We are sometimes told by its defenders that the National Health Service is the envy of the world. Well, I wonder if all those countries yearning for socialised medicine are dreaming of this?
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Yes, but I bet that British rats are cleaner than other country’s rats!
And a David Attenborough show was talking about how rats are one of the most adaptable animals on the planet- so it’s no wonder they can outthink NHS staff!!! Let’s keep things in perspective!
Look again. Those ain’t rats. They’re administrators.
It’s hard to tell the difference unless they’re side-by-side. The actual rats have clip-on neckties as opposed to real ones.
While the NHS is, undoubtedly, a shambles and a disgrace, I think that the problem in the UK goes deeper than simply the socialisation of provision.
I have no doubt that each of us could bore for England with tales of inefficiency, carelessness, casual errors and abysmal customer service encountered when dealing with medical services. You know, the kind of commercial practice that would send any normal business into receivership, as its customers took their business elsewhere.
Yet, thanks to the monopoly enjoyed by the medical guilds and enforced by the state, there is no elsewhere to take one’s business.
One danger of dismantling the socialist delivery mechanism without tackling the underlying monopoly is that we’d end up with something approximating veterinary medicine. While a human can, at least, get on a flight to Germany or the USA and deal with a *different* guild (not really a market, but at least it’s something) try getting an animal out of the country (or worse, back in to it) without a vet’s permission. Not a hope in hell. Piss a vet off too much and you’ll have the RSPCA round, impersonating police officers and killing your animals. So, you’re stuck playing supplicant to a guild that, first and foremost, looks after its own.
Tens of thousands of medics (of all stripes – doctors, vets, dentists etc…) qualify every year. Clearly, by any measure, their abilities must range along a normal distribution. Yet no guild member will ever suggest that any other member graduated with anything less than a starred first. When mistakes are made, guild solidarity takes precedence over patient care.
I’m not sure how to go about creating a genuine market in medical services. But I am convinced that breaking the power of the guilds is a necessary step.
Sunfish wrote:
‘Look again. Those ain’t rats. They’re administrators.
It’s hard to tell the difference unless they’re side-by-side. The actual rats have clip-on neckties as opposed to real ones.’
To the editors – when are you going to get some more guest pieces out of Sunfish? We may not always see eye-to-eye but he fits this site like a hand in a glove (no OJ jokes, please), and, dammit, he’s funny!
The Other Rob’s post about veterinary medicine struck a chord. I’m in the US and I raise large animals. I would far sooner deal with my veterinarian than with my GP because
– she makes house-calls
– she knows that we’re paying for her services out of our own pocket, and so she has a keen appreciation of costs vs benefits
– she knows that we have a dozen DVM’s to choose from, and so she works hard to make sure that we keep choosing her.
– she will deal with us by truck-and-barter
– her stitches are 1,000% better than any MD’s.
Even the somewhat-more-free-market US healthcare system doesn’t get close to the relationship we have with our vet. Sometimes, I wish it did.
llater,
llamas
2nd both of llamas statements. I really want to hear the full details on the self administered, full immersion, electro convulsive therapy. If I ever want someone to do a Mutual of Omaha on an electric eel, I know Sunfish is qualified.
As for veterinarians, the veterinarians guild is not nearly so strong in the US (at least in Wisconsin and apparently Michigan). Without the mighty boots of the state stomping a pathway for them, they actually rely on service for business. We recently had one of our dogs examined on a first house call, followed up a couple weeks later with a second house call, picked up (by the vet himself) for surgery in an animal hospital 20 miles away with a third house call, and returned to us after surgery (and minus the suspicious growth) with a fourth house call. The entire works including 4 house calls, anesthesia and surgery cost us a total of $344. Our vet rocks.
The other rob is exactly right. Without breaking the stranglehold monopoly the medical guilds have, everything else is deck chairs. I am not sure which tactic will be more effective. Breaking the funding path (NHS, Medicare, etc) first or breaking the absolute and unaccountable monopoly first. Let’s aim for both.
About ten days ago I went to0 the local docs. He has a look in me lug-holes and suggests I get my ears syringed. In the mean time I have had to make a passable stab at BSL because Maureen was off ill and is on holiday this week. maureen does, tya see, all the era syringing, blood pressure-testing and smear tests in the practice. There are other practice nurses but fuck knows what they actually do.
5 minutes ago I phoned them to make an appointment for me lugs but guess what? They’ve all fucked-off down the pub. Wednesday, half-day closing innit! I have tried. I have tried. I have tried every fucking NHS outfit from Buxton to fucking Manchester and no, because I is not registered they will not syringe my ears. I could go fucking deaf because of this and they couldn’t give a shit. They are though more than happy to piss my taxes up against the wall. No, that would be too little. They’re more than happy to take my money and piss on me from a great height, whilst laughing their collective tits off.
An NHS GP makes minimum £104,000pa. I got the appointment with the doctor fine, no probs. It was the only the treatment that was lagging. D’oh!
I don’t need an MRI scan or a new kidney for fuck’s sake! I have decided that, with the aid of the NH-fucking-S, I shall become disabled and ponce off the rest of ya for the next fifty years. Well why the fuck not! Every other cunt is doing it.
A quote from the article: “If these hospitals were restaurants they would be closed down and out of business.” That about says it all.
Nick, have you tried urea hydrogen peroxide eardrops? These days if possible I resort to self help before attempting to invoke the NHS…….
Not for many years. Certainly not since it has been obvious to Blind Pugh that the NHS is the envy of precisely nobody.
Hello everyone — I have a bit of curiosity regarding the NHS, et al.
If I understand correctly, private practice clinics are still legal in the UK — right? I mean, a physician can still legally practice medicine outside of the NHS — or not?
I could be very wrong about this, but I heard from somewhere (wish I knew where) that private practice isn’t allowed in Canada. So — if that’s the case, I’d say that what you have in the UK is probably better than Canada, at least.
Also, for you Australian readers, do you have socialized medicine in Oz, too?
‘The envy of the world’.
They never tell you WHICH world, do they? Mars? Galafrey? Trantor?
To follow on from nick g.’s last point:
… Third? Fourth?
I remember the grand old public health films about hygiene. Now hospitals brag about how energy efficient they are by not using hot water to do the laundry.
When Brits talk about the NHS, they are really talking about two things.
1) The actual service which everyone realizes falls far short of any acceptable standard.
2) The Platonic Ideal of the NHS which is a lynchpin of national identity, a wellsping of solidarity and a symbol of how much we care about each other. As I have said before on here Socialist disrtibution of health care (NHS) and socialist distribution of entertainment (BBC) are the baseball and apple pie of the British Psyche. The average Brit isn’t psychologically capable of criticising them as institutions because he would be rejecting the core of his national identity.
Anchoring feelings of national identity to morally bankrupt socialist garbage IS a bad idea but that is what has happened in this country.
It’s not their doing. I’ve only had one submission not published on the front page. I just don’t send much in.
That’s been my experience too. I chose my GP because:
-He was accepting male patients at the time.
-He was in the network for Blue Cross.
Highly selective, I know.
On the other hand, I chose my vet because of a, what you said, and B, she and my dog like each other. And she’s good at explaining to me what’s going on and why she does what she does.
There wasn’t that much to tell. We were doing a shock survey of the river: pass an electric current through the water. It stuns the fish, and they float to the surface. We catch them in a big seine net and count how many of which species we find. Then we throw them back in, because the shock doesn’t actually kill them.
It’s very similar to a poaching technique (which I of course know absolutely nothing about) called ‘telephone fishing.’
This wasn’t ground-breaking research. Our professor just wanted to show the undergrads how he collects data for his research. So we all took turns putting on waders and the shock backpacks (cheap plastic external frames with large batteries on them) and stunning the fish.
Until some clown slipped and went in. The probe from his pack was live when he went in and he got a bit of a jolt. Then the current caught him and he went downstream a little before he returned to planet Earth and got his footing.
Didn’t get me any points with female classmates either. Most of them seemed to be thinking “what a maroon.”
Sunfish wrote:
‘That’s been my experience too. I chose my GP because:
-He was accepting male patients at the time.
-He was in the network for Blue Cross.
Highly selective, I know.’
I do detect a shift, tho’. In the previous HMO offered by my employer, you were pretty-much assigned a PCP, and changing to another one was systematically-discouraged – lots of hoops to jump through.
In the current HMO-like offering, they make a big deal about finding a GP “that works for you”. I suspect that this is, in part at least, code language for ‘letting female patients choose a female GP’, but of course you can’t say that out loud. But the system works, and I used it to try 3 different PCP’s before settling on one that ‘works for me’ – a doctor from Ethiopia, FHS, who thinks about my healthcare the way I do and who takes care of me the way I want. She’s not quite like my vet, but it’s better than the ‘take what you’re issued’ approach of the past.
llater,
llamas
I agree with much of what has been said about the NHS but I take issue with the suggestion that the ideas (of creating a public-service broadcasting network or a public healthcare system) were wrong, in the first place. That is an opinion borne of right-wing dogma, as spread through the British tabloid press and satellite TV stations. [I note, in particular, the comments about patients having to travel to Germany, France etc, in order to receive safe, effective treatment. Bang on target, old son!]
The BBC and the NHS have not fallen apart because they were useless, pointless organisations from the very start. “Know-it-all” [i.e. “know-almost-nothing”] politicians and civil servants, many of whom despised everything socialist and wanted to see the back of the institutions, have constantly tinkered with them over the last thirty years, until they have become unworkable. Hardly a week goes by without another “bright idea” coming from some mutant policy maker in Westminster. The Treasury is only too happy to go along with anything, which allows officials to cook the books and pretend that public spending has been reduced. [PFI and PPP don’t count as public-sector borrowing, even though the taxpayer is being royally ripped off by the banks and construction/administration consortia behind them.]
There has been a failure to protect what are essentially public services from the greedy elements, which are bound to damage broadcasting and healthcare (and education, transport etc etc). In other words, it was allowing the viruses of unregulated Thatcherite capitalism and political corruption into the BBC and NHS “cells”, which caused the crippling diseases, from which both suffer. [Commerce is much more tightly regulated in the USA, in my opinion, although “pork-barrel” politics is a problem, there, too.]
The English Government has sought to manage the “symptoms” with ever larger, expensive injections of the “wonder-drug”, cash. That’s appropriate, in a way, as British doctors, schooled only in the “art” of guessology, never seem to cure any disease (or accurately diagnose its cause). Official Royal College of Pathologists figures estimate that 50% of diagnoses in British hospitals are wrong. [This is based on the annual survey of post-mortem findings.]
Another huge problem, which existed long before the politicisation of the civil service and the universal adoption by the three main parties of the policies of Mussolini’s Corporate State, is the basic way, in which the country is run (ruined?) by Oxbridge-educated buffoons from their palaces of incompetence and indifference in Whitehall. Everything they handle turns to dust. They are completely out of touch with real life, as experienced by ordinary people, and, therefore, can’t get their heads round the problems. To prevent any further harm, the Sir Humphreys should never be allowed out of the worlds of Academia and Radio 3 discussion programmes.
Right-wing polticians, motivated by a lust for power and money, don’t care what happens to the underclass. A large part of the electorate (and it’s the part, which is likely to vote) is the same, so heartless, un-Christian policies have been popular. It’s a very shortsighted view, though, because, in the end, every single citizen suffers. As any true Tory realises, it is the disregard for the social contract, which leads to discontent, instability and, as a reaction, the heavy-handed socialism, which Neo-Cons and Neo-Liberals dread so much.
The NHS (which wasn’t designed or dreamt up by any socialist, as it happens) worked reasonably well until the mid-1970s, when local control was abolished and Regional Health Authorities were introduced.
On top of excess bureaucracy [which Thatcher and Sons-of-Thatcher, Major and Blair, never did anything about], came
(i) Mrs T’s petty penny pinching [resulting, for instance, in junior doctors having to work a solid 70, 80 or 90 hours a week, at great risk to their patients, instead of merely being “on call” for 100 hours a week and having to work about 45 of those],
(ii) the ludicrous internal market [something also imposed on the BBC, which, incidentally, was responsible for the recent Russell Brand/ Jonathan Ross fiasco because (a) the producer was employed by Brand and not by the BBC and (b) the Corporation no longer has the guts to stand up to its over-paid, over-rated “stars”]; and
(ii) then the back-door privatisation, which was all about handing out contracts to friends of the party in power. [PFI and PPP schemes are hire-purchase in disguise. They cost around five or six times what the equivalent work would, if done “in house” within the public sector. New Labour is a Thatcherite party with a different coloured rosette.]
Today, appoximately one fifteenth of the British population is employed by the Health Services of the four constituent countries of the UK at an unbelievable cost. Every man, woman and child in the UK is paying over £2000 a year for these out-of-control bureacracies. The UK’s doctors are the second most highly paid in the World. [Their mouths are well and truly “stuffed with gold”.] Yet, the “profession” remains free of independent regulation and, to a large extent, is unaccountable.
A recent report found that techniques and knowledge in the average British doctor’s surgery (“office” for Americans) were about 35 years behind those in Germany. Evidence-based medicine is almost unheard of, outside the top tier of teaching hospitals (and, when it comes to the crunch, even enlightened doctors can’t afford to investigate complaints because Health Service accountants and senior bureaucrats determine what can and can’t be done).
There is almost no choice for patients because, in most cases, the only difference between “private” and “NHS” appointments is that the former means paying about £200 for a consultation within a month, while the latter involves waiting four months to see exactly the same consultant in a publicly funded hospital, down the road.
The UK’s Health Services (in which there is enormous variation in standards, both between the countries and within the countries of the UK) are ranked 21st out of 27 countries in the EU, by the official European Commission statistics. That puts them on a par with countries, which have only joined the EU (and to which we used to send medical aid). British medical education and training are so poor that many doctors are applying for courses in Contintental European countries, the United States and, in some cases, India, where they feel they will gain the skills they need.
The lesson is not that public healthcare is bad and private is good. Only a dummy would think that. The lesson is that greed will destroy any healthcare system, no matter how it is funded. The NHS is a trough. The Government pours in the “swill” at one end and the big piggies [doctors, building contractors, “cleaning” (sic) contractors, Chief Executives etc] scoff most of it, leaving the little “patient piggy” at the far end with only a few scraps. That doesn’t sound much like socialism to me but Americans do have very odd political terminology!