Saturday, 15 August 2009

Hannan and the NHS

It seems that Labour are wanking themselves into an utter coma about Dan Hannan daring to be critical of the NHS. I suspect that if people listened to what he actually said, they would be disappointed with the anodyne nature of his observations.

Let me make a few random comments based on my experience of health care in the third world.

  • Firstly, I am quite used to paying at the point of service.
  • I am also quite used to fucking off and seeing another doctor if I don't like the way I'm being treated (or not.)
  • Finally, I am also quite used to paying for health insurance.

This has several consequences:

  • I don't go to see my doctor frivolously, because I know it's going to cost me.
  • My doctor is glad to see me and interested in my problem, because he knows that if he fixes it, I'll come back next time I'm sick.
  • My doctor is also quite keen to own the treatment as far as possible, because he knows that just sending me off to a specialist will earn him nothing.
  • My doctor knows that if he doesn't make excellent and visible progress in treating my problem, I will get annoyed and go elsewhere.
  • My doctor knows that if he keeps me waiting for my appointment every time I go in there, I will fuck off to another doctor who can manage his fucking diary.
  • I have a safety net that will cover me if it really does all go badly wrong.

My experience of the first-world health care offered by the envy of the world is very different:

  • People go see the doctor for things that should entail a visit to the pharmacist. Especially if they can then get their cough mixture or Panadol on the taxpayer.
  • My doctor quite literally doesn't care if I live or die, as long as I've been in for my 10-minute slot. If I die, he has a whole bunch of other involuntary supplicants who can take my place.
  • My doctor has no real interest in fixing me, especially if he can string out a whole series of 10-minute slot-fillings.
  • If I actually want to be cured, I have to ask to be sent to a specialist.
  • I always wait more than 30 minutes after the scheduled time before I actually get in to see the cunt.

I was amused by a defender of the NHS, who said that her local PCT often offered public consultations and seemed very keen on finding out what the public wanted from them. I countered that with observations of the third-world health care from the same country, which we had both experienced. The doctors there wouldn't dream of consulting the public about what they wanted because they were already too busy delivering exactly what the public wanted: doctors that fucking do their job in a cost-effective manner.

The British deification of this shambolic, expensive clusterfuck is nothing more or less than a malevolent manifestation of "Not Invented Here" Syndrome - any alternative cannot be as good because it's not British. Well, I've tried other health care systems and they have all been better than the NHS.

The NHS sucks donkey cock. End of.


ByrneTofferings said...

Which system is it you used btw, India's is excellent.

David Gillies said...

I was in to my ophthalmologists' surgery on Thursday to get an injection in my fucking eyeball. It wasn't free but it stands a good chance of stopping me from going blind in my right eye. This was full-on, gowns-and-masks, Robin Askwith quality nurses plus one of the best eye doctors in the country. Waiting list? He waited for me. It cost me the thick end of four hundred quid, but for that I get after-care at my convenience, in a surgical environment the standard of which I have literally never seen in the UK. This is Costa Rica, which incidentally has a life expectancy almost congruent with the UK.

Wesley Groves said...

Costa Rica abolished the army as they "couldn't be arsed" and have a democracy too.

Ian B said...

I think it's more like Stockholm Syndrome, if you ask me.

Or Wikipedia Syndrome, that is,

"I don't care if it's shit, it's free!"

RobW said...

Obo you always put things so well.

David Davis (Libertarian Alliance) said...

The point of the NHS is, of course, as is it one of the prime GramscoFabiaNazi creations and occupies a strategic position, is to destroy the UK, and in particular England, as a social, ethnic and historiographic entity.

The (British, mostly) bastards (who hate us and what we and their own culture stands and has stood for) can't do Genocide onto us - not quite yet! - although they would bloody dearly love to.

We, and our Grandparents more or less prevented the re-occurrence of that at Nuremburg. (There are too few left to make a difference now.

We showed what would happen to genocidal, ideoligical GramscoFabiaStalinists, eleven of which we hanged formally, missing a few. The nationalities of those hanged were merely incidental and reflected the tragic vagaries of four humdred years of Gramscian European wars, the loose-ends of which we nobly tried to tidy up in about 1946. Happily the Poles and so-on got a few hundred more.

The NHS, sadly, will not be able to be abolished on the first morning of a Libertarian Government in the UK.

We shall have to keep quiet about malleting all its disks and servers, and the incineration of all its wages and salaries records, by specially-fitness-trained-groups of libertarian "activists".

This will need to be done in the furore-interval, about three days later, while all the staff of outreach groups and the Department of "Education and Skills" are being actively fired.

It will be a good day to bury bad news.

AntiCitizenOne said...

The NHS certainly isn't free! It's funded by extortion.

John Demetriou said...

Excellent article.
This shit needs pumping out.

Nicely done.


Mark Wadsworth said...

@ DG, best of luck with the eyeball. I had an injection into my eyeball once, it's not an experience I'd wish to repeat.

@ Obo, yes, agreed, the quality of care in any country that has competing providers is of necessity better than in a country with a state-run monopoly provider. That much goes without saying.

What you have to remember is that the 'provision' side is quite separate to the 'funding' side. The NHS scores high marks on 'funding' (because it is universal, free at point of use) but fails miserably on 'provision'.

The US fails miserably on 'funding' as it is all down to insurance companies (the only people I trust less than the government are insurance companies) and quality may be good but they spend twice as much as we do.

So why can't we have the best of both worlds, like in most European countries - low cost or subsidised* healthcare with competing providers?

* @ AC1, yes I know that taxpayer-funding is extortion, but in some cases it is better than insurance companies doing the extorting!

AntiCitizenOne said...


Americans trust the state less than insurance companies. In fact the longer you've been insured the bigger the gap.

Chalcedon said...

You are correct. It isn't as good as the French or German health systems by a long way. It is expensive and wasteful. It's only free to anyone who doesn't pay income tax. The rest of costs us a bloody huge amount.

bayard said...

Apropos of your comments based on your experience in the third world, my experience of private medical care in the UK is somewhat different. Dentistry in the UK is now more or less a NHS-free zone. I pay at the point of service. I am free to go elsewhere (well, almost, most dentists charge you to take you on their lists). I still get crap dentistry and crap dentistry is irreversible, your teeth being almost the only part of your body that your body cannot replace. I still have to wait an age for an appointment, then turn up on time and wait again. There are only so many dentists within reasonable travelling distance in a rural area and most of them round here are crap. Those that aren't, aren't taking new patients.
I am afraid tht the system you advocate wouldn't make for better medicine, it would just make things cheaper for you, personally, because you appear to be one of the tiny minority of people in the UK who are prepared to complain (i.e. to the person who can do something about it at the time) rather than grumble (i.e to their mates afterwards) when they get poor service.

Obnoxio The Clown said...

@bayard: I suspect that this is not entirely true, because I attend an NHS dentist and every dentist in my town is an NHS practise.

However, in every competitive market you will also find incompetence and they don't vanish overnight.

I suspect that part of the issue here is that British people are so accepting of crap medical care that they don't worry about changing dentists, even though they can. It's not just in supply side of the market that things have to change.

But also, you have an entire generation of dentists who have the "fuck-you-I'm-from-the-NHS" mentality and so it's also going to take a while to change that.

bayard said...

Perhaps it is just in this corner of Wales that we are so badly off for good dentists. However, it does raise the point, although this is somewhat irrelevant to your main argument, that even in a private system, it is possible for providers of crap service to "corner the market" geographically, when it just becomes too far to go (literally) to find someone who can do the job properly and isn't currently inundated with work.
The dentists do, however, appear to run their own medical insurance scheme (I say appear, as I've not investigated whether they do, or whether it's just another bloody insurance company, however most dentists seem to push some sort of insurance scheme, so there must be something in it for them). This would have the major advantage for us in that it costs the dentists, not us, every time something goes wrong with our teeth, so they have a strong incentive to do the job properly, unlike US-style private medicine, where if everyone remained healthy all the time, the doctors would all go bust.