And another thing…

40,000 avoidable deaths per annum is OK, then? Because their heart is in the right place, bless ‘em?

You’re an idiot.

Any Health Organisation that has more managers than doctors, more administrators than beds and kills 40,000 patients a year deserves to be called much worse than a mistake.

However, as I made clear to John Prescott when he tried to defend the NHS, if David Cameron does not support Dan Hannan, the Libertarian Party will.

But Tom he is correct. You are just so obsessed with preserving the NHS you are not prepared to look at this openly without scare tactics. as I have told you before the Tory party talks about things like this in open debate. unlike Labour who just follow the party line come what may.Just look at the mess you have made of things with just throwing money at things without improvements.

Are you going to show the rest of the interview. ?

God, these sad far right loons who sit at their computer waiting to punch in the Truth As Revealed By Ayn Rand. What a bunch of losers.

@Johnny Norfolk – As I said, many Tory supporters are as extreme as Hannan and support his anti-NHS point of view. You’ve just proved my point, Johnny.

As to the whole interview, I did link to LabourHome which has the whole thing.

It’s a bit ‘Daily Mail’, isn’t it?

It’s fascinating just how much the Labour party has resorted to using scare tactics and half-truths in the past year.

Tom, you would never be able to engage with contentious issues such as this in public, and I respect you for taking what is probably a sound career move in not doing so very often. However I don’t respect you or your colleagues for trying to make up some sort of fictitious row or some sort of apocalyptic vision of a capitalist society. “You know and we know, and you know we know that it’s nonsense.” So stop it.

The NHS, like many socialist ideas, is a humanitarian ideal which is highly commendable, but becomes a nightmare because of human beings.

As Ian Parker-Joseph said, “Any Health Organisation that has more managers than doctors, more administrators than beds and kills 40,000 patients a year deserves to be called much worse than a mistake.” I feel a need however to remind everyone that it was the Tories who introduced the fragmentation, creating NHS Trusts and targets, which I found very disappointing.

What I also found disappointing was that the Labour Government kept it this way.

I also have to add here that the Tories closed the Mental Hospitals for Care in the Community, to save money. This is another thing which the Labour Government did nothing about. Another NHS experiment, created by the Tories to save money, which only created a new debt, ie more crime and a growing prison population.

Tom, it’s getting harder and harder to support the NHS in it’s current form.

I am STRONGLY in favour of free universal healthcare, but the NHS as it is is quite frankly RUBBISH.

Their budget is enormous and has never been higher. What is it you Labour types are so fond of saying? That the budget is three or is it four times what it was in 1997? Does anyone here really think the NHS is four times better than it was in 1997? I don’t.

The first problem is that Labour has made the NHS untouchable. Nurses are heroes, Doctors are Jesus reincarnate, and anyone who dares be critical should burn in hell. Well that’s helpful isn’t it? Keep the criticism to a minimum! Us proles shouldn’t have an opinion anyway eh?

Both my parents rely on the NHS for their heart problems, and what I see when I accompany them to the hospital is nothing short of baffling. Accident and Emergency is often understaffed, yet the clinic’s, such as the heart, ent, xray etc.. are RIDICULOUSLY overstaffed. I was there for 4 hours the other day and saw a fat nurse waddle around with a clipboard and a mug of tea, in between her fascinating conversations with other staff about her kids. She was far from alone aswell. The NHS are openly paying too many clinic staff to sit around on their backsides. Since the majority are qualified nurses on nurses salary, i’m incredulous.

Then just look at the conditions of the hospital. It’s like a third world two bit operation.

Another example. My parents rushed me to the GP 2 years ago because I was so ill. I was quickly examined and the GP told them he thought I might have meningitis, to take me straight to A+E, he gave them a note and he called ahead. Upon arrival at the hospital I was told to take a seat in the waiting room. I was there for an hour before I was seen. A nurse then ushered me into a cubical and took my details on a clipboard, and said she would get me some paracetamol. It was a further 2 hours before I was seen by a doctor.

Go to America and see their facilities. Go to Cuba. Go to France. Go to Germany. Then come back and go to one of our hospitals, and you’ll probably think you’ve just wandered into a field hospital in Nairobi.

The NHS is a disgrace, and something has to be done.

The NHS used to be a world leader in the provision of efficient healthcare but over time (and under successive governments) it’s become a money pit. Every £1 that goes in gets us 10p of better treatment with the remaining 90p swallowed up by the needless bureaucracy that has surrounded it.

Labour is pathetically hanging onto the concept of the NHS like a dog with a bone, not because of the good works that it does, but because its employees represent about 10% of their core vote.

Any move to implement a more efficient system could jeopardise jobs and funding which would, in turn, jeopardise your union paymasters which is why the NHS will never receive its desperately needed reforms under this or any other Labour administration.

It seems that in the absence of a National Health Service you get a three tier system: A fully comprehensive health insurance policy for the stinking rich, an adequate policy for the adequate earner, and social help/welfare for those who make ends meet and lower.

I suppose car insurance would be a good example: Fully Comprehensive, Third Party Fire and Theft, or Third Party Only.

The NHS is Third Party Only.

The things I would like to say would not get my comment published. But rational argument doesn’t seem worthwhile. He deserves to be on the bbc’s ‘have your say’ page. he is the patron saint of phone in/text in no-nothing nonsense. So I won’t rationally debate with your previous commentators because they are idiots. Headbutting is too good for them. Rationality is too good for them. Perhaps I should emigrate to Canada. Or Scotland…. they deserve to be on this site: http://ifyoulikeitsomuchwhydontyougolivethere.com/

The NHS should be there as a safety net for those that can’t afford it. It’s patently obvious the country (no country) can afford totally universal healthcare. The whole ludicrous concept leads to NICE and all the fun that entails. Herceptin etc.

The tone of your comment suggests you think everything is great with the NHS. This rather suggests you have not had to rely on it recently. I’ve got news for you Tom. All that money ‘invested’ (or to put it more accurately – pissed up the wall) was wasted, it has not resulted in a better service. And any figures you may quote about waiting lists or number of MRI machines is _irrelevent_ – the three people closest to me all rely on the NHS to some extent. I can tell you it has gone to absolute pot over the last couple of years. Dunno about third party, third world more like.

Doctors no longer seem to have patients needs as their top priority. Actually you’ve broken the NHS in almost exactly the same way as you’ve broken the police.

those that can’t afford it – meant those that can’t afford healthcare.

Tom,
I’m all in favour of an NHS that supplies free at point of service care.

However; if we have more administrators than beds, dirty wards, a blotted management etc Then something needs to be done about it.

Doesn’t really matter who did what when and why.

In some regions drugs are available whilst in others they aren’t, especially large disparities between Scotland and England.

What is the NHS for? is another good question; is it to provide basic medical care to all or is it meant to be a cure all fixing things that aren’t unnatural (IVF for example).

Oh yes, if Hannah is saying scrap it then he is being foolish (the US system is economically and morally crazy); if he is pointing out its failings that may be for the good.
Pretending that it is perfect does no patient any good.

Labour say the Tories want to destroy the Health Service. It wasn’t that long ago the Tories said Labour wanted to have the country run by the unions.

I believe the thing that drives most party politicians is getting into power and staying in power. For the Tories, even if they aren’t keen on the NHS (debatable particularly as it has had a big impact on the life of Cameron’s family), they are more concerned with being and staying elected. The same with Labour and the unions.

The Americans are lucky that they get to see alternative viewpoints rather than the one view stuff that gets pumped out here. At least Daniel Hanna speaks with conviction rather than the sort of pointless waffle Dave spouts which is nicely illustrated in the Thunderbirds video.

I was listening to an article in which someone from the NHS was saying how they should refuse treatment to smokers, drinkers the obese etc which made me think that I’d rather opt out of it and pay my own way. What’s the point of paying for a service only to be told by some self righteous bigot that you’ve got to lay off the eclairs before you’ll be eligible for treatment? If your window cleaner started trying to lay down the law before commencing work you’d sack him. Why should a state provided service be any different?

When you think of the wastage in the NHS (£130 per hour to an agency for a nurse who gets £15 for example) you’d definately get better value if you could choose to spend your contribution elsewhere. It might sharpen up the NHS as well if people could opt out.

I can’t believe how quickly Hannan has discredited himself by going on FOX News! Yes FOX News that bastion of balanced, high-quality journalism.

He’s been on it twice now as well lol. Make him Tory leader asap please!

I think Cameron genuinely had to re-appraise his attitude to the NHS regarding his experience with his son. Before that he shared the attitude most people of his background (that includes public school educated Daniel Hannan) have to the NHS. That is, they felt it was a socialist experiment that failed, and since they personally always had the choice of opting out they were always going to be at best negligent, and at worst destructive towards it. Cameron’s ‘Patients’ Passport’ idea from the 2005 Manifesto would have destroyed the NHS.

Whether Cameron actually has the integrity and strength of character to defend the NHS against the naysayers within his party remains to be seen. As Tom says at the moment it is politic for Cameron to make out that the NHS us safe with them. However, I think this is one of those issues, like Europe, which will tear the Tories apart.

Also, what does Hannan mean by ‘iller’? Sounds like very poor grammar from someone who was privately educated.

Regarding the closure of the mental hospitals and care in the community, there are arguments on both sides; but it certainly shouldn’t be seen as some automatic Big Bad to have freed people from incarceration in dickensian institutions. It is wrong to presume that people with mental health problems represent a special danger to the public, as is often whipped up by tabloid hysteria. It’s important to try to help such people, and it’s important to discuss the best way to do that. It isn’t wrong to seek to help such people live as normal a life, within the world, as possible, and it isn’t necessarily right to treat them like criminals because of their health problems.

I lived in the US for 20 years and always had top of the line health insurance. I have AIDS, and the insurance did pay for the care.

But it was employment related. If I lost my job (or resigned, in my case), I lost the “good” insurance. It is true that local programmes picked up the cost of medications, but if these failed, there was no one to pick up hospital costs.

But I was one of the lucky ones, because AIDS activists in the 1980s and 1990s have actually made the situation workable for People with AIDS. But God help you if you get cancer: if you are securely middle class you will find massive “co-payments”, your savings destroyed; if you are poor you will only be given pain alleviation. I had one friend in Florida whose 48 year old mother (a non-drinker, not that it matters) had liver cirrhosis. Because she had no insurance, she could not even be put on a transplant list.

Insulin is not a prescription drug in the US, so that poor people with diabetes are supposed to be able to look after themselves with perhaps one visit to an ER or charity doctor in a year.

The sheer amount of fear about illness and the cost of treatment that affects all but the very richest Americans is vast.

And even when you do have insurance, the hospitals are not one jot cleaner or nicer than here.

@Paul Halsall

That is a fantastic post. It really outlines exactly why free universal healthcare should be a universal human right.

However, as the NHS shows, it’s not as simple as just having the government pick up the bill. Some of the things you see and the stories you hear from friends and neighbours are outright frightening.

Personally, I think the NHS mandate needs to be changed slightly, and that’s just for starters. Did you know cosmetic surgery such as breast augmentation is free on the NHS? Circumcision is too. Don’t get me started on fat people clogging up the OR’s with their gastric band surgery and liposuction. Then there’s health tourism, where anyone in the world can simply come to the UK and get free medical treatment. It’s an ever growing problem aswell. People with serious medical conditions coming to the UK to be treated, all on the British taxpayer.

The NHS needs urgent reform. Unless we all want to pay 60% tax on our income, the current system is unsustainable, and it’s broken as it is.

I think the NHS is one of the glories of Britain. Not having to worry about whether your illness will bankrupt you is a tremendous benefit to the live of millions. The total management levels are actually quite moderate, given that the NHS has the income of a medium-sized country and 1.3 million workers.

Good post by Paul H.

I know it varies from area to area, but I’ve never found cause to complain about our local NHS hospital. My sister had breast cancer (thankfully she’s now recovered) and the treatment she had was first-rate.

People tend to forget about the waiting lists during the Tory administrations, and how the NHS was neglected.

Don’t get me started on fat people clogging up the OR’s with their gastric band surgery and liposuction.

Inside every socialist is a very selfish person, trying to figure out how to maximise their take from the State while minimising everyone else’s, normally by demonising other groups as not worthy of state largesse.

These days, you can’t demonise people for their race, or their religion, or their sexuality. But hey, FAT PEOPLE! Open season!

It really outlines exactly why free universal healthcare should be a universal human right.

Luckily, those fat gits aren’t quite human, right John?

Its not about free health care for everyone, that will never change in Britain, its about how it is delivered. If anyone can say that the way it is currently delivered is acceptable you must be as blind as a bat.
Labour has just poured money in without improving it that much. They have copped out.

Luckily, those fat gits aren’t quite human, right John?

Your whole post is a perfect example of how the NHS and the country is in the state it’s in.

Since when did we abandon the concept of personal responsibility?

With fat people, we’re not talking about a momentary lapse, an accident, a mistake, we’re talking about a lifestyle of too little exercise and a calorie intake of several people per day.

So, if your chosen lifestyle is to be as unhealthy as you possibly can so that you accumulate a lifetime of healthcare concerns, then YOU pay for it. Why should I and the other taxpayers because YOU got fat? You didn’t fall down and hurt yourself, you didn’t have an accident, you DELIBERATELY scoffed thousands and thousands of calories per day.

So you pay for it, fatty. No excuses, it’s not glandular, it’s your own fault. You eat too much.

The sooner the NHS gets back to providing healthcare for those in need, rather than the woman who wants a bigger bust or a tummy tuck, or the fat person that wants a lazy way to lose weight so that he doesn’t have to resort to diet and exercise, the better for us all.

@Ian B – a fair point Ian. However, the Governor of Styal prison said himself that many of the prisoners are mentally ill (which has led them to taking drugs for which they have been incarcerated). I am closely related to a Prison Officer at Styal, and they have told me what the Governor left out in his comment. If the Menatl Hospitals were still there, that is where well over 50% of the prisoners would be. They told me that they feel more like a Phsyciatric Nurse, constantly dealing with self harm and attempted suicide.

A healthy political party SHOULD contain opposing views on major matters; that way there is always debate and contention as to the right way forward.

New Labour’s permanent requirement for all apparatchiks to be on message all the time (witness one Mr. D. Draper’s assertion that party members who disagree with policy should be expelled, viz. LaboursLost) means that everything is dictated from on high, and there is no debate within the party whatsoever about anything that matters.

That makes for a very unhealthy state of affairs. Only a fool could deny that, surely?

I would imagine the floppy-haired toff (New Labour joke. They all ROTFLAO wehn they say ‘toff’) would say to Mr. Hannan, whom God preserve for his gutting of the great gurner, something along the line of

“Bollocks, but do tell me why.”

There, that wasn’t too difficult, was it?

Whatever happened to the idea of the “broad church”, Tom? You ever seen Invasion Of The Bodysnatchers? The ‘55 b & w version (the best of the three, though the others are both excellent a rare thing for a remake. IMDB if you need more, eh?). Well in that film, fake, bodysnatched humans emerge from pods, in one classic scene, in a greenhouse.

I have long held that that is how the likes of Miliband, Balls, .. the list is too long, came into being.

Altogether now, sing from the same hymn sheet, boys and girls…

Hey! Maybe he has been … thinking outside the box?

Come on Villa

And NL honesty on the NHS? Are we not some 5000 beds down on promises? And why do managers crawl out of every orifice of the body politic that is the NHS now?

Pliss to be explaining to this simple country boy. Are Tory lies worse than Labour ones? And why are they not ALL bad, as my mum and dad told me?

PS. Get that second hime in quick, Tom. They won’t be there for long. And don’t forget to get the taxpayer to pay your tax on it as well. I mean, it’s not as if he isn’t loaded, is it?

“This wheeze, you may remember, was to drain billions of pounds from the NHS and divert it to the private health sector”

Like PFI you mean? (And DON’T say the Tories brought that in. Brown ADORES it, as it means he can cook the books. As any fule kno)

Why should I and the other taxpayers because YOU got fat?

And there you have it. Over and over again, we find the people declaring loudest that health (and other services) should be a communal responsibility are the first to shout, WHY SHOULD I PAY?!

You can have one or the other John. If you don’t want to pay for other peoples’ healthcare, don’t demand that other people pay for yours.

I’m thin, by the way, even though I scoff lard all day long. It’s largely genetic, truth be told John. But you’re not interested in that, because you want somebody to hate. Well, go on hating. I won’t try to stop you. But neither will I respect you when you try to claim the moral high ground with the “healthcare is a right” malarkey.

“Free universal healthcare, except for people John doesn’t like”. Doesn’t have quite the same ring to it, does it?

“Free universal healthcare, except for people John doesn’t like”. Doesn’t have quite the same ring to it, does it?

No, it doesn’t. Labour used it in 1983 and it just didn’t click with our target voters.

Timbone-

However, the Governor of Styal prison said himself that many of the prisoners are mentally ill (which has led them to taking drugs for which they have been incarcerated).

Not quite sure what you mean- is it that these people are incarcerated for drugs offences (possession, dealing) or that they’re drug addicts which led them to commit other crimes (theft, violence etc)?

Ian – in most cases they are drug addicts arrested and charged for possesion and/or theft (sometimes accompanied by violence)to feed their drug habit. The important fact is that had there been enough secure units, they may well have been receiviing treatment for their mental health problems before they even dabbled in the drug culture. Alternatively, their ‘crime’ would have been seen as diminished responsiblity due to their mental state, so they would have been put into a secure unit.

They are human beings who have suffered acute social trauma in their childhood and teenage years. They are not criminals, they are ill, and need treatment.

Hope this answers your question.

Feel I ought to point out that this debate, while interesting, is also irrelevant to Tom and his constituents.

Health is devolved in Scotland. Whatever may happen south of the border under the Tories or anybody else will not affect Tom’s current constituents directly though there may I suppose be Barnett consequentials if UK spending is slashed.

Another argument for fiscal autonomy.

Er Tom nice to see how many of your frequent commenters are loony tunes on this. Now here’s a free market question for them. Why is it that actuaries keep rapidly revising annuities down over the last 10 decades. Why is there a pensions crisis? Could it possibly be because the NHS has so much improved that people are rapidly living longer? Or could there be any other factor other than a Labour government properly funding the NHS for why this is. And as I sense all those commenters ignoring this question to talk about pensions crisis. The question is why are people living longer than ever, and why did actuaries (all working in the glorious private sector) get it so wrong? Answer 1. Labour Answer 2. there are too many actuaries with the political numbskull mentality of the right wing commenters on this thread who are in denial.

@Iain B

If you don’t want to pay for other peoples’ healthcare

Wrong. I don’t mind paying for other people’s healthcare. What I object to is paying for those who deliberately make themselves ill, not through a mistake, not through an accident, but a course of conduct lasting YEARS.

Someone eating 10000 calories a day for years and then expecting the taxpayer to pay tens of thousands of pounds for their gastric band surgery and other treatment can naff off.

Your attitude smacks of the apologists that defend the likes of these: http://www.dailymail.co.uk/health/article-1162503/The-real-telly-tubbies-X-Factor-failures-83-stone-family-claim-simply-fat-work.html

Just read their story and tell me you are happy for the taxpayer to carry them and people like them.

I don’t know which is sadder.

The fact Tom wrote this rather weak piece about a fairly fringe member of the Tory Party [as was spun during his attack on Brown]

Or that he’s now reffed to as “The One” [Because that worked so well for President McCain in the USA]

OR that Tom’s LABOUR blog only has right wing readers and commentators.
———————————-

Now I will say, overall, my encounters with the NHS have been positive, and I consider myself a Tory.

Hannan’s interview is more in depth and complex than Tom would care to admit if he found a fuller speech of this interview in that he does still agree with the idea of free-for-all healthcare but it needs serious refinement, removal or refinement of it’s bureacracy and the scrapping of various things. We need to be looking at the New Zealand Model of the NHS, not the Soviet ones.

And before he goes on to ask me again and again if I support the line Hannan takes I will say this:

“If you agree with 80% of what I say, vote for me. If you agree 100%… see a Psychiatrist.” Which I believe was said by Roosevelt.

@ Angryvoter

(Why oh why won’t people post with their full names. Sometimes, if I am just being silly – posting on fashion etc – I will use “Paul H”, but I think not using your real name devalues any post)

You make some interesting points. I do think the NHS could be improved. I don’t like how it’s “consultations” are merely fronts for pre-agreed policies. I don’t like that I had to loose two (back) teeth because of a millimetre too much below gum decay.

But “market” forces apply only in the crudest sense in terms of healthcare.

We have one of the best healthcare systems in the world. Perhaps the French, Germans or Dutch do better, but ours is a marvel.

I consider myself a socialist because I believe that human beings can choose, as members of large groups, to mitigate the sheer pain of natural life.

The way I look at it is this. I am a socialist (and an unrealist if you like) because I will always come out on the side of the runt.

Other people seem to be willing to let the runt die.

Everyone is whining on about how wonderful our “socialist dream” healthcare dream is, forgetting that £500 million per annum is paid out to private contractors merely to service the interest payments on debts accrued under PFI.

There are reasons, you know, why the SNP are refusing to build anymore PFI funded hospitals, and they are exercising a darn sight more social responsibility than New Labour and its cynical stealth-tax laden methods. £500 million! It’s not even buying any doctors or hospitals or anything! It is going straight into the pockets of private investors. Tom, you are having a laugh.

@John

Once again we have the ’self-inflicted wound’ argument – those seeking state-funded health-care should be judged on the choices which have led them to be ill.

Tell that to all the ex-servicemen who take to drink once they leave the forces and make themselves ill from it. You’ll have to tell them John, because I’m too weak.

@Paul Halsall. Largely because I use this “monicker” for every blog and other thing I post to, it gives me some vague consistency.

“You make some interesting points.”

Thank you.

“I do think the NHS could be improved. I don’t like how it’s “consultations” are merely fronts for pre-agreed policies. I don’t like that I had to loose two (back) teeth because of a millimetre too much below gum decay.”

Which is part of the problem, we have to look at I think the NHS, the Doctors and Nurses themselves rather than the burecrats and managers need to take a good, hard look at the NHS and say “Is this necessary?

Should we use state money for that?” rather than “We have to use this as otherwise the budget for this department will be immediately slashed by central.” as is the problem at the moment. I know I don’t like the fact that state money is used to put gastric bands on Obese people because they ate too much food. Society didn’t make them that way, the fact they had a fork in their hand did.

“But “market” forces apply only in the crudest sense in terms of healthcare.”

Yes, I agree. That was largely my line of argument in that we should look at how “market” forces have refined or removed their accumulated burecratic needs. Beyond that I don’t think there’s much we can or should do to the NHS. The Buisness sector has managed to move and exploit post-burecracy rather rapidly and as ever the state is dragging it’s feet.

“We have one of the best healthcare systems in the world. Perhaps the French, Germans or Dutch do better, but ours is a marvel.”

As a Brit I have to remain skeptical. I do think there are better systems out there that manage to do a better job on larger bodies of populous and we should look and learn from some of these models as well as look at how the business sector deals with similar problems. Pseudo US systems might be best the eliminate unnecessary paperwork.

This money saving idea about withholding treatment from ’self inflicted’ illness is both naive and lacking empathy. It is very rare to die healthy, if a person suffers prematurely because of obeseity, alcoholism, drug addiction, smoking, car racing, mountain climbing, skiing etc etc then they are requiring medical treatment early. The vast majority of people will require medical treatment when there body starts to wear out, not forgetting that cancer is what everyone gets if heart failure doesn’t get them first.

As far as saving money is concerned, if someone like myself dies tomorrow (I am 58)due to self inflicted enjoyment of life, just think of the money saved on state pension. If I live another twenty years, I will cost well over £6,000, and that is before medical expenses in old age.

haha sorry, what I meant to say was that if I live another twenty years I will cost well over £62,000!! before medical treatment.

@Angryvoter

Fair enough over the moniker thing.

What you find the the US is vastly more paperwork, which is why healthcare costs takes up a much bigger percentage of the GDP that here.

Let me give you the kind of figures:

Three years ago as part of a standard check up my (US) doctor discovered he could not do the pin-prick test for TB (since the BCG we all got at university here in the UK makes us positive). So I had to have an X ray – as a separate private radiologists office. That showed some little nodules in my stomach. So my doctor sent me back to the private radilogists office for a CAT scan. That caused enough worry that I was referred to a hospital oncology department. There I had two more CAT scans with a five week gap to check whether there were any growths.

As it happened there were none, and the nodules were probably there because I have been HIV+ (probably) since 1985.

The first thing you shoult note is that the medical care was excellent.

The second thing is that no one without insurance would possible get that level of treatment.

And then you need to know the costs:

I was billed (part to be paid my Insurance, a copay by me for)

4 physicians visits

For the X ray (around $400) and for the expert radilogists reading.

$4000 (four thousand) each for each of the three CAT scans, plus bills from the Hospital for seeing me (the hospital bill), a separate nursing bill, a bill for the radiological consultation after 4 weeks.

Altogether around $20,000 (of which I was supposed to pay perhaps $16,000) and, since I could not afford that, innumerable dunning letters.

Anyone who things that is an efficient system needs to rethink. And when it comes to how you feel, not only do you have to spend time worrying about having cancer, but how you are supposed to deal with the bills that come every day.

Because the NHS is now over 60 years old we have come the take it for granted. In recent years I have had a number of friends and family require hospital treatment. Upon visiting them I am amazed at the equipment that we now have to treat people. I am also aware that without modern medicine which is free at the point of use that some of the women who are closest to me and thier babies would have been lost during childbirth. We now take for granted that if someone has an accident that they are taken to hospital and treated. My Granddad told me a horrific story of when he was growing up in the 1930’s of a neighbour who had an accident working for a local oil refinery where he got badly burnt. This gentleman was not taken to hospital and was left to die of gangrene. When I asked why he had not been taken to hospital he replied that people weren’t back then. The people who wish to do away with our National Health Service seem to think that they will never have an accident or long term illness and that they will always be fortunate enough to be in a well paid job.

Angelina, the argument put forward by us anti-nationalisers is that there are better ways for healthcare to operate and be paid for than as a nationalised industry. The problem is, that people can’t imagine anything else. They presume that if there were no nationalised healthcare, there would be no healthcare. This isn’t true.

It is as if 60 years ago the government had nationalised food distribution. This is done on the basis that food is a necessity, that it should be free at the point of use, that nobody should starve because they have no money, and it is socially just, and so on. So 60 years down the line, you have a network of government food depots. The food isn’t very good, there’s never enough, there’s little choice about what you get to eat, people argue that other people are getting more food than they are and it isn’t fair, and politicians endlessly argue about how they can best fix the problems in the NFS, and whatever they do they never can. So some crazy libertarian argues that the NFS is a basically bad idea and food shouldn’t be provided by the government.

And because they’re used to it, people say, “but then, where will the food come from?!” They can’t imagine food being provided in any other way.

And when the crazy libertarian says, “It will be provided by the free market. Private farmers will grow it, and private shops will sell it,” people say,

“There would be no way to ensure people get enough food, farmers and shops would just care about profit, not feeding people. It would be all right for the rich, but what of my grandmother who depends on her food ration? She’d be dead now without it!”

This sounds silly because we know from the real world that private food production and sale doesn’t produce these awful effects, and has in fact led to a variety of foods unprecedented in human history. But if we’d had the NFS, nobody would know this, and libertarians claiming that such a result would occur from privatising food would be derided as nutballs.

There are more ways to skin a cat than having the government skin it for you.

Ian – the fact that at every US election, health cover reform is a major issue is testament to the fact that health provision there has been an unmitigated disaster – one which Hannan and his supporters would like to emulate here.

Tom, the American system is a mess in many ways, but that doesn’t mean a nationalised system is the right one either. For instance, the obvious flaw in the US system is employer insurance provision, thus meaning that the customer is the employer, not the consumer of the actual healthcare. The American Health Insurance industry effectively operates as a kind of privatised bureucracy that leaves its consumers bewildered and under-covered in some situations, without even the certainty of care that we have in the UK. It does need radical reform.

I’m not actually a fundamentalist on this issue, but neither should we just blindly declare that the NHS is beyond criticism as a model. The greatest problem with it is the same as that reported in the US- that consumers themselves have no direct power over it, since there is no direct contract between the sick individual and the health provider. You get what you’re given, and that’s it.

Ian, Thank you for debating with me. May I ask how you would feel about people on benefits being given money for health care as they now are paid so that they can feed themselves?