According to a recent study by the Cato Institute of Britainâ??s National Health Service (NHS), there is no perfect scenario when it comes to health care.  On one side of the spectrum is the desire to have unlimited medical care to extend oneâ??s life as much as possible, and the other end of the spectrum is to ration care to control spending.

The NHS is a centralized government version of the one-payer system in England, and it pays directly for health care and finances the system through general tax revenues.  Most physicians and nurses are government employees.  Below are some key statistics to keep in mind when looking at a government system without competition.

• Waiting Times. Presently as many as three quarters of a million Britons are waiting to be treated in Britainâ??s hospitals. Cancer patients, for example, will wait as long as eight months before being treated. A byproduct of that wait is that maybe 20 percent of colon cancer patients who were initially considered â??treatableâ? when first diagnosed, will become â??incurableâ? as a direct result of all that waiting. Even more alarming is the fact that as many as 40 percent of cancer patients have never even been seen by an oncology specialist.

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• 50-70% wait longer than 18 months to see specialists. In 2008 Britainâ??s goal was for a wait time of no more than 18 weeks.  The study showed that only 30-50 percent of patients actually received treatment within the 18-week time frame. Whatâ??s worse is that only 20 percent of orthopedic and trauma patients received care from a specialist within the18-week target window.

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• Rationed care. Not surprisingly, a direct result of Britainâ??s over-taxed system is that certain types of care for more expensive procedures such as open heart surgery and kidney dialysis are now â??rationed.â? Even more alarming is that patients deemed â??too illâ? or â??too oldâ? for a procedure to be â??cost-effectiveâ? are being denied treatment altogether. One government â??solutionâ? being proposed is that the NHS be allowed to refuse treatment to those with â??unhealthy lifestylesâ? such as smokers and the overweight.

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• Widening gap between NHS and private insurance. Another solution is â??competitionâ? in the form of private health insurance. Currently about 10 percent of Britons have private health insurance, and that number is growing, as more and more Britons seek to gain access to a wider choice of healthcare providers and avoid waiting lists.

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• Growing demand for private health care. Studies conducted on the British public indicated that 63 percent felt the need for healthcare reform is â??urgent,â? and another 24 percent believe that it is at least â??desirable.â? Even more telling, however, is that 60 percent of Britons believe that making it easier for patients to spend their own money on health care would â??improve quality.â?

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Things you will want to know about Britain before you visit

• The best times to visit are May, June, September and October
• Heathrow Airport handles 67 million passengers a year
• Britain is 35 miles from France
• 80,000 umbrellas are lost annually on the London Underground
• Britain receives on average between 20-35 inches of rain per year
• Nowhere in Britain is more than 75 miles from the sea
• Cars drive on the left hand side of the road
• Voltage is 240 â?? do not use your 110 American appliances!

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Funny thing pain, if you’ve never had a severe pain then the suggestion of taking simple analgesia and resting the affected area all seems quite reasonable. I was reminded of this when I read recently of a doctor’s advice to someone who was suffering from sciatica. Having personally experienced sciatica, it’s a condition I would not recommend to anyone who wishes to walk, sit, laugh, sleep, or to just simply pull up your trousers. It’s a bit like a dentist drilling your teeth without an anaesthetic, but it affects your whole leg. In other words the pain is consuming, exhausting and without respite. Clinical studies do show that in the majority of cases the pain will eventually subside and surgery may not be necessary, but in the meantime the patient has to deal with the pain or deal with the medication required to dull the pain. Remember, pain-killers are not selective to the area affected. They affect the whole of the nervous system and elsewhere so there may be significant side-effects from these medications.

Dealing with severe pain can be a complex issue, but I suggest that you have to treat this sort of pain fairly aggressively as acute severe pain is relatively easier to treat than chronic severe pain. In the early stages of an injury or insult to an area of the body, most of the pathological processes are happening at the site of the injury or insult. Throughout time the brain begins to modulate this pain and so no only do you have the injured area to deal with, but you also have complex neural pathways within the brain to deal with as well. This often means a far more complex management plan and a far more protracted recovery time. Specialists are very skilled at dealing with these issues but they do rely heavily on the stories their patients give them. That means being honest in answering their questions and not being heroic with a grin and bear it grimace! Often the use of a pain scale is helpful with zero being no pain at all and a 10 being the worse pain you have ever experienced.

Another health issue we commonly down play is influenza. Over the years I have frequently heard people say that they would not have the flu vaccine because either they never get the flu or that they had it last week for a couple of days and then it was all over! Influenza is a serious debilitating disease that will usually last from 10 days to two weeks and often leave you flat on your back exhausted. It’s not a happy 10 days either as patients do not have the energy to read a magazine or even watch a DVD. You will literally feel ancient with every movement being a real challenge and that doesn’t include the aching all over or the fevers and sleepless nights. The influenza virus is also extremely contagious and most people are unaware that if you spread it to someone who is more frail than yourself that you may actually be putting their life at risk.

With the ‘flu the big challenge is to vaccinate as many people in the community as possible, including children, those employed and unemployed, the elderly and the infirm, to reduce the chance of an epidemic occurring. Recent research has also showed that vaccinating pregnant women in the last trimester of their pregnancy will help protect their new born infants born during the ‘flu season.

Medicine has evolved over the last 40 years, but the change has been fairly slow with doctors by nature being very cautious and conservative people. But we can’t leave the doctors to take all the initiatives. As patients we need to be good listeners in our approach to health by heeding all the great health messages that keep being given to us about vaccinations, smoking, alcohol, exercise and healthy eating. We also need to be good communicators and tell our doctors how we are feeling with conditions such as pain. If the team treating you doesn’t have the best information then it may be that you will not end up getting the best treatment!

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