The NHS, health care in Britain, and liberty: Daniel Hannan replies in full


The NHS row: my final word

By Daniel Hannan

Politics

Last updated: August 14th, 2009

169 Comments Comment on this article

I’m in France, with patchy internet and mobile coverage, but I sense that a row has been generated in my absence. Journalists keep calling me to ask for comments. The ones from print newspapers are polite, and offer juicy fees. The broadcasters tend to begin, without preamble, “Do you stand by your statement that…?”

As far as I can tell, three separate charges ae being laid against me. First, that I have insulted NHS workers. Second, that I want to impose a US-style healthcare system on Britain. Third, that I have made criticisms overseas that I wouldn’t make in Britain.

Let’s take these in order.

Start with how I insulted the 1.4 million NHS workers. Here’s what I said: “I don’t want to imply that, because we have a bad system, it doesn’t contain good people. A lot of very generous, very patriotic people become doctors, even though they’re working in a system that doesn’t maximise their utility, because they have a calling to help other people.”

Pretty rude, eh? I suppose I should have learned manners from the NHS’s founding spirit, Nye Bevan, who described Conservatives as “lower than vermin”. Nor do I believe – as Peter Mandelson seems fatuously to be claiming – that Britain should adopt a US-style insurance-based system. While in the States last week, I repeatedly emphasised that I thought their set-up could be improved, that costs were too high, that litigation drove up premiums and that powers could be shifted from big insurance companies to individuals.

There is a difference between saying that the US shouldn’t adopt the British model and saying that Britain should adopt the American model. Think about it for a few seconds and you’ll see that it’s quite an obvious difference. If you want to go in for shorthand categorisation by country, the model I’ve been pushing for is one of personal healthcare accounts, a system most closely approximated in Singapore, whose people enjoy a higher level of healthcare than Britons do while paying considerably less for it. Nor can it be repeated often enough that Singapore – like every developed country – pays for the healthcare of those citizens who can’t afford it.

No one I know wants a system where the poor go untended. Nor will you find such a system outside the Third World: it really isn’t a British peculiarity. After ten years in the European Parliament, I have found that the only foreign admirers of the NHS are those on the serious Left. Mainstream social democrats on the Continent do not, as a rule, argue for a heathcare system funded wholly out of general taxation.

The third charge – that I should, as Labour’s Tom Watson puts it, “say it in Britain” – is the most asinine of all. I have been saying it in Britain for years. I’ve written a book all about how to shift power from bureaucracies to consumers. It’s called The Plan: Twelve Months to Renew Britain, it’s been in Amazon’s top 30 best sellers for nine months, it has become the best selling political tract in Britan and you can buy it here. In it is a lengthy chapter on healthcare which sets out how Britain compares with other countries in terms of survival rates, waiting times and so on, and proposes to replace the NHS with transferable savings acounts (which, to repeat, since some of my critics seem deliberately mulish on this point, would be met by the state for those who lacked the wherewithal).

Now, you can agree or disagree with my views. But to ignore them for ten months, pick them up when they are attacked by John Prescott, and then – then – to complain that I haven’t expressed them in Britain, strikes me as a bit much.

Of course, that isn’t how these rows work. Almost no one who has phoned me seems to have watched what I said in full. If they had, they would have seen that I conceded that there is majority suport for the NHS in Britain (although I believe this is partly based on the false premise that free treatment for the poor is a unique property of the British model), and that my views did not reflect those of my party leadership. Still, I do wonder at the tone and nature of the criticism. It seems to be based on playing the man rather than the ball.

My detractors say that I’m out on a limb, that I’m in the pay of the insurance companies, that I’m insulting those who have had successful treatment from the NHS. (What? How?) If supporters of the status quo were truly confident of their case, surely they would extend their logic.

I mean, why shouldn’t the state allocate cars on the basis of need, with rationing by queue? Or housing? Or food? I am reminded of the debate over asylum ten years ago, or Europe ten years before that. Remember the way even the most moderate and tempered proposals for stricter border controls were decried as “playing the race card”? Or, earlier, the way any suggestion that the EU wasn’t democratic was dismissed as “xenophobia”? Remember how keen supporters of the existing set-up were to shut down any argument?

There are good and honourable people who support the NHS; and there are good and honourable people who don’t. Is that really such an extreme thing to say? Anyway, if you’re a journalist, I’m afraid you’ll have to make do with this as my last word on the subject until I get back. If you want a dispassionate discussion of healthcare – rather than a “Tory row” story – please get in touch after 25 August. The rest is silence.

RSS COMMENTS

Charles is a crank, and astonishingly unfit to be Head of State, but it’s no reason to scrag his outfit over his dodgy herbal remedies, if people want to waste their own money.


Caveat Emptor…

David Davis

This caught my eye just now, and I for one am always pleased to see overpriced and no-better-than-the-competition stuff get egged and floured.

However, there are some principles going on here. In may cases we don’t _really_ know if stuff like Hypericum extract, or “dandelion tincture” have any effect on snything or not. It’s most probable in the face of decades of evidence that they don’t, with the possible exception of things like willow bark extract (for pre-aspirin-like compounds.)

But if people wish to spend their money this way, the ought to be allowed to, and the seller perhaps ought to be allowed to tell them what he thinks the gear does. If it does not, they will stop buying it, and if enough do, he will go bust or delete the brand. Problem solved.

And this sentence was wonderful:-

Similarly Duchy Herbals Echina-Relief Tincture is a “traditional herbal medicinal product used to relive  (sic) the symptoms of the common cold and influenza type infections.”

Old Holborn: The NHS Is Bad For Your Health


UPDATE:- Here’s what Mummylonglegs thought about what someone did at Staffs hospital – taking his dead dad’s ashes to a meeting about (dead dad) not attending appointments…..after two years….

Sean Gabb

Old Holborn: The NHS Is Bad For Your Health

The Libertarian Alliance is on record as predicting that abolition of “free” State Health Care would be unpopular with the British People, in the event of a libertarian/classical liberal minimal-statist administration coming to power. Indeed, I stated as much in my speech to Conservative Future a little time ago.

Nevertheless, this alters nothing of the truth of Old Holborn’s main thesis. The destruction of lives and deterioration of care in general is no more or less that what’s expected of a state-run, bureaucratic behemoth. But it is no more excusable for that. Those who say and think they know what is best for the Common People, thus show publicly that they cannot deliver.

What I said about the NHS under a “libertarian government” takes account of priorities faced by such an administration. We believe there would be worse threats to be countered on Day-One, than the size, expense and uselessness of hospital buraucracies. Addressing these would be feasible later, in a climate of renerwed enterprise, individual spirit and general positivity towards what some would at first see as too-revolutionary change.

Death by paper cut.


Mummylonglegs

It’s Me, Mummy. Mr D has only gone and asked me to rant on here as well. This Mummy is very, very flattered. So here is my first post on The Libertarian Alliance : BLOG.

Who does this sound like?………..

“It is unacceptable that the pursuit of targets was repeatedly prioritised, alongside endless managerial change and a ‘closed’ culture, which failed to admit and deal with things going wrong.”

Sounds like a description of the Labour government to me. Unfortunately this is a description of Stafford Hospital which is run by Mid Staffordshire NHS Foundation Trust. The actual statement said……..

“It is unacceptable that the pursuit of targets – not the safety of patients – was repeatedly prioritised, alongside endless managerial change and a ‘closed’ culture, which failed to admit and deal with things going wrong.”

Can you spot the difference?.

This is a shocking but not very surprising story. What the hell did Alan Johnson expect? For the last 12 years Labour have messed around with the NHS and have just about destroyed it. Why? How? Because they could. No other reason really. Because they are control freaks. Because they think if you set a target and tick a box every thing will be just fine. Because they think that the NHS can be run like a private Doctors surgery, maximum profit for minimum out put. Because tax payers money/NI contributions are an endless pot to be dipped into, as and when you need it. Because not one of the idiots that dreamt up the million and one targets/tick boxes/schemes/ideas/drives that will bring this institution to it’s knees has ever set foot in an NHS hospital, let alone been treated in one. They don’t use NHS GP’s, NHS Polyclinics, NHS Nurse Quacktitioners, NHS Direct, NHS Dentists, NHS Paramedics, NHS Ambulances, NHS Midwives, NHS Mental Health Services. In fact they don’t use anything NHS at all. They go to Harley Street, they go to The Priory, they go to The Portland Hospital, they go to the States, they go private, they go anywhere but to the NHS. I wonder why?

Lets fisk shall we………….

It said there were deficiencies at “virtually every stage” of emergency care and said managers pursued targets at the detriment of patient care – Managers, not Doctors, not Nurses. Managers chased targets. Managers forced their staff to obey these targets, regardless. Targets set by who? ah Labour.

Mr Johnson said: “On behalf of the government and the NHS I would like to apologise to the patients and families of patients who have suffered because of the poor standards of care at Stafford Hospital”. – Sorry seems to be the word of the week. Nice of you to apologise on behalf of the hospital, Mr Johnson, How about apologising on behalf of all those that ‘Targeted’ this Hospital right into the ground?

“There was a complete failure of management to address serious problems and monitor performance. This led to a totally unacceptable failure to treat emergency patients safely and with dignity”. – It’s them pesky Managers again.

Its report cited low staffing levels, inadequate nursing, lack of equipment, lack of leadership, poor training and ineffective systems for identifying when things went wrong. – Let’s look at this bit here. Low staffing levels – Why?, you have money, employ staff. S*** nursing – that’ll be because Nurses don’t nurse anymore, they quacktition. So nursing is left to Non-nurses aka Plebs. Lack of equipment – again why? Lack of leadership – that’ll be even worse now, since you sacked most of the Doctors (MTAS etc). Poor training – well what can I say, we have Plebs doing nursing, Nurses doing doctoring, Doctors doing nothing cos they can’t get a job and Sally from accounts running the whole s*** and shebang. They are all trained, but they are doing jobs that don’t relate to their training – duh, it’s not rocket science.

It said that:

  • Unqualified receptionists carried out initial checks on patients arriving at the accident and emergency department – Receptionists are not Nurses.
  • Heart monitors were turned off in the emergency assessment unit because nurses did not know how to use them – What Nurses?, they are too busy being quacktitioners, I think you mean Plebs.
  • There were not enough nurses to provide proper care – All the Nurses were on 4 week courses learning how to do the job of a Doctor, can’t blame the Nurses, they weren’t there. So it must have been the Plebs (or the Managers).
  • The trust’s management board did not routinely discuss the quality of care – Who would they discuss it with, the Doctors are unemployed, the Nurses are on quacktitioner courses so that just leaves the Plebs. And most of them don’t speak English.
  • Patients were “dumped” into a ward near A&E without nursing care so the four-hour A&E waiting time could be met – And who’s fault is that. Did the Managers, Doctors, Nurses or Plebs come up with these targets. No. Labour did.
  • There was often no experienced surgeon in the hospital during the night – There was often no experienced ANYBODY in the hospital at night. Or during the day for that matter. You could have had a squillion surgeons but with no Doctors or Nurses to make initial diagnosis they would have been pretty idle.

The trust’s chairman Toni Brisby and chief executive Martin Yeates resigned earlier this month. The interim chief executive, Eric Morton, said lessons had been learned and that staffing levels had been increased. – It appears that neither Tony or Martin were Doctors, I am certain if they were they would have had Dr before their names, but they may just be shy. If so Eric is the shy type aswell. He doesn’t appear to be a Doctor either, but hey, that’s cool. You don’t really need to be a Doctor to understand how to run a medical facility do you. As long as you hire more Plebs staff it’s cool isn’t it.

The health secretary added: “The new leadership of the trust will respond to every request from relatives and carry out an independent review of their case notes. This will be an essential step to put relatives’ minds at rest and to close this regrettable chapter in the hospital’s past.” – Oh, with 400 cases on the books, and quite possibly many hundreds/thousands more to come it sounds like Eric isn’t gonna have much time left to actually run ANYTHING.

So, what have we learnt from Mummies Fisk. Well I think it is safe to say that Labour has F***** the NHS. Big Time. I could extend this fisk to all other aspects of the NHS. GP’s, Dentists, Emergency Peeps etc but it would just take too long.

I know that out there in the blogosphere there is a list of pointless NHS jobs, many peeps posted it up a while ago but for the life of me I cannot find it now, Sorry. If some one has this link, please could you give it to me. After 12 years of Labour the NHS has a multitude of Managers and Plebs but not many peeps that understand the whole medical/caring side of the NHS. And it is very sad, and it results in stuff like this.

I am not a medical person, but I got into blogging via the likes of

Dr Crippen

Tom Reynolds

Stuart Gray

Mark Myers

Spence Kennedy

and of course last, but by no means least, the very lovely, very funny, very georgous in pink tights,

Kal

These guys are on the Front Line of what is left of the NHS. Every day and every night. If you take a moment to check their Bloggs you will find out that this problem is not just in Stafford Hospital, it’s in the NHS as a whole. Those that work the Front Line hate it. Those that work the Front Line get up every day to do their jobs. They do it because they care. And no amount of Managers, Quacktitioners or Plebs will ever be able to replace those Front Liners, so please Labour, stop trying to.

Nice Message to Mr D – I hope this is ok. If there are any problems with this please edit as you see fit, I reckon the only bit I may have messed up was the Do it in Dark Blue, Italic.’ I couldn’t understand this bit so I put my name, Mummy, made it Italic and then linked it to my blogg. If this is not what you meant, please change it. Thank you for letting me be a Guest Blogger here. I hope you will ‘have me again’

Mummy x

p.s I think I remove all the swear words.

Brilliant George Pitcher (not often) on Prince Charles and artificial life forms


David Davis

Here it is, go read the whole thing. In fact it’s so good that I’ll paste it here. If Pitcher objects, I’ll just leave up the link.

 

Posted By: George Pitcher at Mar 13, 2009 at 14:03:58 [General

I’m waiting for Prince Charles to say that he’s very worried about thebreakthrough by American scientists in creating “artificial life”. His Royal Highness has form on this; in his worldview, genetics and stem-cell research are activities conducted by mad Dr Strangeloves with crazed disregard for the future of the human race. And, please, don’t anyone say “Frankenstein”. 

According to Professor David Deamer of California University, we should have the ability to create a synthetic lifeform from scratch within 10 years. A made-to-order living system could, he claims, produce everything from new drugs to biofuels and greenhouse gas absorbers. 

Some religious alarmists will say this is a step towards synthetic, test-tube humans and, as such, an abomination and a hellish bid by arrogant scientists to usurp God’s creation. Indeed, the scientists don’t help their case in this regard by referring to the advance as “a second genesis”. 

It’s nothing of the sort, of course. There was only one genesis of the human race. I don’t mean the Bible account; I simply mean that the development of the human race was a unique event. This is not a creationist argument – I’m saying that the human mind is of such potential that its ability to create life itself is inevitable. 

In theological terms, the ability of the human species to defeat its own disease and threats to the existence of the planet is a service to the Kingdom of God, to which all three Abrahamic faiths aspire in one form or another. You could go so far as to suggest that these research scientists are not so much building lifeforms as building that Kingdom. 

The artificial creation of human life is another matter. But also so far off as to be hypothetical. And by the time we’re able to do that, our ethical standards should have developed sufficiently, God willing, not to need to do so. 

Meanwhile, the scientists of California are to be applauded, even by Prince Charles.  

The NHS: new Libertarian Alliance series: “A Doctor writes”


David Rønnqvist

No more “bedside manner”?

 

Interpersonal altercations were the sort of thing that it was once judged could usually be left to be negotiated by the people concerned. Increasingly, however, minor disputes are coming to be seen as requiring layers and layers of bureaucratic management, changing the nature of the public services we receive and altering the once-pleasant feel of England as a country to live in. We have all heard of the use of home-school contracts in the state education system and of councils that refuse to take away rubbish where the bins cannot be pulled with two fingers. This sort of thing is becoming the norm across society, and I want to focus on how it is altering the National Health Service (NHS).

 

Doctors used to be esteemed for their bedside manner, but now often behave like faceless bureaucrats who could be working at public expense in any branch of government. I recently joined a new surgery and was very surprised to receive a Patient’s Agreement to sign, promising not be abusive to surgery staff. Apparently these forms are standard now. The covering letter stated that if I did not sign the form and return it within three weeks, I would be expelled from the practice. I wondered how this complied with the requirement under the farcical Patients’ Charter to be respectful to all patients and with the right of patients under the Charter to have a general practitioner. Such mission statements and charters tend to proliferate in the public sector precisely when conflict with members of the public is rising, and can probably be taken as backhanded admissions that such public bodies no longer treat members of the public with respect.

 

In itself the silly Patient’s Agreement is just a small thing, but family members working in the NHS confirm that the trend within the NHS is towards greater officiousness towards patients. A district nurse has told me that there are altercations every single week in her practice between district nurses and old-age pensioners in their own homes over the patients’ right to smoke. Apparently the NHS believes that all their staff have the right to work in a smoke-free environment. But, rather than leaving such a minor matter to individual negotiation, smoking in front of a district nurse is now sufficient justification for explusion from a practice. The same nurse told me that when she visits patients in pairs, the other nurse will frequently issue an peremptory order along the lines of “put that cigarette out immediately or you will be expelled from the practice”. Such issues “empower” the NHS staff to behave in a bureaucratic and officious manner. No longer are they required to show respect to their patients in their own homes by asking politely for the cigarette to be extinguished.

 

Another aspect of this agenda relates to “inappropriate” language or behaviour by patients. The same nurse told me about an occasion where a 90-year-old man being catheterised in his own home made an “inappropriate” joke. When other nurses at the practice found out, one of them put in an official complaint against the patient “on behalf” of the other nurse, leading the surgery to consider whether the 90-year-old should be listed as a potential abuser and placed on a list of patients who cannot be visited alone.

 

Despite the right to care under the Patients’ Charter, patients with “inappropriate” views may be denied care. There are a number of examples in the media where patients with “racist” views have been left without care in hospital corridors. This reminds me of how my dying grandfather, who went through World War II, became disoriented in his final days, and thought the Chinese nurse attending him was one of the “Japanese”. He thought the Imperial Japanese Army was attacking down the corridor. Nowadays, such comments by a less than lucid dying man could in some hospitals be seen as justification enough for denial of care.

 

Professional behaviour in the NHS requires that all patients are treated, regardless of any “offensive” language or behaviour on their part. Medical care is not something that should be withheld as a punishment for political views. Old soldiers who do not wish to be treated by certain medical staff may be violating the most sacred principles of the multicultural elite, but the issue should be treated pragmatically. Similarly, offensive comments by Islamic extremists, or anyone else, should not be used as an excuse to deny treatment, however satisfying the “fix” of moral superiority such a response would give the NHS bureaucrat involved.

 

I note that all surgeries are engaged in constant propaganda over violence against their staff-but I believe such violence is very rare in fact. The ambulance service has a list of homes where violence is feared-apparently 729 in Cornwall, Devon, Somerset and Dorset-and are wondering whether to blacklist the homes or mandate the wearing of paramilitary jackets when summoned to those addresses. However, press reports make clear that the inflated number includes houses where staff have experienced “verbal abuse”. Only a minority of these people will have actually assaulted NHS staff. Some of the rest may have simply expressed anger at the treatment of their sick relatives or slow ambulance response times. A recent survey of around 1800 NHS staff by the NHS Security Management Service shows that 41% of NHS staff have experienced verbal abuse, but only 2% were physically abused.

 

I certainly do not believe that patients should be violent to staff, but knowledge of British society would confirm that violence to NHS staff is very rare. It may be that incredibly minor events are being classed as verbal or physical abuse today. Of those experiencing verbal abuse (in other words, an altercation of words they should be able to deal with themselves), only 54% reported it. An even greater percentage, 66%, of those physically abused did not report the attacks, confirming the view that in nearly all cases what is classed as “physical abuse” is of an incredibly minor nature.

 

I would expect that abusive or rude behaviour among patients is on the increase, but this is likely to be a reaction to the increasingly bureaucratic nature of the NHS. Contrary to the posters adorning surgery walls, serious violence to NHS staff is virtually unknown. It may be that smug bureaucratic behaviour on the part of the NHS is a reaction to perceptions of rude behaviour among patients. Patients dealt with poorly could become angry and emotional. NHS workers on the receiving end of abusiveness may call for increasingly peremptory bureaucratic controls on patients in a kind of vicious spiral.

 

It is difficult to know how to respond to the officiousness of NHS staff. Complaints or even polite comments pointing out the insulting assumptions in NHS literature would get nowhere. In the end, as the Libertarian Alliance has pointed out, the increase in bureaucratic jobs in the NHS tends to produce more and more bureaucratic initiatives. Cutting the state, or even giving the individual the ability, whether by vouchers or otherwise, to purchase healthcare would restore a sense of dignity to patients-after all, these people’s salaries are paid for out of the taxes that we pay!

 


See link at http://www.nhsbsa.nhs.uk/SecurityManagement/Documents/violence_towards_NHS_staff_from_the_public.pdf.