Vir Cantium

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Category Archives: NHS / Health

We Don’t Want an NHS – We Want NHI

NHS logo

National or Nationalised? Our 1940s retro health service.

Man the barricades, make up the placards, light the vigil candles, wind up the hyperbole … someone – Evil Tories, natch – are trying to tweak the NHS. This cannot be allowed to happen, of course, because the NHS is the Envy Of The World. We Love The NHS, don’t we? Without it, people would lie dying in the gutter while big businessmen in their limos swerve towards them to try and finish them off. Like in the USA, you know.

Yes, here we are again. The NHS is being ‘dismantled’ and the world will stop turning, apparently, because the bureaucratic PCTs – installed by Labour to put yet another layer of overpaid management between the patient and their treatment – are being abolished. The woefully underpaid GPs will join forces to commission services themselves, and other changes are afoot which prove that while the memo on localism may not have reached the Department for Education, Andrew Lansley at Health clearly has read it. (This coming years after the Community Health Councils were scrapped by Labour in one of their typical outbreaks of government-knows-best control freakery.)

The health unions, naturally, are quick to claim that patients are at risk because of the changes. Just as the rail unions claim that passengers are at risk whenever someone suggests changing the timing of signalmen’s tea breaks, or future generations’ education is being wrecked because teacher’s pensions are being downgraded from gold- to silver-plated.

Of course, the patient ‘experience’ is unlikely to be significantly affected by the reforms – at least in a negative way. Even so, people are too ready to believe that it will, because it puts us further on the path to fundamentally changing the NHS as we know it – but that is a good thing, because the NHS is not fit for purpose and is financially unsustainable.

The trouble is that debates on the NHS often revolve around who is best placed to take the controls of the steam engine, each proposing their own scheme for shovelling ever more coal into the insatiable machine; all the while kidding themselves that to do so will somehow magically transform the old smoker into a bullet train.

When the Left tell people the NHS is under threat, they don’t mean the National Health Service, they’re referring to the Nationalised Health Service; the top to bottom state-run monolith, designed by 1940s socialists and fundamentally little changed since.
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Equality At Any Price?

Brian Gould was one of the key architects of New Labour, and thus from a tribal perspective I am not a fan. The impartial political anorak in me does recognise, though, that he was very effective in his role; something not to be forgotten in any assessment of Blair’s rise and of the other players (Mandelson, Campbell, et al.)

Putting politics aside, I have found his story of his own battle with cancer of great interest, and naturally I hope he pulls through.

The Royal Marsden Hospital - Sutton. This is t...

The Royal Marsden Hospital

One point that caught my political eye, though, was buried in part two of that story, published today by those evil Murdochians at The Times (£). Here, Gould is comparing the culture of the Memorial Sloan-Kettering Cancer Center, the U.S. anti-cancer hospital in which he underwent part of his treatment, with the Royal Marsden, itself a specialist in cancer care:

The Marsden is, of course, an NHS hospital, and although it gains 30 per cent of its revenue through private patients (of which I am one), this does not fundamentally affect the character of the institution. Patients feel less empowered than in the United States, and patients are probably treated with more efficiency there, but the culture at the Marsden is warmer, less transactional and much more egalitarian. [Emphasis mine.]

So, the lack of efficiency (which, let’s face it, means that we’re not getting the maximum value of care and treatment from every pound) and lack of empowerment (adding to the sense of helplessness felt by the patient and their loved ones) is made up for by a warmer culture and … egalitarianism? Do all the architects of Labour’s success in the late Nineties and Noughties genuinely think that equality is worth the sacrificing of such core elements of any healthcare system?

Treatment available to all, free at the point of delivery, is fine – that’s describing any decent insurance system. However, I’m sorry, but to regard egalitarianism in healthcare as an end in itself smacks of warped priorities, particularly (though I appreciate this probably wasn’t the interpretation intended) in an area where by necessity some will need greater resources per head than others. The trouble with the egalitarian mindset is that it is subject to the ideological equivalent of ‘mission creep’ (viz. the recent ECJ ruling on women’s insurance premiums).

Let’s take, as an example, another field dominated by state provision: education. It’s as if we mustn’t applaud the success of one school or type of school, or in any way promote them, because that would be to talk down – nay, condemn – the others. So as long as everyone is equal, then we can take comfort that we are all subsisting at the same level of mediocrity. Really?

Sadly, in the case of grammar schools at least, it seems that the blind pursuit of equality at all costs is an ideal that still runs deep, even on the other side of the political spectrum to Lord Gould’s.

The third and final part of Lord Gould’s story is tomorrow. Again, tribalism aside, here’s hoping for a good outcome.

(Pic. credit: Jean Barrow CC Sharealike 2.0)