After coming from the land of Argos, creative swearing and free healthcare it is quite a shock to live somewhere where you have to pay for your healthcare seperately (I think this is an important distinction.) I would describe myself as a Liberal socialist with zero tolerence of crusties and anyone who cannot afford a lead for their dog, but even I can see that The National Health Service is an idealist, fiscal dead weight that needs some kind of re-assessment.
Alright, I know that the NHS is a national treasure up there with Brown Sauce, Thora Hird and Custard bloody Creams and I am going to be attacked for being some kind of neo-conservative, capitalist, morals’ prostitute with no feelings for my fellow man in which every human right has a price ticket and ethics are throw away feelings filed on the same shelf as kindness, compassion and kittens BUT it costs the UK a bloody fortune and my family have experienced both.
The comparisons are not that favourable.
So, before you’all come over all Billy Bragg and sit outside my apartment stumming protest songs spat through mouthfuls of wheatgrass falafels let’s pre-empt your argument:
Having a free at point-of-need health service is the bedrock of any humane society with a modicum of social justice. Making healthcare a system more efficient the more wealthy you are is morally bankrupt and teeters on the edge of eugenics and is the burgeoning of a UK caste system. Before you know it we’ll be screening foetuses at gestation for their potential earning potential and terminating any without prospects or the very least a strong line of credit.
Yadda-yadda – I hear ya. That’s established, okay?
In Swizzerland you have to pay for your healthcare (i’m not sure what happens if you don’t, maybe they just leave you in the road and you get swept up by the streetcleaners and recycled into new Swizzers by Nestlé). Healthcare in Swizzerland costs a lot: like, loads. Like, much, much more than you’d think it would. Nothing is free, not even healthcare for kids. It’s brutal.
BUT – and this is a big, fat hairy BUT – this changes the way that you get treated.
From experience, the NHS – because of the way that is paid for – sees a patient, assesses a patient and then decides what kind of priority the treatment has. Many factors – I believe – then influence who gets treated, how they get treated and when they get treated. I think the factors are: do they need immediate treatment? How well will they respond to the treatment? How long will the treatment take? This is, ironically, all related to money because the NHS has a finite amount of resources and they need to manage them properly so that a little goes a long way. For everyone.
The private system is different. Because you are paying for this, as a service, it is in their interests to find out what is wrong with you and treat you as quickly as possible. There is no question about whether you need immediate treatment or not, you just get it because the last thing the healthcare companies want is a perennially sick customer on their books who instead of working and paying premiums is sitting in a plush hospital drinking Nespressos. Because it is all about money.
- Example one: Both my parents were diagnosed and subsequently died from cancer. My father was diagnosed when he was 48 with Myeloma of the bone marrow. My mother was diagnosed with lung cancer when she was 73. My father was relatively young, fit and treatable. He was ripe for a transplant and got one. The care my father got was timely, extensive and professional. Speaking to a junior oncologist at the time, they heaped care onto him because they believed they could cure him. My mother, however, was old and her cancer was quite far along. The NHS – to all intents and purposes – washed their hands of her and left her to suffer (I mean this literally). They gave up on curative treatment (quite rightly, in my opinion) but sadly gave up on palliative treatment as well and my mother’s last few weeks were spent in considerable pain and discomfort. It was only the never-say-die (no pun intended) attitude of the Macmillan Nurses at the end getting her any form of pain management at all.
The point I am trying to make is that this wouldn’t happen here. Not because they are better doctors, or more caring or anything like that but because you pay for it and you get treatment, no matter what your prognosis.
- Example Two: Darling Wife, over the space of six months or so, had progressively worsening back pain. The local GP diagnosed her with sciatica and prescribed her with anti-inflammatory medication, physiotherapy and acupunctual therapy. This combination of treatments had no effect and her back pain continued to worsen. They said it was probably psychological. After repeated visits to the GP DW was prescribed stronger anti-inflammatory medication, slow release morphine and liquid morphine (FFS!!). My only experience with morphine was when my parents had cancer. I persuaded my – reluctant – wife to go and see a private back specialist in London to try and diagnose the real cause of this. The consultant was expensive but he quickly diagnosed her as having a severe prolapsed disc and immediately telephoned our GP to implore them to order an immediate, mobile MRI, in preparation for surgery. They refused because they disagreed that her symptoms were severe – even though she couldn’t walk, was on liquid morphine and had two small children to care for (I am not 100% sure what they consider to be severe. Death?) We then organised our own MRI (at great expense) and (through contacts) put it under the nose of a spinal surgeon who was horrified at my wife’s condition and scheduled in a spinal operation at the earliest possible slot. In the period between my wife was blue-lighted to hospital because she passed out because of the pain.
The point of this example is that the NHS didn’t treat my wife properly because – statistically – she was suffering from one of the most common ailments and was not a priority. The fact that they could have saved themselves a lot of time, bother and (!) money if they had properly diagnosed her from day one is irrelevant. Even when we had a respected private spinal consultant waving pictures-to-prove-it under the GP’s nose we could not make the system bend. This wouldn’t happen in a private healthcare system because that would be financial folly.
I am not arguing that the private healthcare system is better – it’s not. But I think that the NHS has something to learn from it. If you live in the UK you do pay for your healthcare, just not directly. There must be a perfect mix, but I am not sure what.