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A bleedin’ forriner’s view of the NHS

February 26, 2011

I have lived in the UK for over 20 years. I have worked and paid taxes here; loved and been dumped; complained about the weather; had Marmite on toast for breakfast and a strange meal called “supper”. I get very excited about test cricket and understand precisely where on the field is “silly mid-on”. I queue religiously at the bus stop. I am still, however, and will always be a foreigner. There is compelling evidence of this: I eccentrically cling to the notion of rinsing crockery after washing up; I see nothing funny and plenty frightening and dysfunctional in seasonal panto; I refuse to be the same nationality as Richard Littlejohn.

Through an extraordinary process of diaspora I have family in the US, Greece, Scandinavia, even China at the moment. I, myself, have lived in four European countries. There are advantages inherent in my almost-traveller-status. One of them is having observed certain British quirks as an adult – the biggest and most singular of them being the NHS. I was not born into it. I do not take it for granted. I don’t remember the good ol’ days. I still recall with wonder the first time I was treated in a hospital and the surprise and relief of not having to deal with a bill at my frailest and most terrified. I wish to share my observations with you.

Some years ago my back collapsed. Vertebrae L2 and L3 decided they had had enough of my revising for law school final exams, packed up, gave me two fingers and went out. I was doing nothing dramatic when this happened, as is often the case. I turned to pick something up and went down. The pain was of such intensity that I became convinced I would die. It took me 20 minutes to crawl to the phone and call for help through my sobs. I hit my head and it bled profusely. I was in my underpants. Helpless, shivering, creating a pink bubble in a pool of my own blood each time I exhaled. I vaguely remember someone breaking the door down, fainting twice as they tried to lift me. The experience of being given morphine I remember vividly – the instant addiction.

Over the next few hours a group of Angels soothed my broken body, took the pain away and in a few days, with the help of an osteopath paid for by the state, I was well enough to take my exams and graduated with a first. And so, I feel quite protective of this thing that is not even mine. Not yours either. Everyone’s. This service paid for by your mothers and your grandfathers in the hope that they would leave the world a little better for you, illness a little easier to bear, death less painful.

So, before you decide that dismantling this rare physical manifestation of humanity is a good idea, make sure that you are not leaving the world a little worse for your children and theirs. And, above all, make sure it is as informed a decision as possible. The Conservative Party has received 3/4 of a million in funding from private Healthcare Provider interests in the last year. John Nash, chairman of Care UK has given the Tories over £200k in the last five years, as has Dolar Popat, founder and chief of the TLC Group, just before he was handed a peerage by Cameron. Popat’s contributions include a gift of £25k in July, registered a week after the reforms were announced. The man that is spearheading this ill-thought review is Andrew Lansley. John Nash and his wife contributed £21k to Lansley’s private office in November. A spokesman for Mr Lansley said: “[d]onations from private individuals in no way influence policy-making decisions.”

The current government has a different view to mine. They present a picture of an entire service populated by incompetent doctors, cruel consultants, complacent nurses; all supervised by this nefarious group called “managers”. Their spin doctors are secure in the knowledge that all of us have had an incompetent or interfering manager and so, on the most superficial level, the campaign resonates. They say that they are simply creating competition by opening up services to the private sector. But the private sector will choose where to compete: quick turn-around, lucrative treatment. It may become easier to get a nose-job than to be treated for cancer.

Of course there are bad doctors and bad nurses. But there are also scores of thousands of good ones; kind ones; sleep-deprived and underpaid ones. Of course there are superfluous layers of bureaucracy. But we must ask ourselves what our own contribution has been to that. Whether we are an active part of an increasingly litigious society that accepts no such thing as bad luck, accident or innocent mistake.

Before making up your mind, if only for an instant, please look at the NHS through the eyes of this bleedin’ forriner.

Next year we shall be living in a country

That brought its soldiers home for lack of money.

The statues will be standing in the same

Tree-muffled squares, and look nearly the same.

Our children will not know it’s a different country.

All we can hope to leave them now is money.


Philip Larkin

Homage to a Government


7 Comments leave one →
  1. djpnz permalink
    February 27, 2011 12:07 am

    I am British but I live in New Zealand. I loved your piece but I disagree with one aspect of it. It may be a free health service, but it’s a grossly inefficient one. What’s proven to be true is that no matter how much money is thrown at it, expectations will always exceed that which can ever possibly be delivered. What needs to happen is an overhaul of the private sector at the same time as the NHS, the relationship between the two has changed little since Beverage. A model that works quite well is that which we enjoy in NZ, that’s a harmonious private, public partnership. The problem with the UK is that there’s a welfarist mindset where private equates to wrong and public equates to good, which is a cultural misapprehension that needs to change. What also needs to change is the attitude of the ‘health professionals’ they need to be reminded that they are not unaccountable public servants, they are indeed quite the reverse. However, there is a lot that’s right with the universal concept of a free health service, but a lot that’s wrong with the way vast sums of taxpayers’ money is consumed.

  2. February 27, 2011 12:38 pm

    Thank you..really informative!!

  3. April 23, 2011 9:36 pm

    I just stumbled on your blog by accident. (had been looking for other people aware of the relationship between Lansley and Mr & Mrs Nash).

    With regard to view of government portrayal of the NHS you may be interested in my blogs on Stafford Hospital, which you will find on the pressreform site. This is a much more complex story than it seems.

    My detailed study of the very flawed reporting on this story shows that Mr Lansley has played a key part in the way this story developed.

  4. Lisa Wilde permalink
    April 24, 2011 12:40 pm

    Great post, ta. Just an aside really, to provide some balance to the comment above about New Zealand’s health system. That public private partnership we “enjoy”? Not really anything to shout about. Not particularly efficient. And not enjoyable at all if you’re unlucky enough to be really ill.

  5. Pat in Belgium permalink
    April 24, 2011 3:56 pm

    I, too, am a foreigner, living in Belgium where — touch wood — the national health care system remains excellent and untampered with. I also lived in Canada for a decade & “enjoyed” equally excellent, affordable — or even free in Manitoba! — health care.
    Anyone who remotely thinks privatizing this service should first take a long, hard look at my native country, the U.S. of A. where HMOs (Health Management Organizations) run health insurance & care like big business (with an eye to profits NOT service). My sister & her (retired) husband are ecstatic to have found a private health insurance which costs them ONLY $800 US per month (and that’s with a $5,000 deductible meaning “normal” doctor’s visits, annual tests, etc. come out of their pocket; the insurance doesn’t kick in until the bill hits $5,000!) Our mother is mercifully on Medicare which the current Republican congress wants to privatize — or, at least, cut.
    It sounds like this insidious illness has reached England! What short-sightedness and, more importantly, greed….

  6. Almost Human permalink
    May 10, 2011 7:07 pm

    Having been treated 3 times for a recurring illness (twice involving life-saving surgery) by the NHS, I feel that this is an institution that should be fought for and defended rigorously with barricades if needed. It is an exemplar of how state funded services CAN work. Yes, it is a costly service, but for the treatment it provides there is no other service provided globally that can rival the care and professionalism of the vast majority of doctors, nurses, consultants and auxiliary staff. There are some exceptions.
    As a former NHS employee I have witnessed first hand the bureaucracy involved in even the lowliest of positions, but this is something I have dealt with in every job I have had.
    Lansley’s proposed privatisation by the back door is an abomination and seriously undermines everything that has been built up by the NHS. I only hope that there is enough fuss kicked us that causes his consultationary “pause” to develop in to a complete u-turn and that the British public can force the Tory led Privateers and their donors so far back in to a corner that the proposal of gp led consortia is summarily binned and the focus of the public purse moved to more sane matters like the recovery of bail out funds from the banks.

  7. February 26, 2012 7:07 pm

    Slightly relating to your post: For years I have said that I wouldn’t even use the pages of the Daily Mail to wipe my posterior but, having seen that Richard Littlejohn now has a column on Saturdays which even bears a picture of his face in the banner, I’m pleased to say that I have been given cause to revaluate my opinion.

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