The increasingly deluded and reality-challenged fans of the NHS tell us that the NHS is the ‘envy of the world’ and that only a state run, state funded and state controlled healthcare system could provide high quality medical care dispensed to the patient in an equitable manner. Unfortunately that’s not the reality for many of those who have the misfortune to have to rely on the National Health Service. What we find is a healthcare system in utter disarray and run it seems not for the benefit of the patient, but for the benefit of its staff.
The sad reality is that whilst some people might voice satisfaction with NHS services, for others the story of their dealings with the NHS are less so. A good example of how the NHS fails the very people it was set up to serve comes from a Daily Telegraph article about an elderly woman patient who the NHS failed to properly treat and who then, because of poor treatment, ended up with maggots growing in an open wound.
Isabel Oakeshott writing in the Daily Telegraph recently said:
Used correctly, maggots can work wonders with flesh wounds. Centuries ago, Napoleon’s surgeon was among those who spotted their healing powers, noting the way certain species of fly had a positive impact on gashed limbs during the French military campaign in Egypt and Syria.
These days, so-called larval therapy is generally considered too icky, which is why it was such a shock when an NHS nurse peeled back the bandage on my elderly relative’s leg and came face to face with a seething mass of critters. The infestation was very definitely not part of any treatment plan. For a brief moment, there was a stunned silence. Then the nurse quietly signalled that she’d better fetch a doctor.
We were in a tiny consultation room – my relative, the nurse, and I – in a GP surgery so poky and dilapidated it would not look out of place on the backstreets of New Delhi. If there was a window it was invisible. There was no fan. The air hung heavy in the room while we waited for a GP to come to our aid. As the minutes ticked by, the whiff of necrosis grew more sickly. Where was the doctor?
The surgery, located in a fine market town on the edge of the Cotswolds, had three family doctors on duty that day. Any minute, we felt sure, one would appear. But no: in due course, the nurse returned alone, explaining apologetically that she’d been unable to persuade any of the doctors to help. Frowning slightly, she looked at the maggoty wound again. Could she deal with it herself? She thought not. She left us again to reiterate her plea for assistance. Still no doctor would come.
Eventually, Ms Oakeshott said, the practise nurse had a go at extracting the maggots from the wound even though it wasn’t within this nurses sphere of expertise. What galls me about this story is that if this patient had been admitted to hospital when she needed to be admitted ten days prior to showing up at the GP surgery, then the maggoty wound situation might never have occurred.
This poor lady, who had probably made a lifetime of contributions to the NHS via taxation, suffered immensely from a horrendously mismanaged healthcare system and what’s worse is that this didn’t need to happen. If this patient had been seen by her GP in good time and if the patient had been admitted to hospital when it was required then it’s quite possible that this festering maggoty leg ulcer might never have got as serious as it did.
We have a crap, expensive and very badly run healthcare system that badly needs reforms which put the patient and not the NHS as an organisation first. It’s clear from cases like this that this reform cannot come fast enough. I believe in nations having comprehensive healthcare systems that are there for the patient when they need them. Sadly the NHS is a long way from this ideal and I can’t see anything changing for the better as long as the NHS model is held up by the political classes and pro-NHS agitators as the only way to provide healthcare to Britons. The NHS model has failed and as a nation we need to admit that its failed and push for something better than the cruel and badly run mess that is the NHS.
It may be the ‘envy of the world’ but it certainly is the ‘enemy of the British people’.
It certainly does not seem to be serving the British people as it should do. It’s also definitively NOT the envy of the world and no other advanced nation has copied the NHS model.
Yes but what are you proposing as an alternative? A totally private system with insurance schemes for people not able to pay for the full costs of their treatments up front? In a country ATM with a cost of living crisis and many struugling to pay their council tax, rents, or mortages, and allegedly skimping on food, a changeover to funding a compulsory private schems in place of the NI stamp might not be welcome. But having said that, voluntary introduction into private health insurance in the UK does seem to be on the uptake and becoming more affordable, and offered as a perk in many even mid range income jobs now. A problem might be more how far the NHS is profiteering by co-operating with private schemes and ignoring many of its structural defects.
My preference as a replacement for the terminally awful NHS would be an insurance based system where the premiums are both flat rate and affordable which would be similar to the original National Insurance system. Or there’s the possibly of state funding health care either with co-pays or not co-pay but where the healthcare providers are kept to a large degree separate from funders and where the govt does not interfere in healthcare. The American system is for me not an option as this is a managed market and not a free market system which means that there is all sorts of incentives for hospitals to load on bloat to bills. One possibility would be to give every British citizen a personal health budget that they can spend, via a special card, on whatever healthcare services and providers that they wish to spend it on. People might even get tax rebates for not being frivolous with regards healthcare demands which would mean that those who make use of healthcare when it is needed get rebates but those who choose stuff like elective cosmetic surgery or gender transition (which are not essential healthcare needs) don’t get such a rebate.
Whatever replaces the NHS needs to be affordable for both the population and the state and which puts the bulk of the power in the hands of the patient rather than NHS administrators as it is at present. I would certainly welcome a multiplicity of healthcare providers with some from the private sector, some provided by charities and religious organisations and some maybe even provided by local government.
On the subject of cost of living implications if the NHS is not being both funded and controlled by government, with all the waste that entails, then we might end up with a more cost effective system which might eventually lead to NI/insurance/co-pay fees/ general taxation going down. It might be a good idea to look at how other advanced nations, such as Europe, Australia and Israel manage to provide comprehensive healthcare but without the incompetence and dysfunction of the NHS and without the cruelty and delays of say the Canadian system.
As regards problems with changeover then some people are going to need help from the state to manage that at least in the short term.
You are correct about the lowering cost of healthcare which seems to be coming about by economies of scale.
One thing that definitely needs to be done in my view is to separate the funding of healthcare from the provision of it. The current NHS system which is heavily politically controlled is full of moral hazards because there is no separation.
“Yes but what are you proposing as an alternative?”
How about copying what works best in other countries. Your question implies that you think that the NHS provides the best possible service and that any alternative just has to be worse by definition.
“A totally private system with insurance schemes for people not able to pay for the full costs of their treatments up front?”
Who does that? No country has a system like that. You need to google the term false dichotomy.
Even in the USA which is a managed market insurance based system there is still a safety net of sorts. I sometimes wonder if there was a true free market for USA healthcare whether insurance premiums would come down because of competition. I agree with you that we should look to see how other advanced countries provide comprehensive healthcare and consider those.
I’ve recently rediscovered a couple of articles that make for interesting reading on the subject of the NHS and healthcare. The first is from someone who like so many others has had appalling service from the NHS https://going-postal.com/2020/11/protecting-the-nhs/ The other piece is about what UK healthcare was like before the NHS and to be quite frank it didn’t sound too bad, yes there were gaps and sometimes the middle classes got shafted for healthcare costs but it doesn’t seem to have been the unremitting horror show that the Left like to paint UK healthcare as being prior to the creation of the NHS See https://theconversation.com/what-was-healthcare-like-before-the-nhs-99055
Is there a blog anywhere that specialises in covering this sort of thing?
If not, I wonder if there’s a need for one?
Envyoftheworld.com, maybe.