I Still Feel Dizzy

But, like Rufus Hound, I’m also angry

29th January 2014

Actor and comedian Rufus Hound has created a bit of a stir by announcing that he intends to stand as an MEP for the National Health Action Party. As he put it:

I’ve been tweeting endlessly over the past few months about the dangers the NHS currently faces, but over Christmas, something changed. My wife – similarly passionate – suggested that we were becoming “those people”. Those people who whinge on and on, wringing hands and asking “But why isn’t somebody doing something?!” – instead of actually doing something.

So, we decided that we’d do something.

First off, I applaud this decision. Even if I didn’t agree with his viewpoint on the NHS, I’d applaud it as a principled stand for something he passionately believes in. But I do agree, and I think the NHS is currently in grave danger of disappearing before our eyes, without us even realising until it is too late to act.

I also identified with his initial inertia, and the realisation that if something was going to be done, he would have to do it. His words made me see the same inertia in myself, and it prompted me to join the NHA Party, which campaigns to save the NHS.

I was delighted to see Rufus Hound warmly responding to one of my tweets on Sunday morning:

metweet1

Here’s a little journey into why I’ve joined up.

 

Shoot the Messenger

There has been a lot of debate since Rufus tweeted this:

rufus1

Most of the negative viewpoints seem to have been arguing against the hyperbole in this tweet rather than the basis of the argument, and why Rufus was making it. (I’m going to use the wafer-thin pretext of him tweeting me as my excuse to continue to call him Rufus. Anyway, “Mr. Hound” puts me in mind of a character on CBeebies. Sorry, Rufus.)

I don’t think David Cameron actually wants your kids to die, and I don’t expect Rufus really thinks that either, but I do think it’s a likely consequence of the policies the current government are pursuing. Coalition policy towards health appears to be ruled by two unshakeable views:

  1. That markets and competition are the best way to run anything, health services included.
  2. The thread running throughout the current government that people who can’t stand on their own two feet shouldn’t expect any help from the rest of us.

I fundamentally disagree on both points, and I think both lead to ill people not getting the treatment they need. Here’s why.

To Market! To Market! To Buy a Fat Health Service

I was watching an episode of The Daily Show with Jon Stewart the other night. TIME columnist Steven Brill was being interviewed, and he encapsulated very succinctly why marketisation of health services doesn’t work. Dr. Lucy Reynolds says it too in this interview. In brief, markets only work if the person buying has a choice of which product to buy, and is in a position to understand what they are being sold. If you are in an accident, you don’t get to choose which hospital you are taken to, and you don’t get to choose the facilities they have for treating your injury. If you are told by your GP you need a particular drug, there is no alternative, and no competition. You have to pay whatever the price is, or go without. But you can’t afford to go without, however much it costs, because your health and potentially your life is at stake.

Markets only work if there is a balance between buyer and seller. In most areas you generally understand the services your potential suppliers can supply, at least well enough to be able to choose between options. In health care, you usually don’t. It’s not like buying a fridge – you don’t know how to choose between options, and you won’t know whether your GP is being paid to meet a quota of particular treatments. In a privatised health setting, he/she may well be incentivised in such a way.

Does anybody think that all the problems we see with Pharma companies, manipulating the market within which they operate, won’t be hugely magnified when we’re turning the entire health sector over to private providers? What we are moving towards is a health service where everybody has to have health insurance. If you can’t get insurance, you’re in trouble. Even if you have health insurance, don’t expect it to cover everything as routinely as the NHS currently does. Your insurance provider will cherry-pick the profitable areas, it will fill your policy with exclusions and caveats. Imagine what your car insurance is like, and how easily they find any excuse to deny your claim. Want that for your health cover? Costs will spiral under a private market health system – just look at the USA to see how costs even for simple, straightforward treatments can go through the roof.

Every time we make an artificial barrier to accessing health care, it is the vulnerable that suffer most. Those who can’t afford insurance. Those who have complex health needs – insurance companies will hardly be falling over themselves to cover those people. In such a system, we end up with care being based on ability to pay. If you can afford broader insurance cover, with more options, you will be better off than somebody who can’t. Is this what we want for our NHS?

And we can’t look to the state to help. With the current government’s drive to stigmatise anybody on benefits as scroungers, can we expect them to be any different when it comes to health cover? Look at the awful situation over disability benefits, with the terminally ill and people with permanent disabilities being passed as fit for work. Look at the petty, petty sanctions being levied on people who break pathetic rules. How will that translate to health cover?

Not on the list? You’re not coming in.

What I’m saying here is that I think everybody has a basic fundamental right to decent healthcare. But this is a view that our current government does not appear to share. As part of the anti-immigrant narrative that has been swilling around Whitehall the past couple of years, there has come the bright idea that health care providers should check the immigration status of anybody they see before giving treatment.

This inevitably means less people being treated. That is the objective, after all. So as far as our government is concerned, sick people should be turned away untreated. Let’s state that again – people will be denied medical care.

On top of this, we can expect that some will not even go to the doctor – why would they, if they think they may be deported as a result? You might think that’s fair for illegal immigrants; do you also think it’s fair for their children, who didn’t get to choose the situation in which they now find themselves?

When the NHS was formed in 1948, Britain was exhausted, broke, facing massive post-war commitments, rebuilding at home and overseas. And yet somehow, as a nation, we managed to bring into being this wonderful, caring, often frustrating, but ultimately life-saving organisation. As a nation, we said that everybody has a right to health care, everybody, whether they can afford to pay or not.

I am proud that the NHS treats everybody. I am proud to be part of a society that holds this to be a fundamental part of its humanity. I do not agree with the arguments about “health tourism”. Quite apart from the possibility that it costs rather less than some would have you think, I do not think clinicians should turn away sick people. It is inhumane. The recent attempts to check the immigration status of patients are wrong, and I am glad to see the negative reaction from health professionals to being asked to be border agency officials by proxy.  Personally, I don’t care where the sick person came from. No, that’s not quite right, I do care, I would grumble at somebody turning up from overseas to get treatment, but I would still treat them, because to do anything else would be inhumane.

Now, a statement of interest. I have worked in the NHS in the past, in GP practice and in hospitals, though not for fifteen years, and I am not a clinician. During the six years I worked in the NHS, I found almost all the staff almost without exception to be dedicated, hard-working individuals, who regularly and as a matter of routine went far beyond the call of duty in looking after the patients in their care.

A Little Bit of Politics

I’ve never got involved in politics, beyond turning up and voting Lib-Dem at every election. (Now I can see where that particular allegiance got me, I won’t make the mistake again. If the Tories are the school playground bully trying to steal your lunch money, the Lib-Dems are the one sitting on your legs while the bully punches you.)

Much of the criticism of Rufus Hound’s position over the health service seems to accuse him of being a lefty. I don’t know if I am left-wing (I’m not sure if I even know what that means). I think I hate all politicians in their own special ways, adding up to an equal hatred for all. I hated New Labour’s nanny state, over-bearing ID cards, RIPA, control orders, war on terror shit. I hate the absolutely pejorative attitude to the neediest in our society that the current coalition government cultivates as if it’s a virtue. I hate the way all of the major parties seem to be queuing up to attack immigrants. And on health I’m not sure who I hate more – the Tories and Lib-Dems for dismantling the NHS or Labour for sitting back and letting them. So, like Rufus, I feel forced to act.

And so to the punchline

Because here’s another declaration of interest.

I owe my life to the NHS. I would probably not have survived childhood without the surgery which has instead of a painful death allowed me to lead a completely normal life, nor without the extensive supply of antibiotics which kept me alive until I could have that surgery. Nor, too, would two of my daughters have made it past infancy. Our stories are far from unique. Hundreds of thousands, if not millions, of people are only alive today because the NHS was there when they needed it. We have the best, fairest, most efficient, health service in the world. The NHS has been such a part of the fabric of our existence in this country that we really do take it for granted.

I have taken the NHS for granted. But I should be able to take it for granted, that is the whole and complete point of its existence. We should be able to live our lives without worrying that the next time we get ill we may die for lack of basic medical care.

I owe the NHS a debt I can never fully repay. But now it is perhaps time to try to repay at least some of that debt. It is time to stop taking our healthcare for granted. This is why I now stand up for the NHS, and stand up for the NHA party.

Okay…. what next?

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3 Responses to “I Still Feel Dizzy”

  1. Nan Parkinson (@parkitwit) January 29, 2014 at 5:07 pm #

    I agree with every word.

  2. Elene February 23, 2014 at 6:55 pm #

    Possibly a bit late ……. I second that!

Trackbacks/Pingbacks

  1. I still feel dizzy | NHA Party - June 3, 2014

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