September 22, 2006

The last bastion of Socialism

Polly is trying to defend the last bastion of Socialism.

Last year I unfortunately had to go to a NHS hospital. It took threats to transfer myself to another (better) one 20 miles away (which I would have done despite the broken ankle, and would have done had there been anymore waiting) to get any service. The hospital was disgusting, the ward was filthy. The nursing was so poor they actually got my notes confused with another patient down the ward, and at one point said I could not go home after my operation since I had not had my operation due to a (non-existant) heart complaint. The person in the bed oppersite me had come in for a minor complaint and was getting his veins burned out because of the anti-biotic they where using was having a bad side effect. I never want to go on the NHS again.

Where it not for the exorbitant amount that I'm forced to pay for a system that I do not want I would be perfectly able to afford private health insurance, and still have more money left each month. I could then spend this on things that would keep me healthy. Like being able to eat every day.

The problem with the 'internal market' wasn't that it introduced a market, but that it didn't. It didn't matter if the numbers added up or not, it was alice in wonderland accounting. It didn't matter what level of service was offered. All it did was create a large layer of bureaucracy.

The problem with PFI isn't that it has introduced a market, because it hasn't. Not PFI scheme can ever be allowed to fail by government, so all the risk is still bourne by government. This means there is none of the 'creative destruction' that allows the market to find the most efficient way of providing a service. PFI is simply an expensive way of hiding debt off the balance sheet.

Under the current centralised structure the NHS will never get better, it cannot. It will simply roll from one crisis to the next. Nobody can manage something that big. But there are other ways, the best health system in the world is sitting just across the channel in France. Why not use that? Or if you have an alergy to insurance maybe the decentralised Swedish model? How about the model used for General Practice and Prosthetics within the NHS, that of small companies (often Co-Ops) competing with each other to provide the best service in order to secure contracts? There are other models, all of which will work better than the NHS because the NHS is simply unworkably big in its current form. The only reason to try and defend it's current structure is if you have some deep seated and irrational love of big government that outweighs any desire to see sick people get better. But then this is Polly Toynbee.


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