Sunday, August 16, 2009

Don't Mess with our NHS

As I was writing the title to this, it dawned on me that it sounded like some sort of Union slogan against Tory spending cuts. They must have used it at some point. They get it right sometimes!

As I said before, I'm a big fan of the NHS. It's not perfect, and there's room for improvement, but the principle of universal healthcare free at the point of need is an absolutely brilliant one. I would fight tooth and nail to preserve that principle and the last thing I want to see is the Tories dismantling it as I fear they might given half a chance.

Charlotte's blog seems to have become a forum for robust debate on this issue and I wanted to respond to some of the points that have been raised there by Charlotte and others.

I think it's quite telling that the people who are saying the NHS is rubbish are either young, rich or healthy or a combinstion of these elements. I was shocked to see people describing it as crap yesterday. How can you call a system crap that, amongst other things:

immunises all our children from all sorts of diseases that were real killers just half a century ago, diseases like Polio, Whooping Cough, Diphteria, Tetanus, Measles, Mumps, Rubella, Meningitis;

provides free access to contraception which is so liberating for women in particular;

that provides a huge range of health care, routine and critical, every single day without people having to worry about being handed a huge bill at the end of it?

I'm clearly not alone, as the momentum that the #welovethenhs discussion on Twitter has shown. I'm quite perturbed that an organisation which has even the most tenuous connection with our party is behind the rival #no2nhs. It's worth pointing out that these people are very much in the minority within the Party. James posted about this the other day.

Mark has not wasted any time getting back to top form on his return from holiday with this posting analysing Daniel Hannan's comments, so I don't need to. Hannan was just plain wrong and I think it's very worrying that David Cameron has not pulled him up severely for what he said. The only reason I can think of for that is that his position is a commonly held view within the Tory Party which will always put the interests of the wealthy first and not bother about the vulnerable.

Where Mark and I part company is his suggestion that we look at insurance based systems such as those in Singapore and Holland. I think we need to keep the NHS funded through taxation as it is at the moment and to maintain its free access. We can debate how it delivers its services and look for different and creative ways of meeting people's needs, but that principle really is sacrosanct.

Part of the reason I feel so strongly about this is because of my father in law. I never knew him - he died in 1974, long before I met my husband. He was for over 30 years a General Practitioner in St Andrews. If you're called Thomas and were born in St Andrews between 1933 and 1963, it may well have been after him cos he delivered you. He moved there in 1933, when he had already been qualified for several years. He was in his 50s when my husband was born, and in turn my husband was almost in his 50s when our daughter was born. I guess there aren't many people who can say that they were born almost exactly 100 years after their grandfather.

He had around 20 years of experience of practice before the NHS was invented and he found it very hard. We don't know much about his early career, but we do know that he spent some time in Yorkshire working with other young doctors in a very poor area. He spoke of people dying unnecessarily because they couldn't afford the treatment. He apparently also spent some time campaigning for greater public sanitation, being well aware of how poverty reduces life chances and health.

He did used to treat people who couldn't afford to pay, but there were obviously limits to what he could do. He found it very traumatic that he couldn't save everybody.

When the NHS came in, obviously all of that changed, and he was able to ensure that everybody got the medicines he needed. Bob says he used to complain even in the early days about all the forms that had to be filled in, though in the creation of this massive bureaucracy.

I don't think that any insurance system that you could bring in would give the vulnerable sufficient protection. They put a much greater proportional burden on people on lower incomes which is why I guess rich young Tories like Hannan are so much in favour of it. What they really want is to pay less tax to the Government and to only provide for themselves without seeing any greater obligation to society as a whole.

Please don’t let anyone kid you that the private sector is going to make better decisions than the public sector, given their imperative to make profits for their investors. If you've ever tried and failed to get an insurance company to pay out on a travel insurance or redundancy protection insurance, just imagine what it would be like if a family member needed a life saving operation and the insurers refused to pay for it. I wouldn't rule out the NHS using the private sector if necessary, though, and I do think there needs to be some flexibility on things like allowing people to supplement their treatment as Nick Clegg suggested last year.

Nor do you want to go believing that you get loads of choice if you have an insurance based system. You don't tell your insurance company that you want to go to a particular hospital. Or you cam, but most likely they'll turn round and tell you that you have to go to the hospital that they have the commercial arrangement with. So there.

It's also worth pointing out that one of the people who posted on the Twitter #welovethenhs thing was Sunday Times journalist India Knight. She told, in 140 characters, how she had gone private with her third child and how she had to fall back on the NHS when things went wrong.

I also read somewhere that the average monthly wage in Singapore is round about £2500 - much more than it is here at around £1900 - and of course many people earn less than that.

I am also concerned that people think that the US system, which leaves at least a fifth of its citizens uncovered for double the proportion of GDP of our NHS, is being lauded as some sort of a success story.

If the US system does provide protection for most of its people, then why is it deemed necessary to bring in what seems to me quite basic comsumer protections - for example, stopping your insurance company from refusing you cover if you’ve been sick, or discriminating on the basis of gender, or charging ridiculous amounts for expenses. To me what Obama is trying to do seems quite mild.

Despite it not being perfect (and find me an organisation, particularly one with over a million employees, which is), I think it's great that people have stood up to be counted in their support for the NHS at the moment, to defend it from the misrepresentations not just from Daniel Hannan but the powerful and rich American right and its health related commercial interests. Remember that a lot of the inaccurate information about the NHS comes from organisations with direct financial interest in maintaining the status quo.

However, Labourlost, with your orgy of self congratulation, and Tom Harris, who seems to think that Daniel Hannan is some sort of get out of jail free card for the Labour Party take note: this alone is not going to win you the election. I suspect that Labour spin doctors are putting together an election campaign that relies entirely on fear to get their core vote out. That might work, but it won't help them where they need to win. If you have a hope in hell of avoiding your worst defeat ever, you're going to have to come up with some half decent ideas that capture people's imaginations on a whole range of things. I won't hold my breath.


Mark Thompson said...

Great post Caron - your evident passion for our NHS shines through. Thanks for the link also.

To be fair, I wasn't advocating the Singaporean model, I was merely trying to elucidate what Hannan actually thinks by summarising the chapter from "The Plan". However as I said I think there is merit in it. My mind is not made up as to what the best way forward is, I just think that the current model is unsustainable in the long term.

More importantly, I want there to be an open and robust debate about this subject, along the lines that you have done here and I have seen other bloggers do but that seems almost entirely absent from the mainstream debate.

subrosa said...

Passionate post Caron, but I disagree with most you say.

Firstly I'm not rich, in fact I'm possibly classed poor now my pension has been eaten by Gordon Brown, but I do suggest the NHS funding system could be improved so as the money is reaching the bottom instead of being creamed off at the top.

Have you ever experienced healthcare in any European country? Which ones do not protect children against diseases? Which ones don't provide free access to contraception for women? Which ones don't provide 'free' access for ALL? Which ones put a much greater proportional burden on people on lower incomes?

I've experienced 2 European country's healthcare systems and you do get choice. It's nonsense to say you do not. The NHS doesn't provide choice.

As I said yesterday to you, the World Health Organisation ranked Britain 15th best in Europe and 18th in the world.

Doesn't it at least make you wonder why 14 European countries are providing better healthcare for their people?

Until people are prepared to listen to all sides of the argument, we will continue to have the heathcare we're given by governments and not the healthcare we deserve or need.


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