Whenever we touch on the issue of state controlled health system versus private healthcare, we get a smattering of outraged readers who cannot understand why we attack that venerable (in their eyes, not ours) dinosaur, the NHS. It’s free and for everybody they screech, you heartless capitalists… would you let your parents/grandparents/children die without treatment and care, if they couldn’t afford to go private?!.
The fact is that those I care about are more likely to be in need of treatment and care, as a result of coming into contact with the NHS. I want them to stay away from the NHS, and the government to give them back their money taken to support the giant leech known as national healthcare.
Many people are now frightened that they could pick up a dangerous infection if they go into hospital. It is hardly surprising. More and more of us know someone who has been infected with the superbug, MRSA (methicillin resistant Staphylococcus aureus). Marjorie Evans has been infected with it on eight occasions at the same hospital in Swansea. Now wheelchair-bound as a result, she says: “I’d rather go abroad and trust foreigners.”
As James Bartholomew writes in the Telegraph opinion section one is vastly safer in a private hospital and the danger of getting MRSA is a risk affecting patients of the NHS.
The NHS both is the most state-controlled hospital system in the advanced world and has the worst record in Europe. At a practical level, it is because of things like ministers driving hospitals at full capacity to reduce waiting lists, with the result that patients with MRSA cannot always be isolated.
But at a more profound level, the MRSA crisis is because the NHS is a state monopoly. Ministers are always making hospitals respond to the latest newspaper headlines rather than doing what is best in the overall interest of patients; hospital workers – like many employees of state industries – are demoralised and their pay rates are unresponsive, thus causing the local shortages. The state has also closed too many hospitals. The list of ways in which it has increased the risk is endless.
This is a result of the fundamental dynamics (or statics) of the public sector, not any lack of funding. There is no legitimate role for the state in healthcare, education and many other sectors that it appropriated for perpetration of what is so misleading called ‘public services’.
The dynamics of the private sector, meanwhile, are simpler and more effective. If you don’t treat your customers well, you go out of business.
Indeed, unless you take their money first and then help yourself to it…
Actually, if you’re complaining about cleanliness of hospitals in particular, my understanding is that the cleaning’s contracted out to private companies, so it’s not demoralized NHS employees who’re slacking, although I would argue that they should be being more demanding with the cleaning companies.
Oh, I see. If government agencies contract with private companies, they can’t be blamed if the private companies don’t do their jobs properly. Gee, you don’t think it possible that private companies get their contracts with the NHS for some reason other than being the best cleaning companies, do you?
Nor is it as simple as the cleaning of the hospitals themselves: a point I’ve repeatedly heard emphasised is that employees themselves do an inadequate job of cleaning their hands.
“Oh, I see. If government agencies contract with private companies, they can’t be blamed if the private companies don’t do their jobs properly. Gee, you don’t think it possible that private companies get their contracts with the NHS for some reason other than being the best cleaning companies, do you?”
…like being cheap? Or are you suggesting some uber-conspiracy?
& yeah, the whole “contract it out, blame someone else” thing’s such a common tactic nowadays… but the responsability at the end of the day lies with the person who is contracting the work out; if the company they choose does an inadequate job, they should have chosen a different company or leant harder on them.
The whole concept of cleanliness, or the lack of, in hospitals, is planned into the system from day-one.
An example, The ‘new’ Charing Cross Hospital, built less than ten years ago, from the ground-up, and incorporating every modern feature that one could wish for, including a wonderful arboreal atrium which costs the earth to heat and light, they say the light projected upwards is used a beacon for aircraft using Heathrow.
I digress, the urology wards are operational from Monday to Friday, when all the patients are either sent home, or occasionally moved to another ward. The week end is used for cleaning the wards, there is no cleaning done during tthe week, if there is a spill, it stays there. Having been there on three occasions, I am pretty sure that this is the normal procedure.
Back to the design, the wards are in groups of five, each holding six to eight beds, that is a mnimum of thirty patients at any one time. There are just two washbasins for patients, the only bathing facility is for the disabled and there are just two toilets, and this in a urology department, where urine etc. is being spilled on a regular basis, either by staff or patients. I should mention that these are ‘mixed’ wards, with both male and female patients sharing the same facilities. Little wonder that ‘hospital diseases’ are so rampant.
The point is, that this building is the modern concept of what a hospital should be, being designed, no doubt, by numerous committees, with the ‘management’ having the largest input. The whole place reeks of a conveyor belt approach to healthcare, where scant regard for patient needs are the order of the day. The place looks wonderful to the casual visitor, mainly because of it’s relative ‘newness’, it is only as a patient that the ‘operational skimping’ becomes obvious.
The lack of cleanliness, whether done by contractors or by in house staff, is the sole responsibilty of the hospital management, any attempt at ‘blame-shifting’ by them should not be tolerated.
A_t
“…like being cheap? Or are you suggesting some uber-conspiracy?”
Are you naive or what ? Don’t you know of contracts going to the nephew of the administrator ? This is standard practice in public institutions.
Other methods are: contracts awarded for kickbacks (bribes) – the French method; and contracts awarded to political supporters – the American way.
I am in almost complete agreement with this post, but there’s one sentence fragment that just strikes me as plain wrong, namely:
“There is no legitimate role for the state in healthcare”
If the effort to control contagious and deadly diseases like smallpox and the plague doesn’t strike one as a just use of state power, I don’t know what qualifies. It may be that many in the West have forgotten or simply never experienced what it is like to live with such afflictions, but there’s no way of knowing what the future might hold; to illustrate, in the late 1970s the notion that sexually communicable diseases could ever again be lethal seemed highly improbable.
All this is not to say that the state should be running hospitals and directly hiring GPs, of course. I think the NHS is a Soviet-style monolith that has all the problems one would associate with such an edifice; my nickname for it – GosHealth – didn’t go down too well when I last tried it out with another audience.
Abiola Lapite: You are absolutely correct. By healthcare I did mean running of hospitals, doctors, hiring GPs and all that goes with the command control style of public services management.
A health crisis such as epidemic was not included in the statement. As someone who believes that protection and enforcement are legitimate roles of the state, perhaps, in times of crisis caused by a disease or health risk, the state should be able to co-operate with or co-ordinate the private sector. However, such cases should not give it carte blanche to run the entire health system.
Abiola – You’re picking nits, which is not like you. You know that commentators are saying that treating patients and dispensing medication is not the remit of government. Who would argue that public health issues – for example, laws against spitting, even – are indeed legitimate areas of government concern? As, of course, is screeing would-be immigrants for communicable diseases and refusing entry to those carrying them.
Second, I read The Telegraph item and the performance of the cleaning contractors is overseen by one of the gigantic edifice of NHS ‘managers’ (as we all know, the NHS has more ‘managers’ than hospital beds, which says it all, right there; there should be no further discussion). So the failure to enforce high standards of hygiene in NHS hospitals does indeed lie with NHS employees.
Yes, the nurses are dirty, and chippy and over-familiar too, which is perhaps due to the absence of matrons. And also because they don’t see themselves as providing a service that is being paid for. The nurses appear to share the same general illusion that the NHS is “free”.
Mixed wards are an obscenity. No private hospital using mixed wards would last a week. However, they are an effective way of robbing the patient of his dignity and disabling his motivation to complain.
So, why aren’t the inadequate services contracted to someone more competent?
I was under the impression that central government obliged services to be contracted to the lowest, rather than best value, bidder. Is this true? It sounds like a recipe for trouble.
This reminds me of a great P.J. O’Rourke quote:
” If you think health care is expensive now, wait until you see what it costs when it’s free.”
There is, in last week’s Economist, a wonderful graph of healthcare spending by country and a measure of what proportion is provided by the state. The US has the lowest amount of state involvement, but the highest spending per head…
Hmmm.
I haven’t experienced NHS or it’s cleanliness problem first hand so I can’t comment. However I have had extended visits with 5 separate American hospitals and I can assure you that any and all spills are cleaned up immediately.
The worst situation I had, in about 45 weeks aggregate time in hospitals, was when I was paired up with a gentleman who had a bleeding ulcer in his stomach. He was a nice guy, but it was hard eating dinner when he was placed on a water only diet restriction.
Otherwise all the hospitals were clean, neat and the nurses came around every hour or so to take basic stats such as blood pressure. In general I’d have to say that i don’t have any complaints.
To explain I have total renal (kidney) failure and so I have a suppressed immune system, rather prone to serious infections and numerous secondary problems.
As for MRSA, it’s as deadly as it is made out to be. I got a serious MRSA infection in my left arm and it required surgery to prevent it’s spread. The coctail of antibiotics weren’t enough so they have to carve the infected flesh out of my arm. Took about 2-3 weeks to heal and was very strange as I had never expected to walk around with a hole in my arm. Surreal experience in some ways.
Frankly if the NHS is that bad then I wouldn’t go near it under any circumstances. Private hospitals cannot allow themselves to reach that point otherwise their legal and financial liability would become enormous. Only government institutions can be that arrogant. Here in America we actually do have a version of NHS though it’s called the VA or Veteran’s Administration. And the VA hospitals can be just as bad, though they’ve gotten a lot better in the past few years.
Too bad there really aren’t any hard or fast rules on preventing MRSA. The most important ones, from my experience, are:
1. Do not allow anyone to touch you without fresh gloves. Sometimes nurses and doctors will come into a room already gloved. Insist that they change gloves in your presence.
2. Insist that nurses and doctors wash their hands, and put on gloves, prior to touching you. While in most cases doctors and nurses wash hands often, you still don’t want to take a chance.
3. If you’re going to get an injection then insist that the syringe be removed from it’s packaging in your presence. Do NOT accept an injection from a syringe that you haven’t seen opened. You have no idea where that syringe has been or how it’s been handled.
Might help, won’t hurt.
The real problem with “the state’s role in healthcare” is related to constant libertarian question:
What about the poor?
And it’s also related to two other issues. 1) “society” = gov’t. Thus, if “we” as society should do something, like help poor folk, this means gov’t.
If this mindset doesn’t change, gov’t will keep getting bigger.
2) everybody is happy to be generous with Other People’s Money. There needs to be a way to make those who get a direct benefit from the gov’t, pay MORE than those who don’t
While I suggest Tax Loans, there might be other ways — but there’s a HUGE need to support some policies that reduce the altruistic sounding demands of more gov’t benefits .
[From the rich – ha! to the poor – right, they vote so much The double lie of Robin Hood]
You are all a bunch of twits! I work within the NHS in a professional capacity and there is more to the NHS than what you are discussing. For goodness sake grow up and try to dicuss this topic logically rather than knocking the whole of the NHS because of MRSA. Becuase of this virus you say we should go private errrmmmmmmm not the brightest crayon in the box are you. Look at the National Health Service as a whole, doctors surgeries, maternity units etc
Of course it is true that many people are now frightened that they could pick up a dangerous infection if they go into hospital we simply says that there is no legitimate role for the state in healthcare.
All people wan is that Out state don;t care about us.BAshin bashin all around us rather of making us comfort from all matters they giving us a frightened talks.Scums