My Lords, I thank my good friend, my noble friend Lord Turnberg, for introducing this debate with great wisdom and erudition. While I entirely agree that the principle underlying the NHS is noble and widely acclaimed, in practice it leaves much to be desired.
Noble Lords have concentrated on funding and other things but I want to concentrate on the more elementary aspect of some of the practices that characterise the NHS. It is very striking, for example, that doctors are inundated with paperwork so that they have hardly any time to talk to their patients or spend much time with them. It is also striking that when a GP refers a patient to a consultant, the consultant’s letter does not arrive until about two or three weeks later, either because—so I am told—he does not have the typing facilities or because he would not use electronic devices to communicate with the GP. I cannot understand why this sort of thing should go on in this age.
As we have talked about our ageing population, it is worth bearing in mind that more and more of our people suffer from Alzheimer’s, dementia and other conditions. The result is that they forget to take many of the medications prescribed for them, or for some reason they take it earlier when they feel ill and stop when they begin to feel better. It may be a good idea to remind them in some way from time to time that they have forgotten to take their medication. I gather that some experiments are being done, and there is no reason why the NHS cannot be technologically more imaginative. Why can blister packs, for example, not be devised so that they warn patients at the appropriate time that they should be taking their medication? Or, for example, why should chemists not be able to monitor whether a particular medicine has been taken by a patient and, if necessary, ring them up and tell them they should be taking it? Therefore, technologically, we ought to be able to produce smarter and more sophisticated packages of medication than we do.
My third point has to do with some of the infrastructure of our surgeries, some of which are located in old terraced houses. Doctors would love to provide all kinds of services but they are unable to do so because of the cramped environment in which they have to function. I cannot see why local authorities and other bodies cannot provide purpose-built medical facilities where GPs services can be housed. This would mean that GPs could provide the kind of services they would like to and patients would not be cramped and would feel much more comfortable.
My last point has to do with the way the Government have treated junior doctors. Doctors remain our main asset, and if they are alienated and feel resentful they may leave in large numbers, which would be no credit to our institution.