Vir Cantium

I'm right, you know …

Category Archives: Health

Before We Defend It, Know What “It” Is

I’m not sure where the overhyped#welovethenhs” twitter thing is going to go now, since even the great Obama has said that he doesn’t want a British-style NHS for America.

Anyway, apparently we are all rallying round to defend the NHS. The trouble is, what is the NHS?

In the eyes of many of the public, the institution of the NHS has become synonymous with the principle of “healthcare free at the point of delivery”. The two are not the same. The NHS is merely a tool for delivering that principle, it is not an ideal in itself and, dare I say, it is a particularly old-fashioned and inefficient tool. There are other ways of achieving Beveridge’s ideals, as many other countries have found. Any of the stories of lives “saved by doctors, nurses, drugs the NHS” need not be taken as endorsements of the state running the hospitals in which those patients were treated, or of the monolithic bureaucracy frustrating managing the staff who worked in them.

I’m afraid I’m getting close to mentioning the evil “p” word here. “Private”? No, worse than that, “profit”! Now if you’re one of those people who only uses the word “profit” pejoratively and never without spitting, then you’re going to get wound up here. Of course, I could foresee many hospitals also being run by not-for-profit organisations, but the provision of publicly funded healthcare and profit-making are not incompatible, just as local councils collecting the rubbish have found that profit making companies have produced a better service for less money. Profit isn’t dirty. It provides the incentive to do things better and more efficiently.*

All this being said, David Cameron was right to defend the NHS. Why? Because after 50 years, so many people do regard the NHS and the “free” healthcare principle as synonymous. The scaremongers have done their job well, and are easily a match for some of the more silly claims of the anti-Obama elements in the States. Some talk of the vested interests of the private sector, yet the vested interests (the unions, the bureaucracy) of the public sector still hold sway in this arena. Just as defenders of the BBC licence fee warn of a future utterly devoid of culture, so anyone who dares criticises our present public healthcare delivery system risks standing accused of wanting to leave the poor dying in the gutter, or decrying the dedication of the “doctors’n’nurses”.

The separation of the principles of the NHS and the NHS itself, as well as from the good work of the clinicians, will take a long time to achieve. Until then, we can never move forward to a more sustainable system for delivering decent medical care free at the point of delivery, for until then we will not be able to properly examine or discuss the alternatives.

*As a slight interlude: cue here, I guess, the examples of private cleaning contractors leaving wards dirty. This, goes the orthodox view, is because the contractors skimp on their work to make bigger profits. Yet even an in-house team could make a slapdash effort at their work for all sorts of reasons (laziness, incompetence, lack of resources). What would be the ultimate sanction? The errant workers get the sack (assuming you can make it through the employment tribunal and trade union objections). The private contractor, on the other hand would … be given the sack (OK, “have their contract terminated”). The issue, therefore, is not whether the service is delivered privately or publicly, but the quality of the management.

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Anyone For Bangers and Mash?

Swine Flu GIF by HappyToast

So, we’re all going to die.

Again.

Yes, even as the staggering (though regrettable) total of, err, 7 deaths have been confirmed in Mexico from swine flu (as of yesterday), saner voices are, as usual, struggling to be heard amid the zealotry of the panic-mongers.

Some have pointed out, for example, that bird flu has stubbornly failed to wipe out the 50,000 promised just for the U.K. (the worldwide actual total is, as of the 23rd April 2009, a scary 257).

Many will remember the BSE scare as well, though. We were all going to die from CJD/vCJD because it was caused by eating BSE infected beef (and, naturally, it was all Mrs Thatcher’s fault). We knew this was true because some scientists said so, shortly before asking for public money to continue monitoring the situation, just to be sure.

People laughed at John Gummer. They also laughed because he had fed his daughter a hamburger to demonstrate how safe beef actually was. Well, on this issue (as opposed to his views on evolution), he was right: confirmed and probable deaths from vCJD since 1990 (to 6th April 2009) have totalled 1,390, with 164 confirmed vCJD fatalities. A sum not at all adjacent to the millions forecast by the more shrill experts scaremongers.

Of course, the inconvenient truth about BSE/CJD is that no link has ever been proven between the human and bovine forms, which means that, unlike influenza, many resources have been expended on what is quite possibly the wrong line of attack.

Anyway, in the meantime, I suggest we make the best of it, and while the morons stop buying pork products “cos of the pig flu innit – I gotta fink of me kids”, we can benefit from reduced prices for bacon and bangers. Just in time for the barbecue season.

(H/T for the GIF: HappyToast via B3ta)

Remember BSE?

News came through yesterday of two cases of vCJD – aka “the human form of mad cow disease” in Spain.

Which all goes to remind us of the time a few years back when, thanks to the evil Tories and their relaxation of some farming regulations, some half a million cases of CJD were being predicted, mainly because of the widely accepted link between eating BSE infected meat and developing CJD. That was a view supported by a major enquiry that heard evidence from many prominent scientists. Much public research funding then flowed, and the cattle industry nearly collapsed.

An epidemic of vCJD did indeed materialise … at a peak of, err, 28 cases in 2000.

But that was then, this is now. Nowadays, we don’t rely on faux scientific consensus backed by governments to hammer our industries and scare people, while doubters are shouted down as ignorant heretics and condemned as being in the pay of those industries being cast as the wrong-doers.

In other news, global warming continues apace.

It’s Not My Fault

It’s Society’s fault that I have just scoffed this jammy dodger with my cuppa, and may supplement it with a Ginsters’ pasty from the corner shop when I take the dog out shortly.

In a way, though, the report’s findings – that many obese people cannot help themselves – are correct, but maybe not for the reasons it states.

If you accept that the state should take on the responsibility of your healthcare, then too many people will interpret that as relieving them of the responsibility for the condition of their own health. It also gives justification for government to take an unnatural interest in what we do with our own bodies and in our own private lives.

PieSo, should we be looking at more radical means of how we pay for state healthcare? Should the “premium” that we are charged for state health cover more closely reflect how well we look after ourselves, as private medical cover does?

Of course, some would criticise such moves as health fascism and more stealth taxation, but that is more a reflection of how abused and ineffective the system has been to date … and the fact that no genuine opt-out exists for non-emergency medical treatment on the state. Sure you can go private, but without a genuine opt-out for non-emergency treatment you just end up paying twice for your healthcare.

Moving on from what was developing into a dangerous line of thought for a loyal Conservative … one problem with reports like today’s is that it does make things even more difficult for the minority who do genuinely have a medical reason for their obesity.

Anyway, Society is now forcing me to think about lunch. Or is it all the fault of the evil Maggie Thatch? Or BushHitler? Now I’m losing track.