The NHS An Inconvenient View

[aka Calum Da Jazbo]

alas i find much to agree with in Charles Moore's oped piece in the ToryGraf


it is not however peculiar to the NHS it is a common feature of all our state machinery ..... under delivery and error; high cost and demoralised staff .... if they were horses ... they shoot them don't they .....

however sticking to the NHS; my own experience has been as bad as he describes very very often and also as good as he mentions occasionally ....

[antongould]

My experiences of the NHS with 2 aged parents and a family of 7 is unlike yours and Mr. Moore's - every contact, and there have been a fair few, has been good and that includes saving my, then young, daughters life.

But on the wider issue is there still a majority view in the UK that privatising anything improves it? and/or
That outsourcing anything to the private sector saves money and/or gives a better level of service?

[Serial_Apologist]

But on the wider issue is there still a majority view in the UK that privatising anything improves it? and/or
That outsourcing anything to the private sector saves money and/or gives a better level of service?

Like, f'rinstance, the police? Now, THAT would never happen, would it??

[Lateralthinking1]

Quote - alas i find much to agree with in Charles Moore's oped piece in the ToryGraf

Really? There is probably not one sentence in it which I recognise as being of the real world.

A neighbour just this week was due to be seen by a private hospital for a serious examination. Tiny and local on the surface. In reality, part of a massive multinational private health conglomerate. Just as he was due to set off on the Tuesday, a call from them to say that they had had to change it to Friday. Then on Wednesday another call advising him that they had got it wrong again. He had to be seen now. So much for private sector efficiency and putting the patient first.

Typically, Moore has huge amounts of money. His types are engaged in a destructive civil war. Only on the day I read someone who has little money putting forward the same argument will I give it any credence. The NHS is the frontline. A defence against an increasingly determined attack by the Fauntleroys for getting most again living to 60 rather than 90.

As for the wider picture, Moore trots out the usual lies about nationalised industries being all for the bad. I never had to get a Ombudsman ruling then about a gas and electricity service or a telephone and internet provider about three years and eighteen months respectively of chaotic, erroneous, billing. In each case, the problems were found to be systemically rooted. The first dropped out of a merged arrangement and never got round to sorting out the computer systems. The second took on a merger and its computers just couldn't cope with it or so it was said. Obviously, it is always financially in their favour.

As for the service of the latter, you wait for over an hour with Bonnie Tyler and Bros blaring out so loudly that most would ring off. If you do manage to talk to someone, they sound like they are in a shed at the back of beyond. They can hardly speak English. When you do say politely "I am sorry, could you repeat that please" they accuse of you being a racist and slam the phone down. Incidentally, if ever there was a more misleadingly named company, it is that one.

Given a choice between the service from those two providers and a month's stay at Fawlty Towers, I would genuinely choose the latter on the grounds of efficiency.

[amateur51]

There is no doubt from my experience that any 'system' involving human beings can be improved.

I understand from friends who have had occasion to use public health services in France and Italy and Spain that they are very good there. I've also hear that things need bucking up in Portugal. I have had heart operations and a replacement knee in the past 6 years and I am immensely grateful for the care that I received. I did not go into hospital for the quality of the food.

But I think what worries people is that no-one seems able to explain to them how things are going to be once the change is completed. Politicians of all hues like to rave about 'increased patient choice'. I don't know about you but I'm not that interested in choice per se. The only time that I thought I was being poorly (dogmatically) treated by a consultant I screwed up my courage and sacked him - I sought a second opinion, got the name of a fair-bet consultant from a friend and bingo I got what I wanted

What also alarms people is the idea that a lot of the 'new ideas' come from the USA. Anyone who has seen Michael Moore's film Sicko will know what I mean.I think that at base most NHS Reform Objectors are driven by the frying pan-fire scenario

Plus no-one in possession of a brain trusts Tories with anything

[MrGongGong]

A few years ago as part of a soundart project I was doing I spent a day with the coastguards at Mallin Head. Most of the time they are doing low level monitoring of the weather, shipping movements and the like and the whole atmosphere is very calm and it seems like one could do the job with a single person and a couple of well chosen computer monitoring systems. Looking from the outside one could conclude that it would be possible to make the whole thing much more "efficient" and save money......... however , every couple of months or so they spring into action co-ordinating rescue operations for shipping over a huge area. I've always thought that the NHS is a bit like this, YES , it is possible to make it more "efficient" BUT what you loose is the ability to respond to a sudden crisis, that;s what happens, people get ill at inconvenient times etc etc

My own experience of the NHS recently has been fantastic , I needed a big operation, it was done efficiently and quickly with much consideration of my need to be off work as little as possible. What they don't do well is "wellbeing" , if you need an organ removed (as I did) its brilliant, if you develop backache the NHS is the last place to go.........

[ferneyhoughgeliebte]

I'm shocked and genuinely saddened that Calum's experiences have been similar to Moore's. My own experiences of NHS hospitals in East Lancashire and North and West Yorkshire couldn't be more different: it astonishes me that overworked nursing and surgical staff can create so much time to devote to patient care and comfort. (I wouldn't want to suggest a North/South division thing: I was equally well looked after when I had to spend time in hospital in East Sussex 25 years ago.)

[gradus]

I hadn't seen the article before but his critical observations and examples ring true with me at least.
In my experience the NHS is a mishmash of some good and much truly awful and reform of the awful is long overdue.

[aka Calum Da Jazbo]

well my experience is my experience isn't it lateralthinking and if Moore writes what i feel to be a true description of my experience then what exactly are you calling me? a liar?
i have had many extremely painful and dangerous experiences of treatment of my nearest and dearest in London, the east Midlands and elsewhere over fifty years or more and i will not be told that this is fiction by you or any one else lateralthinking ....mind what you say ...

and for the record there is no way in which i think suggest or support any notion that privatising the NHS will improve access to care, quality of care or staff morale and development ... my point is that Moore highlights a management deficiency that is endemic to public service in this country and that creates many of our difficulties ... and i also take his implication that the fuss over reform/privatisation clouds the truth of this incompetence in large scale public bureaucracy ....

i also welcome a person one might consider a high Tory taking rational point forward without doctrine or dogma .... some on the Left are beginning to argue in this open way as well ... that the oldies should get the point and debate in such a way is i believe one of the central requirements of the Occupy movement and i am in deep sympathy with it ...

[antongould]

I don't for a moment not believe you Calum - we each have our own experiences - but do you feel the management in the private sector is any better? In, again, my albeit limited experience it is far worse.

[Lateralthinking1]

Quote - well my experience is my experience isn't it lateralthinking and if Moore writes what i feel to be a true description of my experience then what exactly are you calling me? a liar?

No Calum, not at all. I was putting forward my views, ie Moore has an agenda - always has done - and he is evidently biased.

A few truths -

1. All national systems, private and public, are bureaucratic.
2. Multinationals might logically be expected to be more bureaucratic than national systems.
3. Some privatisation was marginally for the better. Some of it was distinctly for the worse.
4. Like any system, the NHS is variable. Experience can be awful. Don't I know it! Often though it's great.
5. Much of the existing privatisation is more oligopoly than competition.
6. Good private healthcare depends on individuals with a fair minded capitalist ethic - my excellent dentist is one.
7. Smaller units are more likely to be fair minded than large ones but so much depends on the people involved.
8. Many of the problems in the NHS are where the private sector is involved - cleaning, radio provision, drugs costs.
9. Labour wasted money by hugely increasing GPs' pay when it wasn't even being asked for.

[aka Calum Da Jazbo]

not at all antongould in the private sector it is more a case of greedy bastards as well as dysfunctional bosses and processes ...

we may have the wit to create large organisations but not in my experience to run them ..... i have experienced very well run cancer care and seen exceptional talent in action in one hospital but i can as readily find ten where the incompetent and the disaffected held sway ...

i am pessimistic about reform; the path of development i favour would involve regional organisations with autonomy from Whitehall and local accountability say between eight or ten helth services delivering care but with a highly intelligent and small central organisation compaaring and contrasting outcomes between the regions remorselessly ... with the odd nation centre of excellence and no doubt other sops to the doctors amour propre ..

and laterallthinikuing you merely obfuscate by perpetrating the calumnies thrown back and forward about public and private .... it seems to me that iti s in our public interest to have successful and ethical commercial and industrial enterprises in our society as much as a health enterprise .... and the ownership is not really the point ... in the last analysis no one owns anything .... we have a licensed greed in business and licensed careerism in the state machinery and a plague on both imv ...

[teamsaint]

9. Labour wasted money by hugely increasing GPs' pay when it wasn't even being asked for.[/QUOTE]

have to agree.
Labour thought that it could improve the service by pouring money in. However, as we know, the NHS spends money essentially on salaries and drugs.

I am all for well paid staff, but we spectacularly over reward many doctors.(not least compared to other countries).
I have to say, in all honesty, the service I generally receive from doctors tends towards the poor. It is ocasionally good, mostly uninterested, and sometimes downright shoddy. (EG my hernia was examined by a consultant who had two patients in the room at the same time.That was the double hernia that they wouldn't fix for six months, and which I had to get done privately so that I could get back to work.

One member of my family is currently being refused drug treatment on the NHS because they won't follow some arbitrary local guidelines.
Brilliant.

[teamsaint]

oh, and as for private sector management........Most of the people i have worked for are good at getting top jobs, and useless at doing anything else except protecting their position and salary.
And they claim your ideas as their own.

[Flosshilde]

it seems to me that iti s in our public interest to have successful and ethical commercial and industrial enterprises in our society as much as a health enterprise .... and the ownership is not really the point ...

I disagree - ownership does matter. Private business wants a profit - or the shareholders do, & want as much money diverted to them as possible (after the board & chief executives have taken their large cut), which means less money is spent on providing the service. In State-run services [I]all] the money is spent on providing the service (which includes paying the people who do the work).

Yes, it would be great to have ethical commercial & indusrial enterprises - where are they? The Co-op is, but it is a business 'owned' by its members, ie people who shop there. John Lewis might be, but again it's kind of owned by its staff. Fry's & Cadbury's used to be (a long time ago), but they were subject to agressive & predatory take-overs which were approved by greedy & short-termist shareholders. I don't think that capatilism can do ethical.

... we have a licensed greed in business and licensed careerism in the state machinery and a plague on both imv ...

So if it's 'a plague on both [private & state]' what are you left with? the only alternatives would be co-operative or individual. I'm not sure that either would work on the scale the NHS has to work at.