Why It Matters NHS GP and Dental Surgeries
Summary
We have captured the number of NHS General Practitioner and Dental surgeries in every neighbourhood in London.
Definition
We have captured the location and number of GP and dental surgeries offered free at the point of delivery of National Health Services in all the postcodes across London.
Why the metric matters from a residential inhabitant’s perspective
Commercial inhabitants are less affected by NHS health services in their locality than residential inhabitants, as in terms of employee health, employees are far more likely to be registered with NHS practises near their home than their place of employment. Furthermore, some employers have a healthcare offering through corporate health insurance. These facts mean we cannot draw clear correlations between access to NHS GP and dental services and the impact on commercial inhabitants.
Why the metric matters from a residential inhabitant’s perspective
For someone who owns, rents or spends time in London and is able to use the NHS, whether or not you can readily access GP and dental services is of paramount importance to how one experiences the liveability of an area. As soon as you need to seek proactive or reactive healthcare, you will become aware of the difficulty or otherwise in obtaining an appointment in a timely manner in certain boroughs in London.
When considering areas to live in, this is often not a primary consideration and is more often an afterthought when one has a medical issue. Other than the immediate benefit to one’s health that goes along with being able to access an NHS GP and dental services, there is a clear correlation between how easy it is for residents to access free day-to-day healthcare and longevity, lesser occurrence of terminal illnesses, fewer admissions to A&E, fewer inpatient stays, better maternal nutrition, higher birth weights and lower infant mortality.
There are also positive correlations between poor access to NHS GPs and admissions to hospital for psychiatric illness. Residents may be more surprised to learn that there appears to be a general amenity value in having one’s day-to-day health concerns met, as there is a correlation between having postcodes with the best access to NHS GPs and dentists and reported feelings of general contentment and psychological well-being.
(Photograph: Wikimedia Commons)
Commentary
UK residents generally feel very glad that they are able to access healthcare which is free at the point of delivery, without the need for any form of health insurance, though of course many seek health and dental insurance in case they wish to access the private system.
In that respect, there is no other comparable healthcare offering in the world. London is home to some of the best teaching hospitals and surgeries in the country, and even though some are tested with their very high numbers of patients and challenging ratios of GPs to surgery members, many deliver world’s best efficiency, value for money and care in spite of these conditions.
Further, access to day-to-day healthcare delivers much wider benefits to one’s mental and physical health than one PO might expect, and due to these aforementioned relationships, there are some studies which actually show a causal relationship between lack of access to healthcare and poverty – think lesser access to family planning and more time off work due to unattended ailments - as well as a lack of access to healthcare being a result of poverty.
Trivia
As of 2017, more than 700 NHS GP surgeries had closed in the UK since 2012, due to decades of underfunding. Now 1 in 4 practices has over 10,000 patients which leaves GPs in these practices seeing as many as 40 patients per diem.
History
The idea of uniting the country’s hospitals and doctors’ and dental surgeries under state administration was conceived during the Second World War, when the volume of wounded returning to home soil almost bankrupted the existing health service. At that time, Britain’s 2,700 hospitals were run by charities or councils. Those without employment were not entitled to free treatment, which tended to leave the sectors of society most in need of access to healthcare in a precarious situation.
Because health care was locally funded, less-affluent areas had less healthcare provision - for instance in some areas, women had to have home births and could only be admitted to the hospital when there were serious complications. Further, the war, and the under-investment of the pre-war years, had created a system devoid of the necessary funds to pay health services staff a living wage. In 1945, the new Labour government had promised a revolution in health care. The job health minister- a previously minor one and below cabinet rank- was now filled by a well-known and experienced politician, Aneurin Bevan. His stated ambition was to build a health service based on four principles: it was to be free at the point of use, available to everyone who needed it, paid for out of general taxation, and used responsibly.
At the time, there was furious opposition from consultants, doctors and the Conservative Party. Even the Labour PO cabinet was divided, as some felt local councils were better qualified than the government to administer health care. That would have conflicted with Bevan’s principle that the service should be universal. He was relieved and grateful when the country’s biggest local authority, the Labour-led London County, Council gave over their hospitals to be ran by the government. However, the British Medical Association were vehemently opposed to all GP and dental surgeries being brought under the NHS banner, so faced with the threat of a BMA strike, Bevan conceded that they would retain the freedom to run their practices as small businesses. These consultants were given more money and allowed to keep their private practices, whilst the remainder were brought under NHS administration.
The first year that it launched, the allotted budget was hugely overshot, and Clement Atlee had to beseech that people did not overburden the service unnecessarily. Bevan had argued that the huge initial expense was the result of years of under-provision. By 1951, he had apparently been proved right, because the rush had died away.
However, what Bevan and his allies perhaps failed to foresee was how advances in medical science would forever push up costs. After 60 years, it seems no amount of money will satisfy the infinite demand for better NHS care. Soon after Bevan’s resignation, a Conservative government gained power. The issue of whether health care should be paid for out of general taxation was back on the agenda. A committee was commissioned to look at different ways to pay for the nation’s health. It reported that the NHS was efficient, cost-effective, and deserved more money. The principle of a free health service for all, paid for out of general taxation, had been won.
When the NHS was founded in 1948, the life expectancy was 66 for men and 71 for women. Today those figures are 77.2 and 81.5. In 1948, there were 86 deaths per 100,000 total live births. Sixty years later there are just 62. The average child in 1948 would receive just two routine vaccinations: smallpox and diphtheria. By 2008 that list had grown to seven: diphtheria, tetanus, polio, whooping cough, influenza, MMR and meningitis C. In 1948 the annual cost of the NHS per head, per lifetime, was £200. Now, that figure has risen by more than 800 per cent to £1,700. The NHS now sees and treats more patients than ever before. Last year, on an average day, 50,000 people were seen in A&E alone.