The first post of 2013 comes to you from the cardiac care unit of the QEQM Hospital in Margate. Three days ago I collapsed for the second time in two days; an ambulance was called and a paramedic arrived within 5 minutes, with a full ambulance arriving inside a further five minutes. The NHS at its amazing best. I am well looked after.
This is how the NHS should work; public services provided by the state quickly, efficiently and directly. Yet a couple of weeks previously I had an example of just how the NHS should not operate. I returned from Ghana with a persistent ear infection, resulting in pain, deafness and loss of balance. I went to see the GP who agreed to refer me to a consultant. A few days later, instead of an appointment, I received a letter outlining the NHS “choose and call” programme listing a number of hospitals and phone numbers, and giving me a code to use to book an appointment. This is all in the name of patient choice.
But I really do not want this choice. I want my local hospital – and every local hospital – to have an ENT consultant working to a high standard who can sort out an ear infection. Then I want an appointment to see them quickly. I am not buying a novel or a washing up liquid. The idea that every transaction involving provision of state services should be based on an expensively created and entirely artificial market mechanism is an ideological frippery. Behind that letter lies a mass of administration to record my choice and shuffle invoices and financial transfers between my GP’s practice and whichever hospital I pick. Those invoices and transfers are all entirely internal state administration yet add massively to – multiply – the cost of simply getting a man to look down my ear canal.
There is a parallel here to the private sector distortion by which the middlemen who transfer the money for transactions have contrived ways to complicate that function until they are the major beneficiaries of economic activity.
Thankfully in emergencies this craziness is not yet applied. But I do not rule out one day being stretchered into an ambulance, asked where I want to go and handed a telephone.
Kempe 5 Jan, 2013 – 5:54 pm
“How would that have worked and in what way was I “suckered in”?”
Really? You cannot speculate how it might work? Well lack of imagination is a sucker’s trait. Markets are constantly rigged in a multitude of ways.
That you believe privatisation can increase hospital efficiency by 1200% is plain stupid.
The (private) us health care system is the least efficient of industrialised countries. The nhs is second most effecient. Here’s one quote from an oecd report:
“In 2008, health care spending in the U.S. reached $7,538 per capita—far more than in any other country studied and more than double the OECD median of $2,995.”
http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jul/1532_Squires_US_hlt_sys_comparison_12_nations_intl_brief_v2.pdf
But just in case you think that americans are sicker than everyone else, here’s another quick comparison: Cataracts cost £741 per eye at the nhs. Private hospitals averagely charge £1,800.
http://liberalconspiracy.org/2010/03/10/nhs-more-productive-than-private-healthcare/
One last observation: “…carpal tunnel syndrome is caused by making the same hand and wrist motion over and over”.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001469/
Made me laugh.
Anon, thanks again. Do you have a link to the Kelly documentary other than the one I posted please?
Market madness: 2 pairs white sports socks for a pound.
Our elected reps, from pissed MPs at the Westminster cess to toun cooncillors draped in gold -whilst the people wasted for want, have for a long time been the creatures of middlemen; vulgar calculating tiny minds, these merchants ramping up the price of goods, speculating in new ways to the mass of a people’s ruin, producing or creating nothing. Bodies who meets in secret counsel to plot and betray those they rule interminably. Top hats and foppery, no basis for anything but idleness, vanity, turmoil and wreck.
Those who celebrated the nation’s ruin at Culloden, drunken debauched affairs distinct from universal mourning due to such wanton bloodshed, the flower of Scotland slain; these parasitic choking weeds prevail still, toasted the butcher Cumberland’s vile and barbarous excesses, you should have seen the bill from French wines, cruel monsters rule, no hell of the imagination could match this earth with such upon it.
All primed to respond with the militarised civil power and the regimented heavy stuff then as now, if the people so much as assemble.
Keep them on their toes.
We revolt tonight!
GWS Craig, it’s the dread lurgy due to overwork, cut it back, get out the smoke, take up smoking, soon be fighting fit again.
“There may not be enough ENT consultants for one in every hospital. Even if there were, there may not be enough work for them to do at a local level so they have periods when they have no work to. But they would still get paid, and consultants are not cheap to employ.”
ENTs allocated to patients locally can at one extreme be fully utilised and at the other extreme fully redundant. If they were distributed randomly they would tend towards 50% utilisation, complicated only by overall ratio of supply to demand, which is an over arching factor in any case.
The natural 50% utilisation tendency can (and should) be bettered very easily by adjusting ENTs boundaries- like jerrymandering. It is very easy to arrange mainly, a level of utilisation which is productive and has headroom to cope with sporadic demand.
If we get into the business of sending people on extended searches and journeys to get to see idle ENTs – for that to have a significant effect, we need to send significant numbers of people on significant journeys, we will require poor utilisation to continue doing so. And the maximum benefit of this complication to a properly managed local allocation system is fractional, except when the system of local allocation can be messed up and denigrated to the point were sending significant numbers of patients on extended journeys to unfamiliar and less utilised places seems like a good i-deal.
John Goss,
Found a preview of “Aperture-The Death of Dr. Kelly-An Open Case” at http://www.presstv.ir/doc/detail.html?name=Aperture-The+Death+of+Dr.+Kelly-An+Open+Case
Craig , best wishes for a speedy recovery . Your blog and excellent links provided by fellow posters always a ‘ must read ‘.
David Halpin earlier. A correction. That was the Centre for Policy Studies, not Research.
Set up by Keith Joseph in 1974 and endorsed by the Leaderene in 1979.
‘I do think we have accomplished the revival of the philosophy and principles of a free society, and the acceptance of it. And that is absolutely the thing that I live for. History will accord a very great place to Keith Joseph in that accomplishment. A tremendous place because he was imbued by this passion too. We set up the Centre for Policy Studies, and it has propagated those ideas, and they have been accepted.’
Margaret Thatcher, 1979
The present board. Just some of the usual suspects with the usual connections – Goldman Sachs, Rothschilds, J P Morgan etc and headed by Lord Saatchi of ‘Labour isn’t Working’ fame who brought Thatcher to power.
http://www.cps.org.uk/about/board/
:::
Phil – good riposte.
thatcrab, 5 Jan, 7:00 pm, NoScript can block iframe, but it is not enabled by default on the version I’m using here. iframe blocking can be enabled on the “Embeddings” page of NoScript’s “Options”.
Thanks Clark, I didn’t realise. I have just enabled blocking iframes.
If anyone is not using noscript you should consider it. It makes for far, far safer web browsing.
https://addons.mozilla.org/en-US/firefox/addon/noscript/
Techno, 5 Jan, 6:53 pm, I’m not opposed to market economies; just ask Cryptonym, whom I expect reserves various terms of abuse for the likes of me. But all medical software should be open-source, free (ie. libre, GPL etc.) software. Our medical records are just too important and personal to consign to systems whose operation is a trade secret.
How is your company’s software licensed?
Best of luck Craig. Any pretty nurses there?
Hurrah for Cryptonym. We WILL keep the parasites on their hairy legs. Someone raised the fact that Bonnie Scuitland (under another doubtful specimen) has no D9 of a ‘Health’ and Social ‘Care’ Bill doing its worst. And Wales too is immune. I cannot recall this remarkable distinction being made anything of by the ZBC. Its agenda is plain to see.
David Kelly Doc confirmed at 01:30am UK time (just saw it on Press TV advertised for that time). Will be repeated often during tomorrow I would think.
Press TV live links at their website. http://www.presstv.ir/live.html
Livestation app carries Press TV so you can watch on a phone/pad as well as PC now they’ve been kicked off various satellites.
@Mary..heard the same rumour…all over the net..Hope Craig is resting peacefully in hospital and has not heard about this…if he has then he will be charging up to London as I write…
Very sorry to hear of your condition Craig and I wish you a speedy recovery. You’re a bit young to be having cardiac problems. I know you don’t fear death and that is admirable but if you fancy reaching sixty – if only for the hell of it – please start looking after yourself properly.
Thanks Anon. You’re a star. Don’t know whether I will be able to stay awake for the Press TV documentary on Dr Kelly’s death. But thank you. It should be informative; much more informative than the Hutton whitewash and the Grieve cover-up.
Even though you persist in believing in this “democracy” nonsense, may I offer wishes for a speedy and complete recovery.
“But all medical software should be open-source, free (ie. libre, GPL etc.) software. Our medical records are just too important and personal to consign to systems whose operation is a trade secret.
.
How is your company’s software licensed?”
.
Its old products are written in MUMPS: http://en.wikipedia.org/wiki/MUMPS
.
What I work on is closed source. Most open source software started out as closed source. I don’t really see why it couldn’t be open source in the long run because, as is normal nowadays, the data is kept entirely separate from the code, and I would agree that it is in the public interest. But in the short run we have to respond quickly to technical problems – there is 24 hour support – so we have to have complete control over the code.
.
I would prefer to work with open source but I needed a job 🙂
“That you believe privatisation can increase hospital efficiency by 1200% is plain stupid.”
I never mentioned privatisation. I dread privatisation of the NHS. My cousin spent Christmas in an HDU at his local NHS hospital, previously he spent two years in an NHS hospital being treated for carcinoid cancer. I’ve no illusions that under the US system he’d have used up all his insurance, been unable to get further cover and been left to die. I was offered the choice of attending other NHS hospitals but declined because of the travel difficulties.
“One last observation: “…carpal tunnel syndrome is caused by making the same hand and wrist motion over and over”.
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001469/
Made me laugh.”
Oh aren’t you the clever one. Why not come straight out and call me a wanker if that’s the best you can do.
Techno wrote
I’d just love to think you still had an old PDP-11 sitting in the corner running it all 🙂
Craig, I sent you the requested details via the contact form. (I’m currently migrating between PCs and homes, so it’s a better option than email right now.)
I’m definitely feeling better today, just a residual cough and aches. No significant chest pains since Thursday; I hope it’s the same with you. A good remedy is an instant hot toddy (Lemsip + whisky) – I’d recommend some of that special extra-smooth 18yr-old malt.
Kempe
5 Jan, 2013 – 3:49 pm
“I’ve had to use “choose and book” recently and not had any problems with it. About five years ago I had to have a minor operation and was offered the choice of going to the local hospital (6 month waiting list) or a treatment centre a bit further away (two weeks). No prizes for guessing which one I went to.”
Kempe, treatment centres were set up to alleviate pressure on hospitals that were inundated by demands from patients with minor ailments. These extra demands came about under John Major’s Patient’s Charter.
You don’t say what minor operation you required but it was obviously not serious enough to place you at the front of the queue at the local hospital. The NHS works on the basis that those most in need get treated first; waiting lists are inevitable under this ethical position.
Had you had the money though you wouldn’t have to wait even two weeks; you could have gone private.
What makes matters worse is the continuous underfunding of the NHS since Mrs. Thatcher and on under Major, Blair, Brown and now Cameron; the idea being to destroy the ability of the NHS to maintain its position as the best in the world. No private company could ever compete with the NHS at its best so it has had to be undermined (and has been undermined) by successive governments keen to let the private sector in.
The message has always been that the NHS costs too much and must be economised. If overfunding the NHS got us into national debt what a terrible thing that would be – to have doctors and nurses with relaxed schedules, inefficient waiting rooms.
Now we are in inconceivable debt sprung on us by stinking rich bankers – better squeeze more out the NHS!
Kempe 5 Jan, 2013 – 10:02 pm
“I never mentioned privatisation. I dread privatisation of the NHS.”
Your comments seemed to support the internal market and privatisation of the nhs. Why didn’t you correct me before? And quite what where you saying then? Nomatter, my mistake.
Come on, my insult was almost carry-on funny. Really, it was too obvious to resist. I did try. But you are offended so please accept my apology.
Fight the cuts comrade! See you on the street.
“Now we are in inconceivable debt sprung on us by stinking rich bankers – better squeeze more out the NHS!”
Heh. I have to say this is wise economics; privatitize profits, socialize the losses. Makes good sense, doesn’t it?
It makes sense like, prescribing cortisol in vip lounges instead of surgeries.
Blimey. I wonder, is the cardio issues in any way related to Craig’s, ah, ‘unfortunate’ imbibing of substances that may or may not have been put there by someone in securitat. Allegedly, etc.
And as to the NHS, this just depresses me no end. Whenever you say the NHS is being privatised, and we are going to go along the US route, a Tory clown (sometimes Bumface himself) from the insta-rebuttal unit scoffs and mocks, and belms out a one-liner (‘free at the point of care’, ‘freedom of choice’, ‘no US model’). But, they are telling porkies. It’s that simple. They are telling whoppers – and getting away with it.
And, alas, we can’t blame Evil Tories. It’s the Labour Party who are doing fuck all; here they have an easy win: a whopper vote winner, defending the NHS, which was set up by Labour Lions like Attlee, a chance to reach across the spectrum whilst, curiously, being able to draw back some of their core vote. But they are just too timid, I can’t explain why. Milliband doesn’t appear to be a bad guy, I don’t get chills like I do with Bliar (and Obama), so I’m not really sure what the timidity is all about. Very odd.
Basically, certain interests have been after the NHS and the welfare state since it’s inception – they just waited for a better moment. And now we have it, apparently.
What a horrible way to start the New Year for you.
Best wishes for speedy and complete recovery.
You’re right….. the NHS can and does deliver something almost miraculous day after day.
They do this despite politicians of course and certainly not because of them.
hey, they get things wrong though sometimes….that ear infection of yours should have been picked up much much sooner….the symptoms were there….I mean your lack of balance isn’t something new….and that your deafness was willful was an assumption that should have been investigated. I hope the pain goes away though.
The dirtiest thing about that comment was how it brings up pain right at the end. Quite twisted, but i dont expect Craig will be reading these in his sickbed.
Good grief, I `feel bad for my irritation at a lack of blog updates – sorry Craig, please get well soon. The world needs you to keep contributing to truth and justice.