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Saturday, July 05, 2008

Happy Birthday to the NHS- and how we can save it

The National Health Service, the greatest of all the many great achievements of the post-war 'Old' Labour governments of 1945-51, is 60 years old today.

How should we mark the anniversary? By wearing badges like Nu Labour politicians and pretending that everything's hunky dory? No, we should mark the anniversary by doing all we can to restore the NHS to its original state. That means an immediate halt to plans for the greater involvement of private companies in public health provision. It means axing the planned polyclinics- which would eventually be run by big business. It means scrapping the scandalously expensive PFI schemes. It means bringing back in-house those hospital activities which have been privatised to such disastrous effect- such as cleaning and catering. It means putting Matron back in charge of the wards and stopping the politically motivated attacks on the medical profession. It means restoring NHS dentistry and scrapping prescription charges in England. In short it means fighting for the sort of National Health Service that that great socialist and humanitarian politician Aneurin Bevan envisaged sixty years ago.


Anonymous said...

I am in support in all you say. Nowadays you go into hospital with a minor graze and come out with a major disease.

Anonymous said...

I realize this is non-well-formed to you, but perhaps the birthday of NHS is a good occasion to consider the validity of the entire concept.

Claude Castonguay, the architect of the Canadian healthcare system, recently expressed great disappointment with the consequences of the whole project.

Question: When NHS was first implemented, did the electorate consider it a good idea at the time? I grasp that nobody lost their seat in Parliament for supporting NHS.

Anonymous said...

No, we should mark the anniversary by doing all we can to restore the NHS to its original state.

By which you presumably mean getting rid of all medical treatments that weren't available in 1948?

Certainly, if you remove cosmetic surgery, sex changes, expensive drugs regimes and similar items that weren't included in Nye Bevan's original plans, you'll slash so much from the operating budget that the 1948 funding model would almost certainly be viable once again - but I foresee a great many complaints from vested interests along the way.

Not least the patients and their relatives, as mortality rates would certainly rise, and probably dramatically - but that would also help balance the books in the long term.

Anonymous said...

Right on! I have had a lot of experience of hospitals since a catastrophic decline in my health in 2001. At first, I wondered what all the fuss was about; I found the staff almost universally saintly, with great morale, spirit and humour, and was more than happy with the attention I received. However, the last couple of times I've been an in-patient I've really noticed how the cleaning has deteriorated. I've seen toilets for days on end as bad as a pub loo on a Saturday night after a big football match, and it just doesn't seem to be anybody's job to do anything about it - I suspect the nurses aren't allowed to do anything, even if they could find the time. Sorry to be disgusting, but I had to use a portable toilet at one point; I think it was at the end of someone's shift, so it sort of got forgotten about, but when I pointed it out to a nurse, it was still ages before anyone did anything about it. It must have sat there stinking in the middle of a crowded ward for half a day.
Another time I had a DOCTOR(!) lick his finger and touch the tip of a needle (God knows why - to see if it was sharp?) which was to go into my liver for a biopsy. I refused it, insisting that he use another needle, and he got very snotty. There you go; one man's observations. Something far wrong, and a pointer to what we can expect when the privateers move beyond cleaning in earnest.

Anonymous said...

Well, the biggest problem - as I alluded to above - is that the public's expectations of the NHS have risen over the past sixty years to the point where what were absolutely unimaginable luxuries have now become expected norms.

Which inevitably and unavoidably means that the overall bill has had to go through the roof as well - which is why it's impossible to go back to a 1948 model of funding, because the rest of the health service isn't being run on 1948 lines.

So you're left with two unappetising choices - raise the money from elsewhere (via PFI schemes, for instance), or make drastic cuts in either the quantity or quality of services. The third method - just pump untold billions more into the system, cross fingers and hope it improves - was tried a few years ago, and much of that largesse went into the pockets of GPs thanks to John Reid cocking up their targets so that they had to be virtually dead not to qualify for bonuses. Maybe if he'd got that right, things might have improved - but probably only in the short term, given the economic nonsensicality of the system as a whole.

So which would you prefer - possibly unpalatable new funding systems, or sweeping cuts? Because it really is an either/or situation.

I don't like this any more than you do - I'm married to a long-term NHS employee and one of my closest friends is quite literally being kept alive by the NHS (she'd probably be uninsurable in a US-style setup). But the economic lunacy of the current system (massively increased operating costs BUT still free at the point of delivery) makes me despair for its future - and consequently somewhat more open-minded towards genuinely constructive suggestions.

Anonymous said...

PFI isn't a choice; that's just throwing billions of pounds at investors (for nothing) instead of throwing it at the NHS or GPS. I doubt that sweeping cuts are necessary; I've a feeling that much of this crisis is manufactured - certainly all reports on the state of the NHS from those with vested interests in privatisation should be treated simply as propaganda.

Neil Clark said...

douglas: in answer to yr question- yes the electorate did consider it a good idea in 1948- and they still do. Which gives the privatisers a problem. No one can come out and say 'our policy is to privatise the NHS' so instead they plan to do it by stealth.

jock: I couldn't agree more. The propaganda that we're hearing now from those with a vested interest in NHS privatisation, reminds me of the propaganda we were subject to prior to railway privatisation.
How we need more 'choice', how it would be better for the 'customer' (we're no longer patients) and how radical 'reforms' are necessary to 'improve' the service.
We're told we can no longer afford an NHS without private sector involvement, but it seems we can afford to take part in illegal, costly wars around the world, and we also can always find the money to subsidise the banks. The corporate vultures are circling over the NHS- I don't know if you saw yesterday's excellent Panorama programme on the private companies who are taking over GP practices? The profiteers won't be happy until every single organisation still in public hands is privatised.

slapheads: Can I ask you in question? Are you in favour of charges for visits to the GP/stays in hospital? You seem to be implying that you wouldn't mind if chargin were to be be introduced; I would be totally opposed to that on principle.

Anonymous said...

slapheads: Can I ask you in question? Are you in favour of charges for visits to the GP/stays in hospital?

Under certain circumstances, yes. I definitely approve of fining people for missing GP appointments without bothering to warn them, as that wastes a staggering amount of taxpayers' money.

One of the problems with the NHS being free is that certain people take it for granted - which is why its staff often have to put up with quite unmerited amounts of abuse from people who, frankly, have no idea how lucky they are to live here and not... well, most other countries!

You seem to be implying that you wouldn't mind if chargin were to be be introduced; I would be totally opposed to that on principle.

OK, so what would you cut to slim the NHS back down to the 1948 model?

Anonymous said...

Well, we would have a lot more money for the NHS if we hadn't spent more than 3 billion pounds so far this year on the 'war' in Afghanistan and Iraq..(and 40, million on the royal family).
The money is there if we spend it in the right places.

Neil Clark said...

slapheads: dimanstein has taken the words right out of my mouth. We have to decide what our priorities are: the NHS or waging very costly, never-ending wars. There's other ways too that the govt could raise more money: such as making the rich pay their fair share of income tax.

Anonymous said...

Well, we would have a lot more money for the NHS if we hadn't spent more than 3 billion pounds so far this year on the 'war' in Afghanistan and Iraq.

I'm about as impressed by that response, and Neil's equally inevitable "tax the rich till the pips squeak" one, as I was by John Redwood's airy "we'll save £6 billion through greater efficiency" line when asked that question when running for Tory leader in the mid-1990s.

All three are non-answers that make no attempt at tackling the underlying problems of NHS funding and the basic economic impossibility of returning to a 1948 model without simultaneously cutting services back to 1948 levels.

My wife's spent most of her adult life working for the NHS, and she tells me that morale has never been lower, not even in the Tory years - and this is after Brown poured billions more into the system! Both politically and economically, he can't get away with that again, so what else do you suggest?