….use them instead to strangle the dinosaurs saying “Hands off our NHS”
It’s an old subject I know, and always causes controversy. But it has, over time, become one of those ‘How could you possibly think such a thing?’ sacred cows that Progressives would rather go lalalalalalala about.
So let me start by making three observations, before the Leftists reach for their vitriol: the things wrong with the NHS are (1) it doesn’t put the patient first, it puts money first; (2) it has the wrong priorities; and (3) communities have no stake in it.
And then let me draw another line so everyone’s clear: privatisation simply is not the answer, because the mis-match between soaring medical costs and plummeting personal wealth would restrict Premier-league private medicine to a tiny elite.
If I may, I’ll expand on all those issues. First, the NHS puts money first because it’s always short of the stuff. It is short of it because it’s over-bureaucratised, raised by direct State taxation, hampered by 70 year-old Right/Left polemics, restricted by mad bonuses and targets, and increasingly exploited by greedy GPs. (Not that many, but enough to corrupt the values of the system).
Second, it has the priorities of an organisation driven by cost-cutting rather than socio-medical creativity and imagination. It rations care rather than doing only what a free service should. It prolongs life, rather than making it more pleasant when people are fully in possession of their faculties. It hides information rather than sharing it openly with the community it serves.
Connected directly to that inward-looking mindset is point the third: there is no mutuality in the Health Service. Primary Care has become a bottom-line driven system that is private in all but name. Hospital care is obsessed with achieving targets by any means fair or foul: waiting lists, inpatient stays, solved cases….all are manipulated by bureaucrats playing at being crypto-accountants with the measurement systems.
Why? Because the State – Whitehall primarily, and their bastard cousins the Trusts – run it for their track-records, not for the community.
The provision of free health-care in Britain needs to be owned, run, and managed by a set of ‘members’ – like any mutual building society. It needs to be run by doctors, nurses, and patients in a way that is not for profit – producing only surpluses to pay for vital research. It needs to be putting the patient first every minute of every day…and it needs to have a clear vision about who those patients are.
The key word there is vital. Free health provision isn’t a bizarre, mammoth-sized cosmetic boutique: it should be designed to improve health for solid socio-economic reasons, and as Nye Bevan originally put it, “to remove anxiety about medical bills”. For any civilised and efficient society, those are very fine aims. However, a State-run, directly tax-funded NHS trying to do everything, everywhere simply is not the way to achieve those goals.
Free health provision should abandon any activity involved in increasing longevity or providing cosmetic solutions. I know this is harsh, but rebuilding faces and allowing gaga folks to struggle on for another eight years of pointless life is just another example of medics playing God. Worse still, the act of doing such things has already created an under-the-table euthanasia trade in the NHS, and many State and private nursing homes. If you doubt this, then you don’t have an aged parent.
Free health provision should only provide free medication on a means-tested basis, coupled with the severity of the lost life quality involved.
Free health provision should focus almost entirely on saving active lives at all ages, and making chronic suffering a far less common syndrome.
We’d all like to be Lady Bountiful, but largesse in a health system aimed at people of generally OK, modest or very limited means will destroy itself – and the level of patient care – if it cannot face the reality of bottomless costs….exactly as the NHS is doing now.
The time has long passed when the answer to Britain’s health needs was a National Health Service. What we’re going to need in the future is a mutual health sector signed up to the rules of a Community Health Bank – the CHB.
As for the rich elite, they can go fu can go for a fully insured, privatised system with enough money to fund more specialised research about nose jobs, boob enhancement, penis extensions, IVF, and cryogenic miracles. There are too many of us around as it is, without adding to the crowd: if people are that desperate to have children, let them adopt – God knows, there’s a big enough need for it.
It may be a cliche, but being a cliche doesn’t make any observation any less accurate: sometimes you have to be cruel to be kind. Low-cost health provision in the UK is now entering one of those times.
The Slog 