This post originally appeared in The Mostyn-Thomas Journal on April 1st, 2013.
I have a kidney infection. This is my fifth day.
I am able to say that with certainty, because I visited a NHS general practitioner and that’s what she diagnosed me with. When I first felt the stabbing pain in my lower left backside, I texted 999 for NHS paramedics, who came and assessed me in a matter of minutes.
The GP gave me a NHS prescription for a seven-day course of antibiotics and advised me to try and get plenty of rest, and she achieved that on the basis of strategic questioning, a thorough physical examination and an urine test.
All of which was done in the name of public duty – paid for entirely by the state.
Now, imagine if the NHS had already been privatised a few years hence. At what point would I start paying? If the government continue with their plans for an American-style healthcare system, that might be covered by health insurance. (Note that the NHS do charge for a few services, but measures are in place to ensure free treatment for those on low incomes.)
What if I couldn’t afford the insurance? I am a single mother already setting aside a large chunk of my time for two children under the age of four. As my older child Isobel and I are disabled and deaf respectively and claim DLA, we look set to join around 3.7 million people with disabilities potentially affected by £28 billion of welfare cuts over five years. What if the diagnosis was wrong? What cost my health then?
Yesterday – with little media forewarning, and certainly no public consultation – the coalition launched a new medical commissioning board. Nothing unusual about that you might think, except that this board is being encouraged to buy services from a healthcare ‘open market’ – both public and private – with NHS funds. What makes this scary is that the public services do not have the acumen of the private businesses and so stand a good chance of being edged out of the market altogether.
Meanwhile the private sector will certainly find a way to undercut their rivals every time, because as far as they are concerned, the NHS represents a highly lucrative slice of the healthcare pie.
Imagine a medical system increasingly driven not by public duty, but commercial gain. Imagine being treated according not to the severity and/or complexity of your medical condition, but how much money you have.
Isobel has quadriplegic cerebral palsy, epilepsy, global developmental delay and microcephaly. Where does that leave the extensive range of NHS equipment, therapies, medication reviews and assessments that she will need to accommodate both these evolving disabilities and her Conductive Education? Where does that leave me and my kidney infection, in the event that my urine test reveals something else?
No private medical company can compete with the NHS for size or bureaucracy. In light of both this and their greater interest in making a profit, how can the private suppliers maintain the same quality standards or even range of services offered by their more experienced public rivals?
Hearing aid and CI costs run to the tens of thousands. I have had NHS audiology all my life, utterly free. I cannot deny the quality of life my hearing aids, and later my CI, have given me. The one time I had a hearing test with a private hearing aid dispenser (before I had my CI operation), their equipment failed me, because it had only half the decibel range of the NHS. Quite simply, their services didn’t extend to profound deafness. Now privatisation is well under way, how can we guarantee we won’t see that happening on the NHS as well?
Sooner or later someone will decide to charge an ‘administration fee’ – and from then on, there will be no stopping them, because they have no obligations to public duty. Will there be a postcode lottery?
The tide of doubt keeps coming in, because the lack of public consultation ensures that there is no knowing the lengths the private sector will go to for the sake of a profit. Just look at how close the coalition’s links to them already are.
Bureaucracy notwithstanding, the NHS is the envy of the world for fast and effective healthcare for all. A Commonwealth Fund report proves that its standards are better than those of private healthcare provision in 11 countries including Australia, New Zealand, France, Holland, Germany, Italy, Norway, Sweden and the US.
Even the American President is trying to drive legislation for a system similar to the British model in his country; that’s how good the NHS is. Why do you think the familiar blue-and-white of the NHS logo was such a feature in Danny Boyle’s bombastic Opening Ceremony in the London Olympics?
I know I have had my gripes about certain aspects of the NHS. No medical system, private or public, can claim to be perfect.
I do not wish to undermine existing clinical negligence claims against individual NHS hospitals or trusts. But these are as a result of over-stretched resources and cumulative budget cuts made by the coalition – and preceding governments going all way back to Thatcher – rather than capitalist greed. That the NHS tops a Commonwealth poll today is testimony to the admirable efforts they are making in the face of such cuts. As far as incentives for a British healthcare ‘open market’ go, you cannot get more machiavellian than the one sought by the present government.
The very existence of the NHS underscores the principle that access to good healthcare is a right, not a privilege. This is why it is a cornerstone of British democracy today – and why the coalition’s NHS ‘reforms’ look like an atrocity.