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Thursday, 4 July, 2002, 20:42 GMT 21:42 UK
'Third world' label rejected
Sir Anthony Grabham, the new head of the British Medical Association, says parts of the NHS are verging on "third world medicine".
This is a view rejected by Sir Peter Morris, president of the Royal College of Surgeons of England, as he outlines here to BBC News Online.
I am on record as saying that the NHS last year was a second-rate service, although the quality, when you get it, is generally pretty good.
I'm sure he's been to the third world, as I have, and there's no way you can equate any part of the NHS as being equivalent to medicine there.
I think it's not unreasonable when you split it into thirds that one third is excellent, the second one is average, one third is not so good.
That's probably a fair statement in general but I mean it's quite wrong to equate the lower third with third world medicine. I think there's no comparison at all.
What we need to tackle first is the waiting lists for serious surgical problems, for example cancer, certain parts of vascular surgical disease, hip replacements, etc.
That's what we should be concentrating on and not just lumping everything on the one waiting list which gives a distorted picture.
What we should be directing all our attention at is trying to get the more serious problems dealt with quickly, under three months, ideally, or even quicker than that if possible.
Then we can start tackling some of the other less serious problems that quite frankly can wait, with discomfit I know for patients, but they're not life-threatening conditions or causing severe disability like osteoarthritis in the hip or the knee, for example, which can quite disable patients.
The time has gone for alternative forms of funding. looking for other sources now the decision's been made and is in progress would be quite wrong.
We have an enormous increase in funding promised and I have no reason to believe that that funding will not be provided over the next five years and even in the longer term.
What I would be concerned about is trying to ensure that a lot of that money gets down to where the doctors, nurses and others are working to deliver a service.
There are numerous regulatory bodies, commissions, etc. which could chew up a lot of this money and I think it is important that it gets through to the people actually looking after the patients and delivering a dedicated service.
Now that does involve some reorganisation in terms of administration etc., I realise all that, but I think all of us have to watch out carefully that it is getting through to patient services directly.
And I've made that opinion quite strongly to the Department of Health and it is also in agreement with that.
I think we have to accept that the funding is everything - in fact it's far more than we would have wished for and we've now got to do our bit to develop it.
As I trudge round the country visiting surgeons and trainees there's no question that moral is down - because of the lack of resources in particular.
As things start to improve that moral will improve.
It won't improve until the people who work at the coal face - the doctors and nurses - start to see some of these resources coming through.
It's going to happen but it will be slow and I think this is something I'm not sure the government had realised.
Not until three years' time when we have made a lot of corrections to a lack of resources will things be improving.
The public will begin, I hope, to see some improvement and so will the doctors but it's going to take another five years to turn the whole thing around and provide a first-class health service.
The College of Surgeons is predicting that there will be a shortfall of 1500 consultants in 2009 unless we do something about it.
Of course that's the reason that I am discussing on numerous occasions the need to increase the surgical trainees in the country because we will have to grow our own surgeons.
Most countries are short of surgeons and we have to grow our own.
It won't happen overnight but if we do it now at least we'll know in 2009 we'll start having the first trainees coming out of training programmes.
We've had years of under-resourcing of the health service, almost since its conception but particularly over the last 10 to 15 years
There's too much spin in the whole system and so what concerns me is the expectation of the public and indeed the profession.
The public expectation is that things are going to happen almost overnight.
That is a mistake and that's why I'm continually saying we're going to see slow but steady improvement over the next two to three years and then another five years on top of that I hope we'll have a first-class health service.
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