Another of our favorite refrains is 'I pay my taxes' and 'give me my money back and I'll spend it on health care as I see fit'.
Let's just work out what that adds up to.
Health Care spending in the UK is currently around £75 billion. There are about 65 million of us, so that works out at £1153.85 per person per year.
This is for everything - ambulance fees, A&E visits, GP consultations, outpatient visits, surgery, home nursing care.
What do you think £1152.85 per year would buy you?
Hmmm, healthcare spending is nearer £80 billion this year and Burning Our Money, examining the latest Wanless Report, gives us just some of the reasons why.
The bald facts are these. Since his first report in 2002, total NHS spending has surged by nearly 50%, or £43.2bn. That's a real terms growth of 7.4% pa, and takes us close to the EU average for health spending as a percentage of GDP. So as of now, nobody can argue the NHS is substantially underfunded.
But as we've said many times on BOM, spending money is easy: it's what you get back that's counts. And across 321 weighty pages Wanless confirms that we've had abysmal value.
To start with, getting on for half of the increased spending (£18.9bn) was gobbled up in those big pay and price increases (see many previous blogs on the NHS pay deals). More money has been poured into hopeless projects like the NPfIT, where the report demands a full drains up.
Second, although there has been a huge increase in NHS staff numbers - up by one-third to 1.3m - their productivity has fallen sharply.
Third, the top politicos and their ranks of health commissars did an appalling job at directing the splurge.
But, the Rant team have some exciting news to impart.
Bear in mind that this works out at a little over £22 per week, and the average person visits their GP six times per year, has 3 basic blood tests per year, and receives 20 prescription items per year.
Really? What the fuck for? I have visited my GP three times in the last 11 years (including my original registration). The other two times, I got antibiotics on one occasion and a prescription for Betnovate on the other (I don't believe that this requires a prescription anymore). I have had no blood tests and no other medication.
Some people really are either very unhealthy or really fucking paranoid. Although, might I venture to point out that taking average in an organism, such as humans, which need more care as they get older might be a little skewed? No matter, on we go...
Devil's Kitchen will no doubt point out that they can get 'fully comprehensive' private medical insurance for £50 a month. Read your policy again: it does not cover ambulance fees, emergencies, primary care, prescription drugs. Even the surgical fees that it does cover (for example, a hip replacement) are heavily discounted because if anything goes wrong the NHS provides all the super-expensive rescue care (such as a bankruptingly expensive stay on a High Dependency Unit).
As promised, I have been getting up to date quotes (from Health-On-Line, who paid for my mother's recent (and entirely satisfactory) operation). The current quote, fully comprehensive, is £49.26 per month. Interestingly, the fact that I smoke has no effect on the price!
There are a few small bits of small print, but they are all quite acceptable; the main one is that you do have to pay an excess of £100 per year (i.e. you pay the first £100 of any treatment in any one year), and they will not pay for treatment for a known existing condition until you are two years into the policy (unless that condition has required no treatment for the previous 5 years).
Now, onto the Rant teams accusations. First, ambulances are required by law to deliver to a state A&E hospital. Second, of course, there is only one private A&E centre in the country at present: one could argue that this is because the state does it better. One could also argue that, since ambulances have to deliver to a state A&E department, that is distorting the market.
Anyway, my contact has come back with the follwing remarks.
PMI policies do not cover Primary care, out-patient prescriptions or emergancy calls.
However they do cover all in-patient drugs and dressings and ambulance costs between hospitals where medically necessary.
Cancer drugs are covered in full, so we are only talking normal prescription medicines that we would all normally obtain from a pharmacy.
Once a patient has arrived at an A&E department, unless they have a six week plan [which Health-On-Line do not sell], there is no reason as to why they should not be moved to a Private Hospital.
The real point about private medicine is that you can get a replacement hip in 2 months (as my father's wife did back in June) rather than two years. It's all very well saying that the NHS is good value for money, but if you need that CAT scan now then getting an appointment to see a consultant in 6 months, who will book you an appointment to get a CAT scan within the next 6 months, simply isn't good enough.
I cannot emphasise this enough: the NHS is not free. In fact, it costs someone on the median wage, of roughly £23,000, more than double what private medical insurance costs. If people paid the money that is taken off them in NICs into a private health insurance plan, at least it would actually go towards their fucking healthcare and not into the pockets of lazy, corrupt fat-cat politicos.
However, if we are to maintain the NHS, I can agree with some of Team Rant's interim policies.
Personally, I think a better service is more likely if we:
- fire 80% of the managers.
- get rid of all the form-filling red tape and give tactical control back to front line professionals.
- get rid of the culture of institutional corruption (targets, lying managers, 'best year ever')
- cancel 'big idea' IT projects and go back to using home grown, successful, 'small provider' local solutions.
- stop diverting money to big companies (PFI, ISTCs etc..).
- go back to old-fashioned nursing (I don't know what they are teaching in nursing school, but I do know its not nursing).
- stop designing services for the vocal minority (like our very own Anonymous).
- stop giving every Ivory Fuckwit with a mouth free reign to implement their pet project.
- use the savings to reduce bed occupancy to 70%, bring cleaning contracts etc.. back in house, hire more nurses, hire more physios, increase nurse:patient ratios, and bring long term elderly care back into the NHS.
On the last note, it is worth pointing out that the NHS has hired more nurses. In fact, if you look at the chart below (pinched from Burning Our Money), you can see that, instead of hiring the 20,000 extra nurses that they had planned to, the NHS instead hired 67,878: 239% over target.
And yet, Team Rant and Dr Crippen both tell us that nursing is in a shocking state. Which is why I agree with the "go back to old-fashioned nursing" point above.
But what Team Rant do not seem to realise is that as long as the NHS is run by politicians, none of this is going to change. And as long as the NHS remains entirely public and funding remains entirely through taxes, this is not going to change.
Privatising all hospitals and forcing them to compete properly would be a stunningly good start, even if you are going to keep the whole monolith publically funded.