The Notional Health Service 101


Today is my 66th birthday, so I am hoping that you will forgive an article that is at core the anecdotal ramblings of an old man.

It was inspired by horror at Wes Streeting (I could end the sentence there but I shall continue it) ‘s plan to give weight loss jabs to the unemployed.

The unemployed are more likely to be underweight than the population average, and this attempt to portray the unemployed as lazy couch potatoes is vile in many ways. Its masking as an “investment” in the economy by Big Pharma is chilling.

If it goes ahead, how many years do you think we are away from those who refuse to have the drug injected into their veins, having their benefits stopped?

How are we to view this attempt to use the “unproductive” as lab rats for Big Pharma?

It has also been announced that the government is to send employment advisers into mental health wards to try to get sick people back into work. This is astonishing. It is extremely difficult to access any mental health care at all on the NHS.

To get residential care requires in truth a level of mental health crisis that indicates a threat to life of yourself or others. Yet people from mental health wards are going to be got into work, when there are hundreds of thousands of perfectly well people desperate for a good job who cannot find one?

What is the purpose of this nonsense other than propaganda and stigmatisation of the unemployed?

Which leads me to my anecdotes on the NHS and its purpose.

Sixty years ago or so, when my siblings or I were sick enough to be in bed, my mother would phone the surgery and the GP would come to our home to see us. This was perfectly normal. It is probably difficult for Generation Z to believe this really used to happen.

Now if I am sick enough to be in bed, I have to phone the surgery precisely at 8am and go through the lottery of getting in to the phone queue, rather than the engaged signal as the queue is at capacity. I may have to call numerous times.

If I do manage to get into the queue I have to hope I get to the front of it before all appointments are taken. If I fail, I cannot make an appointment for the next day but have to try my luck again then, once more at precisely 8am, while a hundred other people are trying exactly the same thing.

If I am fortunate enough to make it through the queue, I am de facto triaged by a receptionist with no medical qualifications but to whom I have to explain my medical symptoms.

She will then, if she thinks I have a case, explain my symptoms to a doctor and I may come out of this process, not with the doctor coming to my home, nor with me attending the surgery, but with a phone call from the doctor and a down the line diagnosis.

I find that everybody I have spoken to – and from all parts of the UK – has to put up with the same system. I cannot believe we have fallen in to accepting this.

It is not medical treatment. It is not a national health service, it is a notional health service.

If I feel really bad I can attempt to bypass the system and go to the hospital Accident & Emergency service, which I will find clogged with scores of other desperate people, waiting hours and hours to try to get medical attention.

I have not told this story before, but about three years ago I was invited to a party in Ealing after one of the Assange hearings. I had just one glass of wine and started to feel dizzy and nauseous, so I made my excuses and left.

I got a taxi back to the hotel near the Old Bailey where I was staying, but collapsed in the street just across from the hotel. I vomited and could not stand up. The problem was my heart condition. I phoned 999 and was told by the ambulance service it would be approximately three hours before an ambulance could reach me.

Passers by assumed I was a drunk or drug addict and gave me a wide berth. After a very cold half hour (it was I think February) a group of Irishmen stopped to help me and carried me into my hotel. I quite soon fell asleep on the bed and the next morning felt fine – and went back into court.

I spent several months this year living in Greece. I had very bad bronchitis and pitched up at the local rural medical centre, the equivalent of the GP surgery. I was seen immediately by two doctors, examined at length, X-rayed and given an ECG and left with prescriptions, all within an hour of turning up.

Some months later I fell and dislocated my shoulder, in a highly remote rural location and after midnight. An ambulance arrived within half an hour and drove me for 90 minutes to the hospital in Volos, where my shoulder was reset.

Now here is the kicker. UK spending per capita on public healthcare is twice Greek spending per capita on public healthcare.

Yet while we spend twice as much, the experience of this patient (I did warn you this is going to be personal and anecdotal) is that key aspects of the Greek system are far better.

The NHS is in a state of near disaster. The reason is that it has been hollowed out for private profit, with the designated “profit centres” which give a high return hived off to private contractors (though not visibly to the patient), and the public purse left paying for the complicated and expensive bits.

Of course, we hear from those the wonderful stories of great care.

The reason we pay such a huge sum per capita for public healthcare – £3,600 a year for every man, woman and child in the UK – and get such a totally unacceptable service in return, is that private companies are sucking out the money for profit.

10% of NHS patients are in fact privately treated, overwhelmingly for the cheapest and simplest problems, and private contractors suck 18% of the NHS budget.

I do not pretend that reform is not needed in the NHS – but getting out the private bloodsuckers and removing the profits would be a good first step.

Renationalisation of the NHS is urgently required.

If it were not so profitable then private healthcare lobbyists would not be bribing our politicians. Keir Starmer, Wes Streeting and Yvette Cooper have between them received over £750,000 from private healthcare lobbyists and companies.

As with the Israel lobby, the essential corruption of our politics is what drives the entire policy agenda of the political class. There is an overwhelming case for banning elected politicians and their parties from accepting large donations.

The chances of this happening short of a revolution are zero.

May I urge you to look at this video of the public meeting we held on the NHS during my Blackburn election campaign. Leaving aside my very obvious exhaustion, I was absolutely fascinated by the speeches of Mary Whitby and Dr Bob Gill.

Purely in terms of its content, I think paradoxically this small gathering was one of the best political meetings I have ever witnessed. I absolutely promise you it is worth your time and attention, and you will come out of it looking at the NHS in an entirely different light.

I most certainly did.

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101 thoughts on “The Notional Health Service

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  • zoot

    happy birthday, Craig. it is totally brazen now what they are doing. yesterday Streeting appointed arch privatiser Alan Milburn to oversee NHS ‘reform’.

    it can be this brazen because they know the media is firmly on board with getting rid of the NHS as a socialist healthcare service. 

    that National article you link to is a total anomaly as far as I am aware. no major outlet has ever informed the public that Starmer and Streeting are paid stooges of private healthcare interests. or will ever.

    they may mention Starmer’s suits, apartments and tickets but not this vital fact. (similarly the £4m donation to Labour on the eve of the election from Israel arms investors).

    instead they are going to pretend all the way that Starmer, Streeting and Milburn are passionately concerned with patient health and making the NHS better. 

    all the way.

  • no-one important

    Many, many happy returns Craig,

    Your experience of the NHS mirrors my own remarkably closely. Because I am well past my allotted three-score and ten the doctor insists that I attend his surgery every now and then so that he can prescribe the various pills and potions pushed by the Pharma companies. I let him prescribe them but never take them and everyone is happy. On Tuesday I had to visit the practice nurse at 10.30 hrs. I entered the otherwise empty waiting room and sat down. At 11.05 – 35 minutes late – I was beckoned into the nurse’s room having seen no-one else leave her room beforehand. I left five minutes later, minus about 10cc of blood and there was still no-one in the waiting room. I can’t imagine where the GPs are – obviously beavering away somewhere seeing all those people who managed to get past the obstacle course of busy phones, no appointments left and Rosa Klebb behind the reception desk.

  • Ewan2

    People will go and take the jab, after all they took the Covid not-a-vaccine. And as with Covid there will be the people who will scream invective and bile at others for not taking it

    I imagine the Covid hoodwink was driven entirely for the benefit of the corrupt political and corporate classes.

  • Tatyana

    Happy birthday, Mr. Murray!
    Sincere congratulations from your devoted admirer!

    I imagine that you may have doubts and perhaps think that Tatyana is
    T – tricky
    A – agent
    T – that
    Y – your
    A – audience
    N – naively
    A – adore
    🙂
    I am a little upset by this, because from my point of view Tatyana is
    T – trustworthy
    A – amigo
    T – that
    Y – yourself
    A – actually
    N – never
    A – appreciated
    🙂
    I wish you on this wonderful day to raise a glass with your loved ones and look to the future with optimism.
    I promise to raise here a glass of champagne to your health today 🙂

  • Lulu Bells

    Happy Birthday Craig.

    Thanks for this article, I thought it was only here that we had no access to a GP but you describe exactly the scenario we are faced with.

    On two or three occasions where I have visited the GP surgery (not to see a doctor I might add) in the last 3 years it is empty, no one waiting to see a GP or a nurse, so what are they doing – are they even in the building? I have no idea. However, there are about 4 receptionists behind a glass screen, in a small rural surgery. Doing what – when there are no patients allowed in?

    We have all accepted this as normal, that we cannot get medical assistance. I fear what will happen if either I or my husband gets ill. As it is I pay privately (as I had no alternative but to find the money or do without) to see a specialist for some routine care and even then getting the regular prescriptions I need from my GP surgery is like getting blood from a stone.

  • Tom74

    I had a couple of thoughts when hearing of the plan about offering unemployed people a weight loss jab: 1) I wonder which pharmaceutical corporation they have been bought by now (see also the deeply authoritarian ‘roll-out’ of the covid jabs)? and 2) That the proposal sounds so unworkable and ridiculous that if we didn’t know that the British government routinely gaslights its own population via their media, I would have dismissed it as a belated April Fool. A good starting point in reacting to those kind of media stories is to work out what issue would be discussed in the media without it. The NHS is still a generally excellent institution, and long may it last.

  • Wilshire

    Happy Birthday, Mr. Murray. Best wishes for this 67th year. And especially good health, because as you say…
    “ It is not a national health service, it is a notional health service.”
    So many things have become *notional* these days. That’s why we just can’t wait to watch this video of yours about the NHS. Blackburn must have been quite an experience I suppose.

  • gareth

    “Sixty years ago or so, when my siblings or I were sick enough to be in bed, my mother would phone the surgery and the GP would come to our home to see us. This was perfectly normal.”

    Same with me and my sibblings. Worth pointing out though that Dr Hamber, our GP (and who these days can name “their GP?”), was the owner of his own practice. Like all his GP colleagues he was “privatised”. Privatisation is not, of itself, a bad thing ™.

    What is IMO the “bad thing” and cause of a lot of the problem is the large scale and bureaucratic agglomeration of “Health Care”. This has the effect of supressing the drive for any improvement that competition could bring while facilitating capture by “Pharma” and other entities with the size and money to do this.

    (Just my 2d worth – & Happy Birthday)

    • Tom Welsh

      My experience was similar, Gareth. As for the NHS… we are all handicapped by the linguistic sabotage that has taken place, and is still continuing. As George Orwell pointed out, many words and phrases routinely used in politics are often understood in ways quite contrary to their true meanings. “Liberal”, for example; “conservative”; “fascist”; and “socialist”.

      Socialism (1) means a system where people cooperate willingly for the common good. According to anthropologists, it is the way in which most if not all “primitive” people chose to live.

      Socialism (2) means a system imbued with hopelessly impractical theoretical dogma, where everything is run (I can’t bring myself to say “managed”) by bureaucrats.

      The classic example of Socialism (2) is the USSR. Today the NHS is converging with that vast monument to bureaucratic inefficiency.

      I believe that if, somehow, every single chair-warming bureaucrat in the NHS could be fired, after an initial period of confusion things would settle down into a far more efficient, friendly, and affordable service.

      The same is of course true of government in general, but if all the chair-warming bureaucrats in central and local government were fired, it might be hard to perceive anything left.

  • RogerDodger

    Happy Birthday Craig.

    I recently had a similar experience due to appendicits. My first attempt at being seen by a GP fell afoul of the appointment roulette that you mentioned, in my naivete not realising that I had to phone at 8am on the dot. The next day I was straight off at the buzzer and still only managed a 3.50 appointment (so getting on for the end of the day) with a practitioning nurse.

    After being referred to a crowded A&E it took 7 hours to get a scan that could confirm the diagnosis. I was transferred to another hospital and had to wait a further 12 hours on a trolley parked in a crowded admissions corridor before I could be operated on. At this point it was confirmed that my appendix had badly ruptured and I was suffering from acute peritonitis. Despite this the surgeons did a fantastic job and after a (very) short stay in a ward I was discharged.

    It should be said that all the people I met throughout the process were wonderful – hard working, diligent, caring and friendly, from the nurses to the paramedics to the doctors and surgeons. But they looked tired and overworked and the hospital clearly under-resourced. I came away with my faith in the NHS both restored and shaken. Restored because it was being held together by the efforts of some truly heroic and under-rewarded people who I could thank for saving my life. And shaken because of the extent to which everything was visibly creaking under the lack of material support.

    I learned many eye-opening things talking with those people. About what seemed profoundly unwise working patterns which had been normalised due to lack of manpower (four days of alternating 12 hour night / day shifts was considered normal for an ambulance driver), a constant drain of staff burning out and leaving the profession, divide and conquer tactics the govt takes to industrial relations (for example trumpeting pay rises for doctors to undermine public support for everyone else’s pay negotiations) and much more (you can’t, for example, simply ask to borrow a walking stick or crutches if you’re recovering from major surgery – even just to move from hospital bed to bathroom. Resources are such that you have to be prescribed one!).

    While I’ve been recovering (being lucky enough to get a second appointment with a GP who would actually sign me off for the time needed to convalesce) I’ve watched Boys from the Blackstuff. Despite the show being an examination of industrial and social collapse, it was striking to consider how in the forty odd years that have passed the situation facing the unemployed and working poor has actually gotten worse, and the social security noose – sorry, net – tightened even further about them. And just as striking to see depicted as normal, scenes of sick patients being encouraged to remain on and even return to hospital wards, and doctors who had time to not only make their rounds, discuss test results and so on with those patients themselves but their families as well.

  • Pietro Polic

    I assume there is a shortage of medical staff in the UK? I live abroad so I’m asking.
    This malaise is found in most European countries, for sure in Italy and Germany.

    My conclusion is that the real malaise lies in the shortage of funds dedicated to the NHS.
    As far as I know this is the case all over Europe.
    Reason: exploding costs of energy and consequently of all other goods.
    And financing the war machinery, which is baking huge profits .

    This is a situation all citizens need to combat as much as possible.

    Many happy returns from an 80 year old!

  • Mike Cobley

    The clear and obvious diagnosis – that the NHS is being deliberately hollowed out and handed over to grifting parasites – is bang on target. Recently I happened to discover a tasty morsel about GP training which made even my jaded eyes widen; applications for GP training last year (or possibly the year before) were over 15000 (this is for England/Wales), and the number of those accepted onto the training program…were less than 5000. There is a national GP shortage, chronic in some places, yet those in charge of the GP training program are suppressing the number that the system is producing (keeping in mind that those applying are already doctors working in NHS hospitals).

    The looting of the UK continues, and all Starmer has done is take over as chief plunderer.

  • Republicofscotland

    Change will only come via revolution – and things aren’t that bad enough yet for this to happen – but give it time, things will continue to go downhill.

  • Robert Dyson

    Happy birthday anniversary Craig. I am about 20 years on from you and fortunately have had very little need for medical treatment over my lifetime. The other aspect of private providers is the pharmaceutical companies that now clearly drive treatment protocols. This is why vaccines are promoted, way beyond what is useful and sometimes with mass vaccination causing more harm than good (I am being generous in my assessment). The government is only ‘Labour’ in name, there is some agenda to cause pain to the majority though I am not sure whether by plan or ignorance, and it is the opposite of what is needed to improve the economic wellbeing of the country. I’m not sure if I will be here for the next election but I really want to be if only to see what happens (I live in hope).

  • Mart

    Happy birthday, Mr Murray.

    Entirely agree about the bribes politicians are paid to do the bidding of their paymasters. This cannot end soon enough.

    But there’s more to the problem. Politics is infested with money-grubbing careerists of extremely low intellectual calibre. Take David Lammy for example, a Foreign Secretary who thinks Marie Antoinette won the Nobel Prize for physics and Eduard Shevardnadze was president of Yugoslavia ten years after it ceased to exist. Streeting is no better, I’m sure.

    These people need the corporations and lobbyists to fill their heads along with their pockets. The work of policy formation and the deceitful spin needed to sell it is done for them by the vested interests. I suspect most of them would continue along this path of ease even without the financial inducement.

  • Pete

    Happy Birthday Craig!
    I met one of these employment advisors a few years ago, when a client of mine asked me to accompany her to a mandatory appointment. The Advisor, who clearly had no mental health qualifications, talked over me and obviously thought she knew more than I did about mental health despite my being a qualified psychotherapist with a psychology degree and a previous career in mental health nursing. Her advice to my client was pretty fatuous as you might expect.

    As for the weight loss injections, I’ve not studied the research so won’t comment on their effectiveness and side effects. However I dare say the government haven’t studied these either, so it’s probably more useful to follow the money. Poor people (including the working poor) are definitely more likely to be obese, and obesity is the biggest preventable cause of ill health now that smoking is so much reduced. However the bottom line is that obesity is caused by bad diet, therefore the simplest solution would be to make healthier foods more affordable and unhealthy foods more expensive. The subsidies would save huge amounts of NHS spending in the long run.

    Lobbying by the pharmaceutical industry is the obvious reason why this doesn’t happen.

  • Michael Droy

    This sounds like American Health Politics. Where 18% of GDP is spent on health for worse outcomes than most of Europe on 11-12%.
    If you think that the MIC are the biggers bribers of Washington, you’d be surprised.

    My own NHS story is a heart attack as a 60 yo jogger outside a cemetary.
    A cyclist passed by on his way to work. Stopped and saved my life expertly with the help of a defibrillator in a Police car waved down by
    a passerby.
    40 mins later I turn up at A&E in an ambulance and there to greet me is my cyclist. Turns out he was the Registrar
    S American of course.

  • Tom T

    It’s neoliberalism becoming fascism. The same thing happened with the dangerous and ineffective Covid jabs. A barely tested group of products were foisted on the general population and in many places around the Western world, those refusing to be used as lab rats were threatened with losing their livelihoods. Considering those proposing this weight loss jab are complicit in genocide it reminds me somewhat of the Nazis during WWII.

  • M.J.

    First of all, happy birthday! Enjoy yourself!

    As for the NHS, it’s not just having to grab an appointment (if one can) at 8 am, but as often as not it won’t be a medical doctor who does the needful, but a nurse or cheaper PA (or perhaps nurse practitioner) who have the power to prescribe (within limits). The NHS is going for them nowadays, cheaper to train and pay.
    Times change. But maybe the Workers Party or Greens will reverse the privatisation of the NHS!

  • Xavi

    Happy Birthday Craig and thank you for all you do.

    As regards Starmer’s intentions for the NHS, start by considering his attitude to the most vulnerable people on earth, in Gaza. He is absolutely pitiless. That should scream alarm bells about the sincerity of his claim to care for the national health, especially of those least able to help his donors turn a profit. Relatively few people may ever know that Starmer is owned by healthcare sharks but everybody has seen over the last year his attitude to this endless butchery of women and children. A caring man with kind intentions, yeah?

  • Lapsed Agnostic

    I would say that Wes Streeting’s* plans to offer weight-loss drugs to obese unemployed people – even on pain of losing their benefits – are considerably less horrific than administering a novel, barely-tested vaccine based on a chimpanzee adenovirus containing DNA transcribed from RNA which codes for a coronavirus spike protein to vast swaths of the population – and then threatening some of the sensible hold-outs with the loss of their essential jobs should they refuse to have it, despite it being shown to have negligible effect on the transmission of Covid-19. But then I’m just ‘anti-vaxx’.

    Despite the six-hour wait in A&E, I have to say that my family’s most recent experience of the NHS has been fairly positive on the whole, i.e. not lethal.

    * If it’s of any interest, my brother is of the opinion that the new Secretary of State for Health & Social Care is “incorruptible” – largely because he was putting in some effort to corrupt him.

  • Republicofscotland

    O/T.

    Sir Tom Hunter – is the private citizen paying for the chartered plane – to fly Alex Salmond’s body back to Scotland.

  • Crispa

    The article is timely and reflects the mess that we are in because we are simply going in the wrong direction and not getting our priorities right. It’s not just the NHS it is all our public services, even the health care regulator, the Care Quality Commission has been rightly slated in recent reports for the dysfunctional behemoth that it is.
    Just before reading this article I was reading the latest Ombudsman’s complaints reports https://www.lgo.org.uk. First on the list was a totally shocking case, the summary reflecting just how shocking.
    “Mr X, a person with disabilities and complex needs, complained about the Council’s response when he became homeless. The Council’s housing team delayed helping him when he was being evicted from private rented accommodation. It then provided him with unsuitable interim accommodation, and at times left him with no accommodation. The Council’s adult social care (ASC) team failed to ensure his care needs were fully recorded and did not work proactively with its housing team to ensure any housing provided would meet his assessed care needs. He did not receive any support for his care needs after the morning call on the day he was evicted and on another weekend when he had no accommodation. As a result of Council failings, Mr X was caused considerable stress and worry over many months before being evicted, had to sleep in his car for a weekend when the Council failed to provide housing, slept in his car for several weeks when it provided unsuitable accommodation and did not always receive his care package. Mr X said the lack of support with housing and his care needs adversely affected his mental and physical health, which meant he spent several weeks in hospital”.
    If the new Labour government thinks it has the solutions to all this in jabs for fat people and job coaches to cure mental illness there is really little hope that things will get any better under it.
    Happy Birthday Craig Murray

  • JohnA

    The Old Bailey is very close to Barts hospital. Back when ambulances were NHS owned you would likely have been collected and treated within minutes. These days, ambulances are yet another service mostly subcontracted to the private sector. Another modern dubious win/win for privatisation.

  • BCase

    Nobody seems to mention the immoral PFIs anymore..
    Corbyn was the last person I noted as having a problem with them.
    Best wishes on your Birth Day Mr Murray.

  • nevermind

    Happy Birthday from beautiful Norfolk.
    Labours mask is falling of their faces. Talk of not hurting working people but then contemplating to raise fuel taxes, so those working people driving to work are fleeced.
    The health service needs nationalising again and private companies who control hospital space and get priority treatment should loose all privilidges.
    PPI payments should be stopped and private finance for all service sectors be banned, incl. Prisons.
    The system of politics, parties and Government does not represent anyone anymore, dare I include the judiciary in this.

    Dr. Bob Gill was excellent, despite being held up on themotorway. His knowledge of the pirates that plundered the health service, he pointed to the enablers, hallo Wes Streeting, who are waiting in the wings to finish the demolition job.
    I was lucky to sit in the audience and later chat to Bob, he is an example to GPs everywhere.

    Hope to treat you next week Craig, should you have time that is.
    Prosit young man, may you like ve a long life.

  • PaulH

    Many Happy returns 🙂
    ” It is extremely difficult to access any mental health care ” is very much the case. There again, given how criminally bad some mental health provision is, this might not be an entirely bad thing.

  • Twirlip

    Apparently there is more than one of you (and a jolly good thing, too), because according to Twitter:

    “Today is their birthday!”

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