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What Aziz Sheikh, Edinburgh University’s professor of primary care research and development, means by “faith-based services”, however, are services for Muslims that take account of their religious beliefs. He wants to see more male circumcision on the NHS, better advice about drugs derived from alcohol or pigs, prayer facilities for staff and patients and female doctors for Muslim women.
At a time when the NHS is struggling to fight infection and meet waiting-time targets, this would appear to be a luxury too far. Sheikh’s proposals in the British Medical Journal play directly into the hands of those who fear the rise of Muslim ideology in the West and who are calling for Muslims to integrate more with indigenous British culture. Making them a special-interest group within the health service flies in the face of the government’s recent U-turn on multiculturalism.
What Sheikh is really calling for is something we should all be clamouring for — an NHS run for the benefit of patients. That it is not was evident in last week’s BBC2 series Can Gerry Robinson Fix the NHS?
Robinson, who aimed to do for the health service what Jamie Oliver did for school dinners, revealed the extent to which the service is run for the benefit of staff and management. Even simple, cost-free ideas that could be implemented quickly and easily to improve the life of patients met a level of resistance that would have impressed General Charles de Gaulle.
As the acceptable face of capitalism whose thoughtful management style is the antithesis of Sir Alan Sugar’s, Robinson focused on one hospital. But speak to any clinician and they will tell you that management ineptitude and consultants’ arrogance are endemic in the NHS. Protocol always takes precedence over patients’ interests.
I experienced something of this first hand on Christmas Eve when my 90-year-old neighbour fell in her home. “Protocol” prevented the carer from moving her until the ambulance arrived so she had to stay on the floor. “Protocol” also prevented the carer from chivvying the ambulance along, which meant it took more than 90 minutes to arrive. But protocol did not stop my neighbour from dying in the early hours of Christmas Day.
Muslims should be accommodated within the NHS not only because they are Muslims but also because they are patients. Sheikh’s assertion that “Muslims are about twice as likely to report poor health and disability as the general population” is, if not a red herring, at least a pink one. The whole point about the NHS is that it delivers the same level of care to all, irrespective of personal circumstances.
What clinicians who come into contact with Muslim patients should be asking themselves is what clinicians who come into contact with anybody should be asking: “How can I make this experience the best possible for my patient?” This is the essence of caring and in parts of the NHS it is absent.
Nobody is suggesting a ward be turned upside down to allow a Muslim patient to face Mecca, but if there is a vacant place within easy reach it should be made available. It’s not just Muslims who might want a same-sex doctor, who shun alcohol and pork. If any patient’s request can be accommodated without undue cost or disruption to others then, of course, it should be entertained.
For heaven’s sake, though, don’t write a protocol for faith-based services. Protocols are the death knell for humanity and common sense. How can it ever be in the interest of a frail 90-year-old to be left on the floor for two hours, yet follow protocol and that is what you get.
There are certain health measures specifically directed at Muslims that are in everybody’s interest. There is growing concern within medical circles that the spread of the next flu pandemic — avian or otherwise — will be facilitated by the Haj. Two million people from all over the world descend on Mecca for the annual pilgrimage and the crowded living conditions make it a breeding ground for disease. Sheikh has, in the past, called for flu vaccinations to be given routinely to those undertaking the pilgrimage, which seems eminently sensible.
The corollary to all this is that the patient makes it as easy as possible for the clinician by not making outlandish demands, by modifying religious and cultural practices to accommodate their treatment and by taking the initiative.
The problem is that all too often the patient has an exaggerated sense of entitlement and the clinicians refuse to deviate from a prescribed path.
Take, for example, the recent row about the £55m cost of translation services within the NHS. Patients need to understand what their doctor says to them and, no matter how desirable it is that everyone who lives in Britain speaks English, there will always be some who don’t.
So why don’t NHS Trusts ask all patients who have difficulty with English to bring a bilingual friend and a small tape recorder to any appointment so they can tape the session and listen to it at their convenience? Not everyone would be able to oblige, but many people would. Community groups could provide such a service on a voluntary basis, thus freeing up millions of pounds for the health service.
Robinson, the ultimate company doctor, has demonstrated how much can be accomplished when clinicians and management work together. Even more could be achieved if patients were added to the mix.
Not everything in the NHS can be fixed by an injection of common sense and a dose of goodwill, but it is sobering to realise just how much could be.
Sheikh’s constituents don’t deserve special treatment because they are Muslims, but because they are patients.
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