Monday, January 04, 2010

David Cameron: The NHS is ‘the embodiment of fairness’


The problem with incarnational politics is that it invariably forges oxymoronic concepts by the fusion of apparently contradictory philosophies or disparate and divergent characteristics through mutually-exclusive entities.

Or perhaps that is just the postmodern condition.

The NHS is both admired and derided, despised and envied, lauded and cursed. It is politic at the moment to consider it a monument to enlightenment, the epitome of welfare provision, or, as David Cameron says, ‘the embodiment of fairness’.

Except it is nothing of the sort.

It may aspire to be, and, to be sure, there many thousands of outstanding healthcare professionals dedicated to its cause in the service of the nation’s health. One can celebrate its achievements and glory in its excellence without being blind to its inefficiencies or ignorant of its failures. For those ‘stake-holders’ who have been driven to seroxat while contending against its labyrinthine bureaucracy, who have witnessed first-hand its arbitrary rationing or even died while queuing for an operation, it is not remotely ‘fair’.

It may be fairer in Kensington & Chelsea, leafy Buckinghamshire, Royal Berkshire or rural Oxfordshire. And ‘fairness’ may be the genuine experience of hundreds of thousands of the sick and dying in the affluent shires of England. But go to Liverpool, or to Birmingham, or to any one of the 20 NHS Trusts which are deemed to be deficient in their management and offer poor quality patient services, and ask those who are doomed to use these services if their healthcare is ‘the embodiment of fairness’. Ask them about their cancelled operations for ‘non-clinical reasons’, or the thousands of cancelled appointments for suspected cancer sufferers or accident and emergency treatment because of a £13 billion computer system failure.

They are all likely to tell you where you can stick your question.

If they have lived to tell you.

The National Health Service does not inspire confidence: however much faith people may have in individual doctors, nurses or carers, the system is dogged by inadequacies and failures of co-ordination which only exacerbate the distress and anxiety already caused by illness. No one takes responsibility because no one appears to know where responsibility lies and, crucially, no one seems able to diagnose the systemic failures in order that they might be rectified for an individual patient. Even the most persistent patient with a determined GP will find it hard to discover a clear path through the labyrinth which is 21st-century patient care in the NHS.

Today, the Conservatives announce that the solution is to invest billions of pounds in the poorer areas in order to bring them to the standard of the best-performing trusts. It sounds right, it sounds good, it sounds ‘fair’, even though it is likely to mean the diverting of ‘ring-fenced’ funds from those areas of the English Health Service which are performing well, for there is not a magic pot of gold in the middle of an economic crisis which may be poured into the areas of deprivation.

But money is not the answer. If it were, every school would be like Eton, for the spending on every pupil in a state education system fast approaches that spent in the private sector. How is it that private health insurance is a whole lot cheaper than the health contribution of one’s National Insurance premium? Money does not change a careless doctor or an indifferent nurse into a good one any more than it can make a bad teacher an inspirational one. Money is not the prime motivator of those in health or education, for they are vocations. The true professional will value teamwork and a clear, sensible and supportive system for delivery and accountability to improve motivation and results all round.

Like education, the NHS is now bound by bureaucracy and oppressed by targets which are distracting in their complexity and depressing in their ubiquity. When league tables became more important than patient care, the core purpose of the NHS shifted and its primary focus became that of seeming: it did not matter if the patient was diagnosed properly or treated adequately; it was more important that he or she was seen within 30 minutes and the statistical box was ticked.

Lord Lawson once observed that the NHS is the closest thing the English have to a religion. And the peculiar thing about the NHS is that it is now exclusively English: Scotland runs its own health affairs, as does Wales and Northern Ireland. So when David Cameron talks of the National Health Service he means the English one, for in the post-devolution settlement that is all that the Conservative Party may now legislate to improve.

But this improvement will not come with money: like all universal religions and socialised bureacracies, it is crying out for reform. The NHS has become more sacred than the cow, more halal than thabia, more kosher than kugel. It has an infallible priesthood propagating unquestionable precepts, and David Cameron has to prove his doctrinal purity and theological orthodoxy by venerating the bones of Bevin. But the system’s corrupt indulgences and waiting-list purgatory can only be addressed with the boldness of a reformer who is prepared to advocate the priesthood of patients and nail his diagnoses to the door of Number 10.

But that, of course, is heresy.

And Cranmer knows only too well what fate befalls the heretic.

33 Comments:

Blogger Gnostic said...

Your Grace, you have more than adequately shone a light on the plight of the NHS. However, you do not go far enough. There's PFI, a particularly nasty type of politically inflicted Acme tonnage that would have given Wile E Coyote wet dreams.

4 January 2010 at 09:45  
Anonymous philip walling said...

An old neighbour in the village collapsed three days ago (in this very cold weather) and has spent 36 hours on a trolley in a corridor at our local hospital recently built under a PFI at huge expense to our children and grandchildren. It has an atrium with huge palm-trees growing there and a nave like a cathedral, but no beds for an 86 year old woman in acute distress.

The NHS is a fraud. We are told we have free universal healthcare, but if you can't pay you get what you're given, not what you need.
It's primary purpose is to pay the salaries and pensions of its employees (and interest on deceitful PFI loans) and the patients queue up second in line for anything left over.
It is supposed to be offering medical services, but it's run by bureaucrats and politicians, telling doctors what to do rather than the other way round.

A large part of nursing and recuperation ought to be based on good nutrition, but the food in hospital is nothing short of poisonous filth.
Nurses no longer feed patients too weak to feed themselves and in one case I know about lie to their relatives that the patient has eaten when she had had nothing for three days.

You say that people laud and curse the NHS, deride and admire it, and so on, but the praise is based on astonishment that the system actually provided something, and the admiration is for staff who, against all the odds and influences of the hideous socialist monstrosity, actually do what they are supposed to do.

"By their fruits ye shall know them" - tell me why most of the NHS staff I've come across are fat and ill-looking.
Not much of an advert for what they offer.
I know it's become a truism to compare French hospitals, but I have direct experience of both systems and I know which I'd rather trust myself to.
I live in terror of having to spend any time in an English hospital.

NHS sacred?
It will eat up the whole of our commonweal unless someone has the balls to deal with it.
It is a metaphor for the most selfish greedy and terrified-to-die society that has ever existed in the history of the world and it is a symbol of our doom.

4 January 2010 at 09:56  
Anonymous Kiwi said...

"The NHS is 'the embodiment of fairness'" Really? Sounds like Cameron speak for, "Carry on as before, no change."

4 January 2010 at 10:12  
Blogger DDIM 'n HOFFI said...

phillip W

Spot on. Hospitals are bloody scary places. Keep yourself healthy because we are back in the stone age with medical care.

4 January 2010 at 10:18  
Blogger English Pensioner said...

As a person who has regrettably had to visit hospital to frequently in recent years, either for personal reasons or to visit friends my main conclusion is that most medical staff are good, but rushed off their feet.
But stay in the hospital for long, in whatever department, and you can't fail to notice the huge number of Administrative staff who appear to wander aimlessly around the place, usually carrying a few sheets of paper. Go to the administrative corridors in the hospital (if you can) and you will find the luxury of carpets, spacious offices and the latest of everything.
There is a need to look at the administration and find the best practice. We have pupil to teacher ratios in schools, why not administrator to bed ratios in hospitals?.
Something also needs to be done about the number of Quangos overseeing the NHS, many overlapping. Are these really necessary? After all, we are still having scandals of incompetence at regular intervals, but no-one seems to get fired, either at the hospital or the supervisory quango.
Incompetence seems to be quite well rewarded; rather than disciplinary proceedings, someone is usually paid off with a huge lump sum and early pension, and they then go and get a similar job elsewhere. Certainly this wouldn't happen in the private sector.
We will need someone with boldness and great determination to make any difference, but unfortunately most governments lack any real desire to change the status quo and indeed anyone of the capability of taking on the task who is not already stuck in the civil service rut of requiring yet more paperwork and supervision.

4 January 2010 at 10:26  
Blogger Dave said...

C Northcote Parkinson summed it up fifty or more years ago. The Civil Service cannot be pruned. It will always grow. Here's why.
Heads of civil service have a heirarchy and a pecking order. You power and prestige depends on two factors.
One: how big is your budget? The bigger the better.
Two: how many staff in your department? The more the better.

All efficiency savings are illusion. They do not want change and everyone, from the bosses to the unions will fight tooth and nail to prevent any change at all.

There are a few businessmen who grew rich by controlling their costs and running a tight ship. Would any of those dare take on the NHS?

The NHS is strangling us. It's a fight to the death I'm afraid.

4 January 2010 at 10:57  
Anonymous Knighthawk said...

During the period 1995 to 2007 my elderly mother was often taken to A&E. I would wander in and ask where she was. The staff were always helpful and told me where to find her.

Not any more. Oh no!
How's this for an example of socialist control freakery:

Recently my daughter was taken to our brand new centre for the walking wounded when she had an accident at work. I went there with her agreement so that she could be driven home after treatment. There was no sign of her in the reception area so I asked the desk staff if she had been admitted yet. They refused to tell me on the grounds of patient confidentiality. In response to my protests all they would do was offer use of their phone so that I could ring her mobile. They said “She can then choose to tell you if she has been admitted if she wants to”.

What sort of bureaucratic lunacy is this? Taken to its logical conclusion, if you want to visit someone in hospital but don't know the ward they won't be able to tell you because of patient confidentiality and presumably even if you do know the ward they won't be allowed to tell you what bed they are in.

The NHS admin staff appear to be enmeshed in a web of paralysing bureaucracy which leads to friction with patients and their relatives when they are unable to help.

4 January 2010 at 11:07  
Anonymous pedant said...

The NHS was founded on the ruins of the charitable hospitals and the friendly societies, in the biggest forced expropriation since the Dissolution of the Monasteries. Its purpose - as was stated with abundant clarity at the time - was not to provide medical care for those who would not otherwise receive it, for in the 1940s such people there were none; but to centralise health care under the State as part of a dogmatical programme of rolling nationalisation and socialisation.

When I think of the health service we would have now, had that sneering reptile from the valleys Aneurin Bevan and his hapless stooge Major Attlee not had their stupid, thieving way, I could weep.

Was there ever a better example of the old political dictum that voters should take care what they vote for, in case they get it?

4 January 2010 at 11:14  
Anonymous Anonymous said...

Personally I would like to see the american system over here, the nhs has had its day.

4 January 2010 at 11:19  
Anonymous philip walling said...

And I meant to say that Cameron is talking himself out of votes saying the NHS is "the embodiment of fairness".

Who does he think he's fooling?

I don't believe a word of it, and nor I suspect does he, so he must be misleading the nation to get elected. He might be right that he won't get elected if he tells the truth, but it's not an auspicious way to start to regain the trust of the people.

Coming out with this sort of rubbish on top of the Lisbon 'cast iron guarantee' of a referendum doesn't do much for his trustworthiness.

4 January 2010 at 11:26  
Blogger DDIM 'n HOFFI said...

One major observation I have noticed about this present government is their ability to close down all avenues of redress. The country is in a shambles of incompetent management from the top down, and they know this so their response is to close down all avenues of redress. It has become near impossible to complain about anything to the point where nobody bothers anymore because they know it is a waste of time.

And it is not just the NHS that has a an immunity from complaint, it's near enough everything from banking to welfare bureaucracy. I am in a dispute with my bank at the moment and it is impossible to break through the arrogance and stupidity wall which is set up in defence against anyone who dares to complain. I have noticed that the usual JobCenter web site has gone down since well before Christmas. I have asked time and again for an explanation but I just get fobbed off. It has become impossible to complain because everyone is taking the cue from the government: they hear and See the complacency of government ministers and they adopt the same attitude. Meanwhile the country sinks into an abyss of incompetence and degenerate services.

After seeing and hearing Gordon on the Marr farce on Sunday, I cannot wait for these TV debates. It is time to expose the complacency and arrogance. If there are no jobs and it has become an embarrassing waste of time to keep the Jobcenter website going in its usual format, then at least say something about it. As for my Bank, If anyone is considering an account with Secure Trust, don't do it, what a bunch of gum-chewing ignmoramouses.

4 January 2010 at 12:11  
Anonymous Anonymous said...

Parts of the NHS may be bad, but most people don't know how bad it would be if there wasn't free healthcare. The alternative would might well have more unfairness and corruption - and the poor would definietly suffer even more (they are not a good profit centre for health). At least people can get to the doctors for everyday problems which does alleviate suffering. In some other countries a significant minority of the population cannot afford everyday care, and suffer, and then end up in the emergency room when they have something serious or at the end of life, and somuch of their life may be spent suffering unnecessarily. In those countries their quality of life is significantly effected and even middle class people can end up bancrupt or heavily in debt if a major illness strikes. Also, in my opinion, corruption in wider society increases with medical as well as other debts (as people keep jobs at any cost because of financial problems) as well as if they can't change jobs lest they and their dependents lose coverage. Healthcare in some countries where it is private is not only a life-and-death business, it is also major money - and it therefore is prone to corruption. Job mobility and therefore non-health economic competitiveness is also reduced by such scenarios.
Many people don't know what it is like not to have access to doctors dentists or opticians - pain and health issues which are not dealt with decrease people's quality of life, ability to work well (or at all in some cases) and increase stress - bad for long-term health.
I hope the NHS will improve dental care as well as general care where needed, enable genuinely independent 2nd opinions (free or private), decrease wastage and reduce barriers to the poor getting treatment or visiting loved ones in hospital (yes, healing improves when people's loved ones can visit) ie parking fines, any copayments which seem insignicant to many but which may be someone's lunch-food money or a portion of their rent.
My point is, it is terrible if someone gets bad care for major or end-of-life illnesses, but it is also terrible when a significant minority get little care for most of their life - it causes terrible suffering, and few empathise fully becuase they haven't experienced that. And it is terrible when the general population gears their life around health and health insurance, even when not sick or pregnant, because healhcare is important but expensive, especially when there is profit gouging or corruption.

4 January 2010 at 13:36  
Blogger Anabaptist said...

Anonymous (13:36) needs to read James Bartholomew's book, 'The Welfare State We're In', which, amongst other things, describes the ample provision that existed before the NHS -- a provision which would have been bound to improve with the passage of time.

There is a web site for the book, containing a lot of useful and informative updates --
http://www.thewelfarestatewerein.com/

Get it. Read it.

4 January 2010 at 13:59  
Anonymous IanCad said...

This comment has been removed by a blog administrator.

4 January 2010 at 16:04  
Blogger I am Stan said...

Yo Cranster...I needed the NHS last year after being attacked,I was impressed with the treatment and cleanliness so what can you say...I pays in so I takes out...

4 January 2010 at 17:03  
Anonymous philip walling said...

Anonymous (13.36) knows next to nothing of the way things were before the NHS bureaucratized medical care.
When doctors were a profession each was an independent man who ran his own practice as he saw fit. He had obligations to his patients which transcended profit and a place of great respect in the community.
My grandfather's doctor (1930s and 40s) charged his patients what he thought they could afford and hardly ever chased a bill if he thought they couldn't pay. His richer patients paid for his poorer ones and he would go out on calls night or day.

The system wasn't perfect, but it was no worse than what we have now and it cost the taxpayer nothing.
The NHS has been a disaster all round and anyone who thinks differently has no historical perspective.

4 January 2010 at 17:38  
Anonymous Steve said...

In my family alone in the last year (we are talking 11 people here):

a. One lamentable failure to diagnose a problem which nearly caused a death on birth (i.e. heart stopped).

b. One error in prescription which cause adult dose of a drug to be given to a 2-month old for 4 days by 8 different paediatric 'professionals'. (Same patient)

c. Two complete brush-offs at A&E for what subsequently turned out to be serious conditions.

d. Two ongoing failures to do anything at all to diagnose or treat recurring acute chest/ abdominal pains.

e. Copious conflicting and apperntly quite silly advice given to two first time mothers. Much of it impracticable and paranoically safety conscious.

Rate of useful interactions with NHS (with someone who gives a damn) - about 20%. The rest - appalling.

Oh, and I forgot a visit to an elderly resident (92 yrs) with dementia (Private home - NHS regulated and funded). It reminded me of stories of Roumanian orphanages - but to be fair was possibly not quite that bad.

NHS - in our view - stinks.Two reasons: broken society and publi funding (in which nobody is responsible and performance is talked up by government).

Oh - fortunately, my GP is great.

4 January 2010 at 18:28  
Anonymous Anonymous said...

I don't think the NHS was a disaster from the beginning - I was proud to work for it when hospitals were clean and when Matron made sure they stayed that way.

In those days, where I was, professionals were trained on the understanding that they were there for the benefit of the patients, not vice versa. In addition, patients had no compunction about reminding anyone in the NHS that they, the taxpayers, were the employers.

I'd be interested to know how many non-Britons now 'manage' the NHS - though that's impossible to discover, if only because my definition of non-Briton is also non-PC. However, I think 'ethnicity' informs the 'philosophy' of health-workers. The the post-modern, euro-asianised world holds to ideals of profit and marketing, not to the Hippocratic oath. And the secular world does not respect Christian definitions of ... well, respect.

Anyway - my most recent (and bad) experiences with the NHS involved 'foreigners'; and having seen what they did to other members of my family, I'd rather die without treatment than go anywhere near a hospital. That philosophy also holds in the US, btw - where people pay vast sums to their insurance companies, and often suffer similar abuses from arrogant and ignorant immigrant nursing staff.

4 January 2010 at 18:50  
Anonymous Anonymous said...

Might Mr. Cameron change his tune now that his Marketing Manager is heading for California?

4 January 2010 at 18:51  
Anonymous not a machine said...

I like the sound of it , but no doubt many must now be wondering if £13mn can be waived as a mistake what other mistakes have happened and why has money been spent on vanity and not delivery .

Try finding an NHS dentist , its a very spin infested sorry state of affairs Labour have created , with too much forms and beaurocracy and bloated quangrocracy , whilst peple are literally missing on basic health care .

4 January 2010 at 21:35  
Blogger Irene said...

I am following you!

4 January 2010 at 21:43  
Blogger Archbishop Cranmer said...

Ms Irene,

Shhh!

4 January 2010 at 21:50  
Anonymous Anonymous said...

Anabaptist from anon@13:36
I am not talking from theory. I have witnessed what I wrote. There is also these days again (these things are cyclical) a hardness amongst many to the poor and a pressure on companies to make decisions shich maximise short-term profit. Health-care these days is also much mre expensive - technology, drugs and also labour is relatively much mroe expensive than in the past.
Our Lord cares about the poor and those in need. Many people do not realise how muh they suffer becuase they do not have the same access to lobbyists and PR as those who have more money who have issues which also need to be brught to the policy discussion table.
And in my previous post I also forgot to say, children who are in pain due to lack of adquate medical or dental or vision care or who see their parents suffering becuase of insufficient access to affordable healthcare and the other suffering and mistreated - they cannot take full advantage of education. Some make it - some the brightest (but what a waste of talent and a lot of unnecessary suffering if they don't get good jobs, the more important point)- some of the brightest don't make it. But some of the brightest who make it don't realsie there are others who didn't - and some of them didn't experience suffering as an adult - and some don't know what policies would help those who are not bright or were not lucky enough to get opportunities without setbacks.
So Anabaptist, I agree that in the past some who were poor were healped by co-operative schemes. But healthcare is a different ball-game and so is the current climate. And people are living longer. It is a mess. Also private healthcare can be an like oligarchy in some countries. That does not reduce inefficiences - private business is not always a free market. Given the sin in all people there can be no perfect free market in a sinful world. And with the rising info state and abuse of it, and lack of privacy, the info which doctors have about people (including misinfo and smears) means more corruption and money-making about things which should be accurate and private. And sadly many doctors are not adequately trained and/or for the Hippocratic oath and ethics which is essential. Some do not have the time to give good care.

4 January 2010 at 22:05  
Anonymous Anonymous said...

Anabaptist from anon@13:36
Re charities in general and specifically in healthcare - there are some wonderful people who give good care and are kind, not mean and ethical in helping the poor, then there are others who are building resulmes, some who are burnt out, and others who despise and lookd down on the needy and cause harm to the poor - and even some who use them for experimental work becuase the poor need healthcare and they have relatively little access to legal aid or influence and little protection from exploitation.
I am for free markets, but since there is an NHS in the UK, I wold be against privatisation especially given the current business and healthcare climate. But I do not like some of the things going on in it. And re litigation in certain other countries - if people are harmed and do not have access to healthcare, and employers won't take them on becuase of potential insurance or medical or disability liabilities, then people sue, else they end up homeless or unable to get back to work and pay rent, mortguage, childrens' university fees etc. In addition, malpractice is expensive to investigate for lawyers (fact-finding) and doctors, healtcare have more access to lawyers and influence. So in certain countries where there is in reality an inadequate healthcare safety net, and where malpractice can lead to homelessness or finaical suffering for the rest of on'e life, oeple sue (as well as for in other cases greed) and becuaes of a loack of safety net, and the lawyers' need to cover high fees and other reasons payouts may be actuarial, long-term and high as well as punitive in other cases. Another reason to keep free health-care. And despite the press about certain other countries, it is heard to get adquate settlements out of court or in-court for cases which society assumes should go to court to discourage wrong-doing by doctors hospitals or other healtcare providers. That is the reality. If you have not experienced that, then you have been blessed. I speak up becuase of what I have seen and becuase our Lord cares for the afflicted and mistreated whether they are poor, middle income or wealthy. Most do not know what goes on.
Also many who are poor do not tell those they know about the reality of lfie for many because they do not want trouble or because they may get put down by some, including in the church. And some who "help" the poor or afflicated are sadly more interested in ticking boxes or looking like they healp than learning about where they do not and some are cruel. I hope that there will be more open discussions - so that mutually beneficial ways will be found to improve services and help. Not old-fashioned style class hatred, warfare, dspising or envy. Healthcare matters because people matter. Things will never be perfect but they do not have to be this bad.
Blessings.

4 January 2010 at 22:06  
Anonymous Anonymous said...

Anabaptist from anon@13:36 (corrected part 1)
I am not talking from theory. I have witnessed what I wrote. There is also these days again (these things are cyclical) a hardness amongst many to the poor and a pressure on companies to make decisions which maximise short-term profit. Health-care these days is also much more expensive - technology, drugs and also labour is relatively much more expensive than in the past.
Our Lord cares about the poor and those in need. Many people do not realise how much they suffer because the poor do not have the same access to lobbyists and PR as those who have more money who have issues which also need to be brought to the policy discussion table.
And in my previous post I also forgot to say, children who are in pain due to lack of adequate medical or dental or vision care or who see their parents suffering because of insufficient access to affordable healthcare and other suffering and being mistreated (ie general injustices of which the poor suffer everywhere and throught history) - they cannot take full advantage of education. They also cannot concentrate without adequate nutrition in their bellies or adquate policing in crime-ridden areas and they have less access to insurance to smooth bumps including disability insurance (though that may be useless sometimes where some wrong-doers abuse their power to shut up genuine plaintiffs, rich or poor).Some kids make it out of poeverty - some of the brightest (but what a waste of talent and a lot of unnecessary suffering if they don't get good jobs, the more important point)- some of the brightest don't make it. But some of the brightest who make it don't realise there are others who didn't - and some of them didn't experience suffering as an adult - and some don't know what policies would help those who are not bright or were not lucky enough to get opportunities without setbacks.
So Anabaptist, I agree that in the past some who were poor were helped by co-operative schemes. But healthcare these days is a different ball-game and so is the current business climate - it appears to be rughtless at times, hard for those who are not poor as well. And people are living longer. It is a mess. Also private healthcare (as much as government funded healthcare) can be effectively behave like an oligarchy or monoploly in some countries or areas (lack of financial or transport or other access also reduces free markets in cetain indistries) reduces access. That does not reduce inefficiences - private business is not always a free market. Given the sin in all people there can be no perfect free market in a sinful world. And with the rising info state and abuse of it, and lack of privacy, the info which doctors have about people (including misinfo and smears) means more corruption and money-making about things which should be accurate and private. And sadly many doctors are not adequately trained and/or for the Hippocratic oath and ethics which is essential. Some do not have the time to give good care.

4 January 2010 at 22:19  
Anonymous Anguished Soul said...

I've only received good care from the NHS, dentists included, when I've prayed substantially into the situation and received what I've felt to be the Lord's blessing and protection upon the situation.

Otherwise, it's like the devil and his minions have got in and taken over.

And with the Church having fallen into apostasy (2 Thessalonians 2), there is little intercession and little spiritual understanding of what is really going on from them and so I am often left on my own in it all.

Even so, Lord Jesus, come quickly. Amen.

4 January 2010 at 22:20  
Anonymous Anonymous said...

Anabaptist from anon@13:36 corrected part 2 sorry due to health and other issues
Re charities in general and specifically in healthcare: there are some wonderful people who give good care and are kind, not mean and ethical in helping the poor, then there are others who are building resulmes, some who are burnt out, and others who despise and look down on the needy and cause harm to the poor - and even some who use them for experimental work becuase the poor need healthcare and they have relatively little access to legal aid or influence and little protection from exploitation.
I am for free markets, but since there is an NHS in the UK, I would be against privatisation especially given the current business and healthcare climate. But I do not like some of the things going on in it. And re litigation in certain other countries: if people are harmed and do not have access to healthcare, and employers won't take them on because of potential insurance or medical or disability liabilities, then people sue, else they can end up not able to pay for healtcare to heal from malpractice, also potentially homeless or unable to get back to work and pay rent, mortguages, childrens' university fees etc and bankrupt (medical bills in certain other countries cause directly or indirectly over half of bankruptcies - and since that study (Elizabeth Warren at Harvard), the recession happened and healthcare costs have increased). In addition, malpractice is expensive to investigate for lawyers (long fact-finding) and doctors and healthcare businesses and charities have more access to lawyers and more influence. So in certain countries where there is in reality an inadequate healthcare safety net, and where malpractice can lead to homelessness or severe finanical suffering long-term and even for the rest of one's life, people sue more (as well as for in other cases greed) and because of a lack of safety net, and the lawyers' need to cover high fees (to cover lost cases as well as their lifestyles and malpractice insurance)and other reasons payouts may be actuarial, long-term and high as well as punitive in other cases. Also genuine psychological bad health (temporary or long-term) caused by physical or psych malpractice or the results thereof including any legal processes may be included in "other" damages in court cases - so some of the large settlements are not large if you look at them actuarily. And apologies (not cover-ups and their harm) would help victims as would getting them good-enough medical help.

4 January 2010 at 22:49  
Anonymous Anonymous said...

anabaptistfrom anon@13:36 corrected final part sorry due to health and other issues
and hoping Your Grace will be patient with me, again.
I hope Britain does not become more litigious, and a free health service should cut down on the need genuine litigation becuase there is mroe of a safety net. Another reason to keep free health-care. And despite the press about certain other countries, it is difficult to get adequate settlements out of court or in-court even for cases which society assumes should go to court to discourage wrong-doing by doctors hospitals or other healtcare providers. That is the reality. If you have not experienced that, then you have been blessed. I speak up because of what I have seen and because our Lord cares for the afflicted and mistreated whether they are poor, middle income or wealthy. Most people do not know what goes on or when things have gone wrong they have had some redress or help or support. Others are not so lucky. (And healthcare for those with psychological trauma - including veterans - and pychological needs is always a cinderalla service, although individuals, families and the community cold alleviate suffering by supporting people where they do not, one-on-one as they are able and feel comfortable and safe doing so - be a friend to someone who is hurting (the stigma is isolating and falely labelling some as violent or insane when they are not)- you could make a difference even if you cannot solve all their problems. Be a friend where you can be one. And why are people sent to grief counsellors these days - except in a few cases of complicated bereavement, have we lost the ability or will or time to be there for the grieving?).
Finally, many who are poor do not tell those they know (who are better off or have influence) about the reality of life for many ie the poor because they do not want trouble or because they may get put down by some, including in churches or charities. And some who "help" the poor or afflicted are sadly more interested in ticking boxes or looking like they help than learning about where they do not and some are cruel or arrogant (a human problem - as long as it is someone else's fault they are suffeing, we don't have to be a Good Samaritan where we could and feel comfortable doing so; as Job was treated by his "friends", & Paul at times in the New Testament). I hope that there will be more open discussions about healthcare so that mutually beneficial ways will be found to improve services and help, as well as individuals doing more where they do not. Government is not our "god" or parent, and if we as indiviuals do not do our part, people suffer unnecessarily as well as not being as economically productive as they could be. Not old-fashioned style class hatred, warfare, despising or envy. Healthcare matters because people matter. Things will never be perfect but they do not have to be this bad.
Blessings.

4 January 2010 at 22:51  
Blogger Anabaptist said...

Hey, Anonymous. I only recommended a book! It's a book that rebuts your earlier claim that there would be no health care without the NHS. There was plenty before.

Get it and read it.

And why don't you get yourself a name? It would be easier to converse with you.

By the way, if you want my opinion, I think health care would be better if the whole lot were handed over to Tesco, Asda, Morrison and Sainsbury. Their places are cleaned every half hour.

And nearly everybody gets out of them alive.

5 January 2010 at 11:49  
Anonymous Anonymous said...

Anabaptist from 22:51

Sorry about being anonymous.

I didn't say there would be no health care without the NHS. But I did imply those with lower incomes would suffer even more under private schemes, and not just a few per cent of the population - my guess is several percentiles.

Re the lack of cleanliness - that is nothing to do with whether healthcare is private or public - wards used to be spotless under the NHS.

"anonym"

5 January 2010 at 15:40  
Anonymous Anonymous said...

Anabaptist from 22:51 corection sorry again.

...But I did imply those with lower incomes would suffer even more under private schemes, and not just a few per cent of the population - my guess/opinion is potentially several tenths of the total national population at the lower end of income distribution; a minority of the population but not just a few people (though everyone's suffering matters)...

"anonym"

5 January 2010 at 16:20  
Blogger Anabaptist said...

Mr Anonym

You are looking at this issue (inevitably) from a perspective in which the NHS has existed for over half a century. I was referring to the time before the NHS was foisted upon us, and saying that there is no evidence that healthcare was denied to the poor. I therefore infer that in an NHS-free world, the poor would be catered for, as they used to be.

By the way, nobody suggests that the system was perfect before the NHS, but that it was not inherently geared against the poor.

Please read Bartholomew's book.

You rightly say that wards used to be spotless under the NHS. That's true, and I can testify to it from my own experience. However, I would suggest that the reason for it was a residual discipline carried over from pre-NHS days. As the NHS has become more 'itself' it has replaced clinical professionalism with bureaucracy, and has put cost at the top of its agenda. So cleaning has been outsourced as a bureaucratic, cost-driven solution. Matrons have been replaced by managers.

I would maintain that such problems are inherent in a state-run, monopolistic bureaucracy, which increasingly exists to serve the needs of the NHS rather than being driven by a vocation to care for people.

On the other hand, Tesco, etc., is driven by an entirely commercial discipline which ensures that costs are as low as possible, that competitors are kept at bay, and that therefore the customer must satisfied. The NHS has no significant competition and is not driven by a customer-focussed need to survive.

6 January 2010 at 11:48  
Anonymous Anonymous said...

to anaptist@11:48
Private companies in this enviroment would not look after the poor, they could not afford to. Health and its costs have changed. And there is so much money and power in the business that I fear that private only car would produce a situation like in the US. Most do not know who many suffer and how society is affected. I would not be for bringing in the NHS to the US because of cultural differences. I would not be for denationalising medicine in the UK because of health industry practices, current business climate as well as modern medical costs and generally lower medical and societal ethics re medicine. And in the Uk, while I think there should be private alternatives, the lack of real private and NHS 2nd opinions effectively reduces any competition in or outside the NHS there. And health is life and death, and info is personal and can be abused, and look at the billions involved - there are and will be abuses of power, and the most vulnerable, poor but also some rich or others do will suffer, and if it were privatised I beleive there would be a lot more suffering and injustice. And many would not know, as in the US how much suffering and wrong-doing goes on. Those industries which deal with life-and-death issues and where there is a very large anount of profits to be made (good or filthy) should be hadnled with care and any consequences of changes thought through. Discussions need to be throgouh and mention the unseemly which does go on, and people might remember that everyone matters and is entitled to a mimum of respect, fairness and protection from harm and abuse of power. I don't think you can have perfect healtchare for everyone in a country in a sinful world, and where there are differences is income due to good as well as bad issues; trying to give everyone top quality cutting edge care is unrealistic and leads to more inequity just as trying to wipe out dincome and asset differences does, and power gets abused more; but I do believe in affordable basic healthcare for all - and free if a country can afford it, and once removed it will be very difficult to re-establish. And most do not know that even small copayments are too much for many, they reduce short-term healthcare costs, but overly for the low-income (you also have to dd in trasport costs and time off work) while the middle income and higher, if they use such schemes, keep going to necessary and unnecessary visits. Even 1 or 2 or 3 pounds copays may be too much for those who strugle month-to-month through no fault of their own, even some working, though that is pennies to the mjority of the population.

7 January 2010 at 02:08  

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