Saturday, June 24, 2006

Time to slaughter the sacred cow?

My "smash the goldfish bowls" experiment has not been a success. The only "hostile" bloggers seriously to engage were Matt over at "The Dirty Leftie", and Jamal at “Opinionated Voice”. I thank them for their cooperation. I direct my contempt at the cowardly leftist bloggers who simply deleted my critical comments; restoring their blogs to ideological sterility. May they continue to swim alone in their little goldfish bowl blogs. Come the Revolution, they already know how to censor.

One always learns something from even the most naieve experiments. Matt made a simply stunning statement in response to one of my comments on his blog. I didn't respond at the time, because I was staggered and needed time to think about it. In response to one of my critiques - and as a throw-away aside to his main argument - he said: -

"you seem to be the first person I have met who is criticising the NHS and the rescue of the coal, steel and gas industries which .... were loss making private companies; companies which were almost essential for this country’s prosperity, but only salvagable through national subsidies."

Let me leave nationalisation for another day. I was shocked that Matt had “never met” anyone who criticised the NHS. Perhaps that is because its opponents are afraid to speak? So mighty a sacred cow has it become.

When Labour wins an election, Britain’s Conservatives quietly hope that it will reform the NHS, as perhaps only it could. Blair seemed the best hope of that, but has failed ignominiously. If not the Labour Party’s voters, then its membership either believe in it, know no better, or fear worse. Yet the NHS (I think of it as the NDS, or "National Death Service") is an unmitigated disaster.

My firm employs lots of East European lawyers. We bring them to London from time to time for secondments or training. One of them, a Pole, was unfortunate enough to need medical care during his stay. He was shocked. He could not believe that facilities in what he considered a rich country, were no better than they had been in the Communist Poland of his youth.

Another colleague, a Brit working in Moscow, was turned away from her local NHS hospital during her holiday at home last Christmas. She was seen by what Dr Crippen over at NHS Blog Doctor wittily calls a “nurse quacktitioner”, who turned her away with painkillers. Lots of painkillers. I advised her to return to Moscow and visit the medical centre we use here. She was promptly hospitalised, given life-saving treatment for a congested lung and air-ambulanced home to recuperate. The NHS had almost claimed another victim.

A female relative was admitted to hospital after a mild heart attack. She discharged herself in fear of her life after being put on a mixed “barracks” ward with a mad tramp who exposed himself constantly in a bed only a couple of feet away. He was so filthy and so belligerent that she preferred (fortunately that proved not to be the outcome) “ die in her own bed...”

Another relative, a nurse for decades, recently worked her last day on an NHS ward. She had become afraid of the situations she was frequently exposed to, such as being the sole person in charge of a large barracks ward full of acutely-ill patients. Despite doubling the NHS budget, New Labour has presided over (she tells me) a decline in actual medical workers. All the money has gone on “jobs for the Red boys” so that now there is one hopeless, Labour-voting, administrator per bed. What they do all day is a mystery to the medical and nursing staff.

There are too few nurses, and the shortage has been compounded by "training" many of them as “quacktitioners” to cover up the shortage of qualified doctors. Of the nurses left to nurse, many (she says) speak English so poorly that they don’t understand their patients - with predictable consequences. Sitting through the night as the sole nurse in charge of people she knew she couldn’t help in the event of the serious trouble that could be expected at any moment, she decided she could not live with the risks. When a patient died of this systematic and deliberate neglect, she would have felt (albeit unreasonably) responsible. She felt she might not be able to live with herself thereafter, so she quit.

Another family member was in hospital after a heart attack. I witnessed an exchange with his consultant. He was walking by and when my the patient called to him, he didn’t come over; he just stopped dead in the middle of the barracks ward. At the top of his voice, he answered questions with ill-disguised impatience, with the whole ward listening. There was no privacy; no respect. The patient was just another piece of meat to this apparatchik. This is of course the precise conduct any follower of Adam Smith would predict from a member of a monopoly producer cooperative - or a c**t. Being the former almost inevitably turns you into the latter.

Yet another family member was admitted to the local NHS pain-station for an operation last year. His mobility is limited and he is in constant pain. He is self-employed and therefore works with gritted teeth, but if he were an employee he would no doubt be “on the sick.” The operation would allow him to work without pain and he had been waiting - as must be expected in any system based on rationing - for some time. The surgeon opened him up, decided the problem was not as bad as he thought and discharged him untreated. The prognosis? Fifteen years of pain, mitigated by painkillers, before the knee was “bad enough” to be worth treating under NHS guidelines. When he presents again in 15 years (his career over) he will be told he’s too old to be a priority and left in pain, untreated, until death.

I could go on. You may think I already have. All these stories are recent and from my own direct experience. The fact is that, in the pantheon of Socialist achievement, the NHS is less akin to the Soviet Space programme, and more akin to the Gulag Archipelago. It is probably the only healthcare system in history to be so squalid and badly run as to generate its own new diseases. It is a chain of filthy islands of humiliation, pain and neglect. It should be replaced with a system where the State owns no hospitals and employs no doctors or nurses, but merely pays all or part of the premium (for those who can’t afford it) under a compulsory insurance scheme provided by competing private companies.

The NHS is not a national treasure, but a national humiliation. If it is a sacred cow, then it is time that it was slaughtered.

There you go, Matt. Now you have heard it criticised.


niconoclast said...

To the Left the NHS is not primarily a health service at all but a safe house for unproductive useless government employees, and cannot therefor be judged by the usual objective business standards of efficacy.

Tens of thousands my die as a result but that's not the point; it is a socialist institution and can only ever be spoken of in hushed reverential tones.

Anonymous said...

Hi Tom

Strong stuff. And some distressing anecdotes.

I am appalled to hear that some bloggers have removed your comments from their sites. I think it is an unwritten rule of blogging that censorship is a total no-no. I never remove anything (apart from the penis-enlarger spammers that get through occasionally.

The underlying thread of what you imply about NHS reform is right. We have to stop tinkering on the edges. We need radical change. The introduction of a Stalinist bureaucracy since 1997 has been a disaster. We need an NHS run on business principals and that means privatising all the providers and then buying healthcare from them in a competitive environment. Compulsory health insurance properly safetly netted.

The Tories would not dare. Blair might have done, but did not.

The outlook is grim. We are stuck with the "free at the point of entry" mantra, which is about as true as Clause IV was for Labour. It needs to go.


Manfarang said...

Having dealt with private health insurance companies, I don't think privatising the NHS is the answer.
By the way, where do you go for a drink Tom.There can't be a White Hart in Moscow!

Tom Paine said...

I know exactly what you mean, O'Brien. British health insurance is rubbish. But in a compulsory insurance system, the ability to price away some customers or remove some risks would be regulated so that universal cover could be available. If it was the system we relied on, we would make it work - which is more than can be said for the NHS.

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