And Another Thing…

Tom, just out of curiousity, what is more important to you. That healthcare is free at the point of use for those that need it when they need it – or the structure of health service and who owns what?

Serious question because I just don’t understand why the structure is a sacred cow if another structure can provide the same frontline result to someone with different backend processing?

This lady clearly talks a lot of common sense about the NHS. Time the whole mess was radically brought up to date. I doubt that Cameron will fall in with all such radical ideas, no such luck.

Maybe you should talk to my MP Mr Twigg about conversations I’ve had about my dealings with the NHS…anf the fact that the minister (Mr O’Brien) said he wouldn’t introduce a change that ensured Consultants could talk to GP’s

Anyone willing to reform the bureaucratic hegemony that is the NHS has got my vote

Why should we be concerned?

It would be wholly irrational to believe that any of Cameron, the NFR or conservatives more widely would want to make changes that makes healthcare provision in the UK worse. Anyone interested will want to make healthcare provision better.

There is certainly an argument that competition will force efficiency and quality. In addition, it must surely be in a health service or system user’s interest to be able to decide for themselves whether they can use their health funding for a certain drug or service or not, rather than leave it in the hands of NICE.

Keeping the NHS for the NHS’s sake is clearly not debating the issue and rather than engaging and explaining why state provision of healthcare is better, is simply a base emotional appeal to voters.

Their ideas deserve consideration, discussion and engagement, not simply to be dismissed out of hand. Convince us!

I’d rather he listened to many different opinions in order to reach an informed decision – rather than commit himself to the status quo simply because a section of the population considers it a ‘sacred cow.’ That applies to the NHS and any other inherited policy.

There’s a classic problem with the ‘provider of last resort’ argument.

Universal payment.

If everyone’s paying…as they would have to, even with a stripped down version…everyone would demand at least the option of partaking.

I’m in favour of change in the NHS. And an element of private involvement is necessary and desirable I think.

Government must define its future position vis a vis the service far more clearly. But anything approaching the expensive and ineffective US model would be completely barking.

The Tory party is far more open and willing to consider the best ways of doing things, as you can see from Toms post he is just governed by the past.
Why do you critisise talking to all concerned. There are many ways to solve problems and the more you look at the more likly you are to come up with the correct answer. You have a lot still to learn Tom.

Don’t worry, Tom: Cameron slurps the purple pole of social democracy just as hard as you do. The NHS won’t get any useful reform while he’s in charge. It will still be as expensive and useless as it is now.

“I think we should be told.
And I think we should be concerned”

You mean like we were told that there would be no tax rises under a labour government in 1997 – or that we should have been told that Gordo was going to wipe out chunks of our pension funds etc etc etc. Get real Tom!

This is a poor piece again. Has it escaped your notice that as it stands the NHS is pretty much unaffordable? It accounts for a vast chunk of public spending (to wit we are borrowing £178 thousand million pounds this year just to bridge the gap on); it the WORLD’s 3rd largest employer after the indian Railways and the Chinese army)and a huge number of its employes are not involved in delivering front line care.

Exploring anything that might drive some efficiency into the NHS can not be a bad thing. If the NHS is left entirely untouched I really can not see how any budget is ever going to get balanced.

You guys have really lost just about all perspective financially these days. There seems to be practically zero acceptance that we just can not afford everything everybody wants.

Finding ways to save money by delivering things in a different way is a “must do”. In principle there can (should) be no “sacred cows”. That does not mean you slash & burn on an indiscrimiate basis, it just means that everything must be subject to an examination.

That you are engaging in the “politics of fear” on stuff like this is pretty grim to be honest.

Tom
Which is more important- Free health care at the point of use, or that health care is run by the state?
Answer this question first, then critiques such as this blogpost will be better respected.

If the state is going to spend a lot of money on anything then health should be pretty high up the list.

Having said that, most people recognise that we spend a lot more than we actually receive.

Your criticism of their criticism of the US system was unwarranted. The US system costs more per person and delivers less than the health system in any other industrialised country.

Paul – you misinterpret my criticism of the NFR’s criticism of the US health system. I deplore the US system, but for rather different reasons than does the NFR. It is too much the product of private health providers and private insurance. NFR believe it is over-regulated and not private enough.

Forgive me if my original text was a tad ambiguous.

From the Washington Post last year:

“Sixty-two percent of all bankruptcies filed in 2007 were linked to medical expenses, according to a nationwide study released today by the American Journal of Medicine”

This is the brave new world that these free-market zealots want.

“I think we should be told.”

Totally and utterly agree.

How about a simple bill that says all political parties have to publish a list of which lobbyists it has talked to, which have pai into a party’s coffers and which are funded by the Government (or party) eg the fake charities ?

I’d treat what Dr Helen Evans says with quite a large pinch of salt. Incidentally, the ‘Dr’ refers to her PhD in ‘Health Economics’. All that means she’s good at academic theorizing, and coming out with gooblydegook like this:

Significantly, NFR believes that all hospitals – as independent entities – should be allowed to pick and choose from a dynamic, fluid and demonopolised labour market. The totally counter-productive idea of nationalised pay agreements must be abandoned forthwith.

That’s as clear as mud then. My sister-in-law is a GP and – although she’d be the last person to say the NHS is perfect – she’s quite positive that on the whole it’s in far better shape now than in all the time since she started practicing in the early 80s.

If it ain’t broken, don’t fix it.

Tom:It is too much the product of private health providers and private insurance. NFR believe it is over-regulated and not private enough.

Your original comment was potentially ambiguous, but I knew what you meant.

I am interested in how you know this though. Have there been many economic studies into why the US system is chronic, especially independant ones…

I am assuming (as my info is over a decade out of date) that most of them would conclude that the problems are less to do with public or private but more to do with competing interests. Although I cannot see how a health industry could be overregulated.

Strangely I can easily see how it can be over-funded though, but it would appear Labour cannot.

Why should your voters be concerned?

According to the Adam Smith Institute the NHS is the world’s 6th largest employer.

As for the “politics of fear”, what do phrases such as “the NHS is pretty much unaffordable” constitute? The politics of hope?

The sordid state of the US health system shows that the application of market forces to healthcare is ineffective, moreso than the state system. It has not indicated that private sector healthcare offers any improvement to quality or lower the price of the system. As a percentage of GDP, the US spends 60% more than Britain. And still there are millions of US citizens without any coverage wahatsoever (15% – roughly 45 million people) and many millions more with only very basic coverage. The US ranks 67th in the world for immunisation – behind Botswana.

It is ironic that this largely private sector healthcare system ends up costing the taxpayer more than a public sector one.

Any new ideas which can help improve the quality and efficiency of healthcare in this country should be welcomed. But wholesale privatisation is, well, a bit old hat.

If one were to look at an alternative which could be an improvement, then why not the French system, rated as the best healthcare in the world? Having said that, the French spend much more on their health than we do, about 33% more.

As for this meeting that Cameron had, it sounds a bit like he’s giving Tory-sympathetic groups lip service to rally support in the run up to the General Election.

Well for all the armchair critics who say ”why do trade unions fund Labour” here’s your answer.

Well done David that’s a nice shot in the arm for Labour’s campaign funds from UNISON.

What a diddy (am I allowed to say that?)

I think we should be concerned and told too (so much so I have blogged about this twice already on LC and my own blog lol!) But seriously, I agree with your general conclusion; it shows how unsafe the NHS would be in Camerons hands I think.

What a phenomenal amount of blinkered thinking. How anyone can seek to defend a privatised insurance system that can delay expensive and urgently required treatments while they are “being reviewed” until the poor unfortunate is too ill and near death for the treatment. A system that can claim some people are too ill to be eligible for health insurance and are left to rot.
A friend whose father is a miner in Virginia, USA told me how his own father was forced to continue working becoming increasingly ill from a lifetime of mining related injuries and conditions even contemplating postponing his retirement as his wife has multiple sclerosis and required the health insurance cover that came with his job. Literally working himself to death.
God help the UK accepting such a brutal and inhumane system.
Hats off to Michael A for giving a more sobering and honest view of the USA’s inequities.
And why is it always the USA we turn to as an example of other healthcare mechanisms when we have world class health care being given miles off the South Coast of the UK. France and Germany have excellent health systems and yet it’s the USA we always hear about. It seems there are many sacred cows as well as the NHS.

Nicky,

“I’d treat what Dr Helen Evans says with quite a large pinch of salt. Incidentally, the ‘Dr’ refers to her PhD in ‘Health Economics’. All that means she’s good at academic theorizing, and coming out with gooblydegook…”

Well, since health economics is the economics of running a health service, I suspect she may be quite well qualified to comment. If however you believe that all academics do is theorise and come out with gooblydegook (congratulations, you’ve joined the ranks of those opposed to evolution) then maybe we should only take the opinions of the stupid and the ill-informed.

On the other hand, perhaps we should have an open mind about things. Talking to someone who has different suggestions is always useful, even if you do not plan to implement them. As several commentators have pointed out, it seems to be a bit narrow-minded to only believe there is one possible way to run a free-at-point-of-delivery health care system, and anyone who says that the system cannot be improved is not so much dunder headed as insane (all systems can be improved, however good they are).

So those opposed to this meeting, giving them due credit for believing what they say and not merely trying to whip up a political storm about Conservative NHS cuts, are displaying worrying anti-intellectual and close-minded tendencies. If you want a dogmatically controlling government suspicious of free thought and innovation, try North Korea. Or Cuba – apparently they do have a fantastic health care system; pity about everything else.

But seriously why should we be concerned?

The NHS is devolved.

Indy – you perfectly epitomise the narrow-minded selfishness that is part and parcel of Scottish nationalism: “We’re alright, Jack – why should we care?”

I think most people in Scotland will be concerned if they thought the Tories intended were planing to introduce policies harmful to the NHS in any part of the country. And if such policies were implemented in nine tenths of the country, it would be absurd to suggest those policies would have no effect at all on the small part of the NHS which is devolved.

Accusing me of narrow minded selfishness is not really an answer.

Your voters will not be affected by Tory policies on the NHS because the Tories don’t control the NHS in Scotland and never will.

Or are you suggesting that David Cameron intends to reverse devolution?

@Indy

Apart from setting light to the blue touch paper in West Lothian, are you sure you want hordes of English ‘health tourists’ coming over the border every day looking for decent treatment?

Paul – that’s what they said would happen if we introduced free personal care. It didn’t happen.

Indy – I expect that a lot of nats wished Obama’s health reforms well. And yet when it comes to the health service in another part of our own country, they couldn’t care less.

With respect that’s quite a silly comment. Naturally I hope that the USA reforms its health system but I have no direct concern in it. It is for the American people to decide how to organise their healthcare system. The same applies here.

You must know that there is as much chance of Elvis being found alive and well and living on the moon as there is of Scotland accepting the kind of proposals being suggested by this group. In reality it is not something that is going to concern your constituents, even if they find it interesting.

If anything like this does go ahead in Ebgland (and I for one sincerely hope not) then there would be riots in the streets, particularly as no such thing would happen here.

We are going into uncharted territory here. Perhaps we will act as a brake on the worst excesses of Tory madness.

Or perhaps not.

Interesting times ahead.

Apols I was assuming for the basis of that post that the Tories one (for the sake of argument).

that the Tories won, even.

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