Visitors to London, especially if they visit the famous Oxford Street shopping area or Harrods are often struck by the number of Arab women in burkhas and Arab men in traditional flowing robes. Indeed, if you go to Edgware Road, a street leading away from "Speakers' Corner", whole blocks are devoted to Middle Eastern restaurants and grocers.
What has this and Peter Pan to do with the British NHS? Follow me over the flip.
The teabaggers speak a lot of nonsense about people coming to the USA for treatment as if it did not occur in other world centers of excellence. London is just such a center and many Arab countries, especially those with oil income, sponsor their citizens to come to London for treatment that they cannot get locally.
The area around Oxford Street is close to one of the main areas within London, commonly referred to as Harley Street, where there are a large number of private clinics and other facilities to treat private patients, including those from overseas. It is common for whole families to come with the patient from Arab countries to both support them and to look after them in their rented apartments. This has led quite naturally to an area convenient for the clinics with rental apartments and shops and other facilities.
Of course it is not only Middle Eastern patients, there are insurance companies in the UK that provide medical insurance in addition to the standard NHS provision. This used to be to make sure that treatment did not involve waits, although this is now much less prevalent, there are instance where people may want to know that they could choose the exact dates of a treatment. More common tho is the wish to have better "hotel" facilities like a private single room, better furnishings and surroundings that these for profit facilities offer. There are other cases where these private doctors are needed. As an example, when I had an injury at work. my union arranged for a report from a consultant in Harley Street as part of our claim for damages. Such reports are not part of the offer from the NHS.
But, you will say, this is private medicine, what has it to do with the NHS? Where do you think the doctors come from. Indeed a very large proportion of doctors involved with private medicine also work in the NHS. You may recall that the Health Minister in 1948 said he had to "stuff the consultants' mouths with gold" to get these senior doctors to agree to be part of the NHS. Part of this gold was to build into their contracts the facility to do private work a number of days a week (note that the very latest contracts can restrict this). Nevertheless, the prinicple remains. The very best doctors work in both private and public medicine and, even if they do not personally treat your, they will lead the team that does. The senior consultant will step in when they feel their particular skills are needed so the poorest can have the same treatment as the richest private patients.
But on to Peter Pan. In many cases British hospitals can trace their foundations back to charity. The London Hospital (where the "Elephant Man" was homed when he could not be treated) relied entirely on charity. Later local authorities started some facilities and of course almost all came into the NHS system in 1948. Charity still continues. Not, as in the USA, to pay for the treatment of patients, there are no jars on British shop counters to pay for "little Sue" to get her operation. Often it will be for the very latest equipment like an MRI scanner that the hospital could not afford to buy from its own resources or to fund research projects. Peter Pan has a very special part in this work.
JM Barrie, the writer of Peter Pan, bequeathed the rights to his work to the Great Ormond Street Hospital for Sick Children (GOSH) when it was still run purely on charity. GOSH was the first hospital in the English speaking world to provide in patient beds only for children. It continues to be a world center of excellence and the funds it gets from Peter Pan and many other charity donations go towards providing some exceptional facilities. As it serves the whole of the UK, it has made a special effort to provide a place for at least one parent to stay nearby - or even next to the patient at night, at no cost to them.
The parents of one GOSH patient have started a web site about their little girl's treatment. She had been born with a very severe and rare congenital heart defect. In the first nine months of her life she had three major operations, the first lasted five and six hours. In Tiana's "own words":
The only treatment available currently is surgery which involves reconnecting the coronary artery to the correct place on the heart. This procedure is delicate and lengthy and the surgeon who operated on me is widely respected as one of the best in the world in his field.
There are a number of other stories about GOSH patients on the GOSH fund raising site here.
Like many grateful parents of GOSH, Tiana's father has been fund raising for the hospital, not because he has to in order to pay for her treatment but so that others can benefit in the same way his little girl has. I should add that GOSH is not unique in having fund raising. Most hospitals have a "League of Friends" who help provide extras for patients.
There is one thing I would like to pick up from Tiana's story that forms a vital part of early childcare:
Initially all seemed well and I went home with mummy and daddy later that day. I was checked by a lady who came to see me at home and had put on a small amount of weight. I was very good and didn't wake mummy and daddy in the night from 8 weeks old! (Mummy and daddy were very impressed!)
Then I had to go to a hall where there were lots of people and lots of babies. Their mummy's were putting them on scales so they could be weighed and eventually it was my turn. The lady told mummy I had lost weight and that I needed to see a doctor
In the simple terminology of "Tiana's words", this describes the first home visit by a "health visitor", usually a trained nurse or midwife. They ensure that the child has settled and make the first of a series of measurements after the initial ones at birth. They also help new parents with coping with the demands of a newborn. While they are not always successful or welcome, they can identify very early where children are potentially at risk of abuse.
The second "hall" visit was again a developmental check and it was at this that Tiana's condition was first identified as causing a problem. One of the things the health visitor gives the new parent at the first visit is the child's personal health record or "red book". This contains details of such things as the birth weight and is used to record all the developmental milestones etc up to the age of five. It also has their National Insurance Number which will stay with them all their life and which gives them access to all NHS facilities.