. We have numerous visitors who come in to have their babies then leave the country only to come back to have their second and even third babies. That is just one example. David

Where to start! I manage a team of practice nurses & HCAs at a two-centre 12,000 patient practice in Bradford and I despair at all the parties. There is not one manifesto or party that has a clue what we do in Primary Care and how our work impacts on admission avoidance, A&E attendance, self- management, referrals etc.

But where we are and what we do is absolutely unsustainable without massive funding. We grow on a monthly basis and patient expectation grows along with that. We open later hours. We've tried Saturday mornings (nobody wanted them). We now offer a walk-in clinic daily Mon-Fri for minor illnesses, as well as a blood drop-in clinic, minor ops, MSK service, physiotherapy and ultrasound scanning. We open our doors to midwives, counsellors, pharmacists, specialist nurses and have a team of district nurses working from our building too. We are only one out of 46 Practices in Bradford. One City!

I don't believe any of them realise what the NHS is worth or how much it costs to be able to run it to the high standards that the patients in this country have grown to expect and deserve. It needs far more than a five-year plan; it needs a lifetime plan. God help us all, for whoever gets in certainly doesn't get us and what we do! Susan Wallis

All parties are liars. Labour opened up the NHS to privatisation and Cameron insists that he is not selling off the NHS. Yet I have colleagues who are now working for private companies. None of them can be trusted. Christopher Tomlinson

None of the parties appear to have grasped the impending tsunami of demand vs funding. They either fail to recognise or ignore the needs of an ageing population and increased cost of health technologies. Regarding the Conservative Party, I remember the Cameron-Lansley manifesto pledge of no major top-down reforms which they promised pre-last election… and then they made the biggest changes in the history of the NHS when in power (which incidentally have cost >£2 billion and made things tangibly worse). So in conclusion, I wouldn't trust Cameron as far as I could throw him. Labour? Certainly well-intended, but unsure what they would actually achieve. LibDems? Their manifesto policies are worthless as they will sign up to those of any party with whom they can form a coalition government so that they can hang on to power. UKIP? I think they've had three different and diametrically-opposed health policies in the last six months. Their only consistent policy is to deny healthcare to foreigners.

Naïve question: whatever happened to politicians driven by conscience and decency rather than personal ambition? Duncan Livingstone

No I do not believe the NHS will be saved by any political party therefore I am going to vote Green. David R Burnett