UK Health “reforms”

The story in today’s Observer about opposition to the UK government’s health “reforms” by the cross-party Commons health select committee, in addition to concerns from societies for health professionals is made real for me by a compelling story from an end user of the health system in the USA.

Why is the USA experience relevant for UK citizens? Because it’s the source of so many ideas for our right wing.

Meg Hourihan writes very clearly, and movingly, about her experience of insurance based healthcare in the USA. She describes the misery of choosing health insurance for her family, and the appalling annual cost; but even worse her experience of trying to use the insurance to make claims on behalf of herself and her children. Her story is a must-read for anybody in the UK with doubts about the effectiveness or efficiency of our National Health Service, and I won’t spoil her story by trying to summarise it here.

At the risk of sounding like Granpa Simpson the discussion reminds me of an argument I had in 1967 with somebody who was convinced that the NHS was hopelessly inefficient, that the whole business would be much better left to private enterprise, where individuals could choose to purchase insurance that would cover them in case of ill health. Choice would raise the standard of care, and competiton would keep down the costs. Then, and now, the basis for these claims was entirely ideological.

A fundamental problem for the Tories in the 1960s (and now?) was that the NHS was introduced in 1948 by a Labour government and was a manifestation of socialism that needed to be purged, regardless of how successful it might be. It just woudn’t do to have any signs of success deriving from Labour Party initiatives. We saw the same phenomenon in the 1950s … in 1951 the Labour government celebrated the centenary of the 1851 Festival of Britain with a new Festival that created many interesting, well designed buildings, and sculpture, on the South Bank of the Thames. The 1951 Festival was a great success much enjoyed and valued by the people, despite a background of Tory complaints about the cost of the initiative. When Churchill was re-elected Prime Minister in October 1951 one of his first actions was to raze to the ground as much of the site as possible (a few relics remain like the Royal Festival Hall that is now recognised as an architectural asset; a recent exhibition in the RFH commemorating the 1951 Festival gave a good overview of what was lost).

We see the same thing today where good ideas introduced by the previous Labour government have been terminated, usually on the grounds of cost, but actually because no Labour ideas should be allowed to flourish under the new regime. Of course some of these ideas have been reintroduced, rebadged as Tory ideas so that if successful they can claim the credit.

The recent scandal about cheap commercial grade silicone being used in cosmetic surgery gives us another insight into the modus operandi of private healthcare. It seems that at least some high-priced private clinics are little more than management front-ends sub-contracting the actual medical operations to whoever they choose according to their own criteria. What is the benefit for the end-user in such a multi-layered system?

It isn’t clear if the UK government is seeking to wreck the NHS as a matter of covert policy, so that a new US style model can emerge from the wreckage, or if they are destroying the health service by incompetence. But whichever it is the results will be the same, and apart from those who can afford first division insurance, the UK population will pay for this ideological “reform” with poorer health and a shorter life.