Friday, 6 November 2015

The Envy Of The World?

There are those in the UK who still believe that the NHS is 'the envy of the world' ... which world they refer to I am not too sure, because its certainly not the envy of the first world. Now don't get me wrong, the concept of some sort of 'universal, free at the point of delivery' health service is a noble one, and indeed I probably wouldn't be here now but for that idea being adopted in Britain.

However the fact is, that what was envisaged by its creators in the 1940's, was always a flawed concept. Having to bribe the doctors to join it, and it seems to stay in it just to keep it running (or is that limping) along ever since, was a flaw that has only been exacerbated by each British Medical Association (BMA) contract renewal since, as the present talks with the BMA are proving.

Once The Envy Of The World.

The truth is that providing basic health care for all, was always going to be a struggle, but when you add in the costs of ever more exotic and expensive treatments, then there was always going to be a point at which resources would never meet demand. We are at that point right now .... we either accept that and restructure accordingly, or let the whole system collapse into third world levels of delivery.

The Labour Party (and SNP's) refusal to accept that the 60 year old model is broken, and we can't just throw ever more money at it, means that even simple reforms like seven day doctors surgeries, and proper 24/7 365 day cover in hospitals, both of which would lower waiting times for treatment and hospital death rates at weekends (they spike at weekends as senior medical staff takes weekends off), are resisted by health professionals, as they just wait for the next socialist government to throw even more money at the unreformed NHS.

But the most telling aspect of all this, is that far from being 'the envy of the world' as a recent health department official repeated, it is in fact offering some of the worst health care in the developed world, with some of the poorest outcomes (which is medical speak for deaths). Sure we are better than bankrupt Greece, but compared with Germany, France, the Nordic countries, etc etc, most of whom don't follow our universal 'free' model, we compare very very poorly.

The Organisation for Economic Co-operation and Development (OECD) have recently given that 'envy of the world' idea a very good kicking. It simply compared us against 34 developed countries, but even so, we failed to rate very highly.

In the UK we have 8.2 nurses per 1,000 people, compared with an OECD average of 9.1. Similarly we have 2.8 doctors per 1,000, compared with an OECD average of 3.3. Apparently we would need 26,500 more doctors and 47,700 nurses to match the OECD average ..... part of this is due to the fact that although our population is exploding through mass unrestricted immigration of cheap labour, our GDP is not rising at the same rate. So we would need to find another £5billion per annum from our existing debts / budget, or go to that mythical 'money tree', to finance these additional staff levels .... this means cutting our cloth elsewhere. These cuts would be very painful, such as cutting from the budgets from Social Services, Probation Services, Prison services, Immigration, Mental healthcare, Defence, Overseas aid ... so what’s your poison?

So (here comes that pesky 'supply and demand' law again), more patients and less money to spend in the NHS (we have had "zero growth" in spending per person in real terms, between 2009 and 2013 as our economy contracted according to the OECD), on training doctors, equals less doctors per head of population.

The same can be said of health equipment, drugs and infrastructure .... countries such as France, Canada, Belgium, Germany, New Zealand and Denmark were all spending more on their different health care models, with better patient outcomes in such areas as the survival rates for cervical, breast and colorectal cancer (where we are listed as 21st, 23rd and 23rd respectively out of 34 in case you are interested).

The OECD summarised their view of the UK as a "world leader in developing innovative approaches to healthcare but often does not do the basic things very well. While access to care in the UK is good, the quality of care is uneven and continues to lag behind that in many other OECD countries." ... meaning that we let anyone turn up and ask for health care, but what then happens is poor. You get what you pay for, or in this case what your model can do.

Of course we also the lard arses of Europe, with 24.9% of adult obesity (against 19% OECD average) we are at 24th out of the 34 nations studied. So not unnaturally our survival rates for heart attacks and strokes, are as poor as our cancer rates .... for stroke treatment we are rated 19th out 34, and heart attacks are worse at 20th out of 34.

NHS Recovery By No Means Certain

While the NHS (backed by cheerleaders on the left), continues to resist any reforms and new ways of working, this situation will remain the case, and at some point the model will be too broken to fix .... what will that have proved?

Only that blindness to the need for major surgery, will leave the lefts sacred cow to die on its feet.


  1. Harry (Lancaster UK)7 November 2015 at 21:07

    Do you no what I read somewhere that each sex change op costs the same as 100 hip or knee replacements. Which ones should the NHS concentrate on??? I no that NHS priorities are not what we really want.

    1. Hmm, not sure about your figures Harry, as I found the US figures to be that female-to-male reassignment can be more than $50,000. While the cost for male-to-female reassignment can be between $7,000 to $24,000. This was based on 100 to 500 gender-reassignment procedures conducted in the United States each year. The UK figures are that more than 1,000 people have had the surgery in a decade, costing the taxpayer up to £10million. .... approx £10,000 each including ongoing psychotherapy and hormone replacement therapy also on the NHS. Eighty per cent of the operations in the UK are to change a man into a woman.

      Total knee replacement costs in US vary by state and location. The average typical cost for a total knee replacement procedure was $31,124 in 64 markets that were studied. However, it could cost as little as $11,317 in Montgomery, Alabama, and as high as $69,654 in New York, New York, and the same variance for hips where you could pay between $10,000 and $25,000 for primary joint replacement surgery.

      In the UK, private health joint replacement is quoted as a Hip replacement - £10,000. Knee replacement - £11,000. Its cheaper when performed abroad, sometimes funded by NHS - over 600 2014). For example, the lowest cost for a hip replacement was £4,153 when carried out in the Czech Republic, and the lowest cost for a knee replacement was £2,756 which was in France. A hip replacement in the UK would cost the NHS £5,943 (or £12,500 if done in a private hospital in the UK), or just £3,970 at the SurGal Clinic, a leading private hospital in the Czech Republic.

      So according to these figures, if performed in the UK on the NHS, a hip replacement in the UK would cost £5,943 while gender reassignment would cost approx £10,000 (including ongoing psychotherapy and hormone replacement therapy).

      So very roughly twice as much ..... thanks for the comment though.

  2. There is a very simple and accepted measure in insurance called the excess charge which reduces premiums for the customer and costs for the insurer and is very effective in reducing frivolous claims. The fact that it doesn't exist in the NHS is one more reason why governments shouldn't try and run businesses. I'm all for nationalisation of vital services but they should be run along the lines of private companies with much less interference from short sighted and inexperienced politicians.

    1. The problem with nationalised industries (and that includes the NHS), is that they forget where the money comes from, and just take more taxes whenever they screw up .... often on wages and more staff. Ministers make decisions based upon political opportunism and not to help the country .... oh and some of them believe in the money tree!

      Incidentally that's why the bailing out of the investment banks (not the savings and current accounts) was wrong, they are supposed to live by their failures. But ironically the labour government panicked and threw vast amounts at banks who carried on paying bonuses the same wankers who had bet the money until they lost it all (even when they had cheated).

      But the point of this was that the NHS needs reforming and can't just rely on the eternal begging bowl when Labour eventually get back in to power in 5 or 10 yrs time..


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