‘A Chinese proverb states that ‘an elderly person at home is like a living golden treasure’. At the moment, around 40% of Chinese older people live with their children, but in Beijing they have a policy to increase that to 90% by 2020.

‘China even passed a new ‘elderly rights law’ against ‘neglecting or snubbing elderly people’, which mandates that people should visit their elderly parents often, no matter how far away they live, with fines or prison sentences as penalties.

‘Western traditions would rightly resist state interference on this scale. But France too passed an elderly care law in 2004 requiring its citizens to keep in touch with their elderly parents. They did this after a heatwave left 15,000 elderly dead, many of whom were left for weeks before they were found.’

These words are taken verbatim from a recent speech by the Health Secretary for England Jeremy Hunt. Given the growing number of pensioners and squeezed social care budgets, he was asking whether we should take more personal responsibility for our families – and looking at how other countries managed.

The newspapers regularly carry headlines warning about the ‘privatisation of the NHS’. So how much patient care is being outsourced? The respected health think tank, the King’s Fund, has looked at the figures.

In the seven years since 2006-7, the proportion of NHS patients treated by non-NHS hospitals as in-patients has risen from around 0.5% (73, 000) to 2.6% (471, 000) of all in-patients (which totalled over 18 million in 2013-14). For outpatient care, the proportion treated by non-NHS providers has risen faster – from 0.2% (123,000) to 5.5% (4.5 million).

Orthopaedics (hip and knee replacements) tops the type of in-patient activity carried out by non-NHS providers, accounting for around one in eight episodes of care. If rates of growth since 2006-7 continue over the next 20 years, non-NHS providers could account for one in five of all outpatient attendances and approaching one in ten inpatient episodes paid for by the NHS.

Would this matter? Surely it is the quality of patient care and the efficiency with which it is delivered that counts?

Pharmacists to the rescue!

Radical proposals to ease the pressures on family doctors have been proposed by the Royal College of General Practitioners and the Royal Pharmaceutical Society which could see a pharmacist in every GP surgery.

GPs and their teams are estimated to make 370 million patient consultations this year. This is 70 million more than five years ago, but as demand has risen the number of GPs in England has remained pretty much the same.

By contrast there is currently an over-supply of pharmacists, who train as clinicians for five years – only one year less than a doctor. The suggestion is that they could step in to treat patients directly at the surgery, particularly those with long term conditions and who are taking a number of different medicines.

Dr Maureen Baker, chair of the RCGP, says: “Waiting times for a GP appointment are now a national talking point. Yet we have a ‘hidden army’ of highly-trained pharmacists who could provide a solution.”

But this isn’t going to happen overnight. Your local community pharmacy will be your port of call to see a pharmacist for a while yet.

The nation’s healthcare, like anything else connected with government, is being put on hold in the run up to the general election in May. Even the National Institute for Health and Care Excellence (NICE), an independent body that provides guidance to improve health and social care in England, is going ‘off air’.

‘As a Non-Departmental Public Body, NICE must make sure that its conduct and procedures during the general election do not call its impartiality into question,’ it announced rather pompously at the end of March. ‘In order to avoid providing a focus for political debate or detracting attention from the general election campaign, NICE will not publish any guidance during the general election campaign.’

Your local community pharmacy, however, will not be putting up the shutters and will continue to provide impartial and focussed health care advice, and the wide range of health related services you have come to expect. Ask your pharmacist if you need any guidance.

England is now the only one of the four home nations that levies a prescription charge, and there it is only paid by around 10% of patients.

Children and pensioners are exempt, along with people with certain long term conditions (LTC) such as diabetes and cancer. But patients with other LTCs such as asthma and multiple sclerosis do have to pay, and it is not clear how the distinction is made. An estimated 7 million people of working age in England have a long term condition.

A survey by the Drug & Therapeutics Bulletin (DTB) shows that two thirds of pharmacists and GPs think that the current exemption criteria for prescription charges in England should be widened to include anyone with a long term condition (A similar number want the charges lowered or abolished altogether).

Around 40 leading pharmacy and medical organisations belong to the Prescription Charges Coalition, which is calling for all those with long term conditions to be exempted from paying prescription charges. It is currently running a public petition to present to whichever government wins the May general election.

You hear the Care Quality Commission (CQC) mentioned quite often in the news these days, so what is it? Basically it is the body that regulates healthcare in England.

It is responsible, for example, for regulating GP practices, out-of-hours services, NHS 111, and dental practices (it does not inspect pharmacies, which have their own regulator, the General Pharmaceutical Council).

It is relatively new in this job, only starting in 2013. There are around 8,000 GP practices in England and it plans to have inspected each of these at least once by April 2016.

When inspecting a practice the CQC asks asking five key questions: is it safe, effective, caring, responsive to people’s needs and well led? It will also look at how services are provided to people in specific population groups such as older people and those with long-term conditions or poor mental health.

Practices will be rated as ‘Outstanding’, ‘Good’, ‘Requires Improvement’, or ‘Inadequate’ for each of the five key questions and for each population group.

Find out more at www.cqc.org.uk