Blogging from the Highlands of Scotland
'From fanaticism to barbarism is only one step' - Diderot

Friday 1 February 2008

The sick mentality that guides the NHS

I just came across a letter from Ben Bradshaw MP, Minister of State for Health Services, to the Economist magazine and published in its 26th January edition - it has been lurking in one of my bags since leaving home and I only got around to perusing it last evening.

I can't find the letter in the online edition - perhaps I've not looked in quite the right place - so I'm going to quote parts of the lengthy second (and final) paragraph as what he writes there seems to me to encapsulate a lot of what is hateful about the mentality guiding the NHS:

"A fundamental principle of the NHS, supported by all political parties, is that treatment should be available to patients based on need and not on the ability to pay."

If you believe in the principle of socialised medicine provision, which I am not in any way sure that I do, then this seems inevitable. But for the sake of argument, let us suppose it is a sound way of doing things. What does it lead on to?

"Patients are, of course, entitled to seek private medical treatment if they so wish."

Now this is really decent of our political masters, isn't it!? They graciously accept that we have the right to deal with our own health care outside the NHS if we choose.

Of course, if you do take out private health insurance (as I and many others have) then it will cost you more than just the insurance premium. You will also pay a health insurance tax. So despite the seeming innocence of the 'State' permitting one to do something outside its control, they still want to punish you for doing so.

"Co-payments undermine the the principle of fair and equal treatment for all and risk creating a two-tier health service - one for those with the ability to pay and another for those that do not. Such a system would directly contravene the principles and values of the NHS."

When I read ridicuous communistic propaganda like this masquerading as a genuine concern with what is best for people concerned about their health I really feel like screaming and smashing some windows. Co-payments of various kinds have been a fundamental part, perhaps a regrettable part, of the NHS almost since its inception! Dental charges, charging for prescriptions and for various things connected with eye-care have a long history under the NHS. You can read a couple of websites which cover the topic in depth here (Citizens' Advice Bureau) and here (Socialist Health Association - not my usual reading, as you might rightly imagine!).

The pretence that the NHS is, or has mostly always been, 'free at the point of need' is fine as a slogan, but it has never been more than an aspiration because of these pesky little charges tagged on. Then of course come the exemptions from payment - adding a huge layer of bureaucracy to the whole edifice in order to administer them.

But of course these are not the co-payments which Mr Bradshaw is referring to, because all the others have become completely orthodox over many years. No, what M Bradshaw objects to is people paying for addtional drugs privately, not available under the NHS, to enhance the NHS treatment they are getting for illnesses such as cancer. Basically what he wishes to establish as a principle is that if someone gets additional treatment privately for something that they are already being treated for under the NHS, then that NHS treatment also becomes chargeable! Have you ever heard of anything so ridiculous in all your life? Or unfair?! Or mean-spirited?! Or simply wrong-headed?! What principle exactly is Mr Bradshaw trying to protect? If NICE (National Institute for Clinical Excellence) say a drug may not be prescribed under the NHS, ostensibly for reasons of lack of efficacy, but in reality as a cost-containment measure, what possible harm can it do for someone to use their own money to buy the drug? And in any case the patient would still have paid his/her contributions to the NHS over the years so why shouldn't they continue to receive the treatment they other wise would have if they hadn't opted for additional private treatment. It's not as if the government is going to offer them some kind of refund for treatment it will thus be with-holding.

What it really boils down to is the 'State' saying to citizens (i.e. we helots) that if everyone cannot have something, then none may have it. Or at least not without suffering enormous additional cost.

The sooner the State gets out of the business of directly influencing medical treatments, or teaching or any other state-provided service for that matter, which are more properly the province of relevant professionals, the better it will be. Prescription charges are a very long-standing form of co-payment; why is some poor lady who wants to spend her own money on a drug like Avastin being punished for doing so? Logically, if you follow this line of reasoning, I should be charged for all my doctor visits (very rare as a matter of fact) whenever I pay for a prescription for my anti-eczema ointment. That's how illogical and mean-spirited and condescending is Mr Bradshaw's whole sad premise.

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