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Last Updated: Friday, 2 June 2006, 16:21 GMT 17:21 UK
Doctor's view
Spiralling debts and job cuts are plaguing the NHS in England, bringing a new focus to how it operates in the 21st century.

Health workers in a variety of sectors - plus the BBC's Home Editor, Mark Easton - offer their views on what is wrong with the National Health Service and prescribe their own remedies.

Mr Mohib Khan, an associate specialist urological surgeon at Huddersfield Royal Infirmary, gives his assessment.

DIAGNOSIS

Mr Mohib Khan

Large amounts of money have been invested into the NHS, and while it has certainly had a positive impact, it could have been spent much more wisely.

There are thousands of staff grade and associate specialist doctors like me in the NHS.

We are well qualfied, but the current NHS career structure we means we don't always get opportunities to use our skills.

Recruiting more staff isn't the only answer to the problems of the NHS - you also need to make make the best use of them.

The other fundamental problem is that when change is politically motivated it carries a high price tag.

Investment has been accompanied by administrative shake-ups and the creation of additional layers of bureaucracy that have soaked up much of the extra money.

The government's determination to take responsibility for improvements in the NHS has led to an obsession with targets, which has compromised doctors' ability to do what they believe to be in their patients' best interests.

PROGNOSIS

My professional advice to the government is, first of all, to adopt a practical, long-term approach to workforce planning.

I don't believe it makes any sense for the NHS to send patients overseas for treatment when there are doctors in the UK who could treat them.

Better career prospects for staff grade and associate specialist doctors - who often find their skills atrophying because of a lack of opportunity to do the work for which they are qualified - would do a lot to prevent this from happening.

However, it might be that all of us will be working in a very different health service in the future.

The current drive for an NHS that resembles a supermarket is now so fierce that I fear there may be no opportunity for a swing back to the ethos of a completely public, completely free health service.

In 1948 patients were granted the right to a high quality NHS free at the point of use.

Over the course of the coming decades, I fear that this could become a very distant memory.



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