The Poverty Of Expertise
I think that if England lost the NHS it would be the biggest misfortune for England. If people had to pay for healthcare, most would probably simply go without it because they wouldn't have the money. I think it is already getting to the point where people are trying to do their own dental extraction. We would probably be in the situation of people becoming seriously unwell and not getting treatment, and I am talking about physical illness, not just mental illness. The rich would thrive and the poor would not.
In mental health care, many facilities, especially rehab services have been privatised but funding packages are usually available.The reason why the services were privatised was because what they were offering was social care mainly.
I don't know which area you worked in but I saw high standards of care in mental health care, because I know that most patients felt that way. I think that statistics is less a focus rather than quality care inspections, and patients views are central in England. The problem which I saw was that so much demand was put on staff members, especially in acute psychiatric care . Also, there is so much anxiety about inspections amongst managers and the staff who look after patients directly. I am thinking that I would like to go in a slightly different direction lon the future , like working with the homeless or in addiction services.
However, I do believe that there is a certain authoritarian aspect to the medical model of psychiatry, when patients are medicated against their wishes. However, it is complicated because the consequences of untreated mental health can be serious for the individual and for risks posed to others. I do see recovery focused care as a positive move, and I do favour holistic ways of helping people. However, I do think that some of the thinking in mental health care is a bit rigid and after being out of the system for a while, and writing on this site, I would find it hard to fit in again. Going back, I used to sometimes say things and other staff looked at me in a puzzled way. Certainly, most of the nursing staff I worked with didn't embrace philosophy, and I am not really sure about the psychiatrists. One funny comment I received from a patient when I was working in an acute psychiatric admissions ward was, 'You're madder than any patient on this ward.'