The National "Health" Service

April, 2003


Contents List:

Primary Care Trust
Why Hospitals?
Politics
The Costs
Waste
Alternatives
What Can Be Done?

Return to:

World Views
Ardue Site Plan

See also:

Of the True Greatness of Kingdoms and Estates
A Sense of Proportion
Towards True Democracy


Primary Care Trust

My local National Health Service (NHS) Primary Care Trust (PCT) has produced a Guide to Local Health Services. It tells me that its annual budget to provide "healthcare" for 147,000 people is one hundred million pounds (i.e. 680 pounds per person). No less than 74 per cent of this money (503 pounds per person) is spent on "Hospital Care".

I learn from the television that the total cost of the NHS is 75 billion pounds a year. Taking the population of the UK as 60 million persons, the mean expenditure per head of the population is 1,250 pounds a year. What this boils down to is that the tax-payer has to find about 5,500 pounds a year to provide "healthcare" for an average family of man, wife, and 2.4 children, and over 2,200 pounds of this is spent on providing hospitals healthy people would do well to keep out of.

We see that for every 1,250 pounds the government collects for each person in the country, only 680 pounds filter through to the people on the local ground. The "lost" 570 pounds represent the cost of the political bureaucracy that controls the "healthcare" workers throughout the country. Our politicians cost us a lot of money.

Could there be a more succinct indictment of the fundamental contradiction on which our so-called "National Health Service" is based? Clearly, what we have is a National Sickness Service. And clearly, the Service is itself very sick.

Why Hospitals?

The human race survived for countless millennia without hospitals. Why can it not do so now? Mother Nature has provided almost all of us with a wonderful system for resisting disease and for automatic self-repair when something goes wrong. The most a hospital can do is assist Nature. So why, here in the UK, should we rely so heavily on hospitals? Why does it cost so much merely to lend a helping hand in a process that Nature does for nothing? Why are politicians involved? Why are there no cheaper alternatives? And why are we, the people, putting up with such a nonsensical system?

Bodily disease has become a focus for a monstrous multinational industry in which mercenary professionals approach human beings as if they were merely physico-chemical structures requiring only mechanical intervention or the administration of magic potions to make sick or injured people feel better. The NHS has shifted the emphasis from healing to treatments. Reputations are gained from pushing forward the frontiers of medical and surgical technology rather than from actually helping to restore normal human functioning. Hospitals have come to resemble hi-tech garages, lavishly equipped with complex machinery for exploring the body and manipulating its constituents. Operations are performed as a matter of "routine", in the hope of doing quickly what the body itself would do slowly had the mind of the patient not already been poisoned against Nature.

So part of the answer to the question is that hospitals are provided for the convenience of a capital-intensive industry, not for the patient. Whereas the healer used to go to the patient, the patient now has to go to the hospital to be exposed to the miracles of the operating theatre and the expensive elixirs of the pharmaceutical multinationals.

The other part of the answer is that, health services having been nationalised, politicians need hospitals as evidence that the State, through taxation, can do things on a grandiose scale obviously far beyond the powers of smaller groups of people. Whether the exercise of State power in health care is entirely beneficial is a matter we must consider.

Politics

In "Prime Minister's Question Time" every week, the NHS seems to be the subject of more questions than anything else. For socialists, it has become a sort of sacred cow. The idea of a service "free at the point of delivery" is such an attractive electoral slogan for the doorsteps of the relatively poor that the NHS is virtually immune to criticism. Yet the truth is that after so-called "Social Security" expenditure, the NHS is the second most significant cost to be borne by taxation and most tax revenue is contributed by the great majority who are relatively poor. Thus the poor pay not only for the hospitals but also for the political parties, the politicians, the state bureaucrats, the executives of multinational companies, the interest paid on their borrowings, and the employees of the hospital construction industry, as well as the actual doctors, nurses, and others who actually work in the hospitals.

We all know that prevention is better than cure. Yet most of the waste disposal operatives, street cleaners, and sanitation workers, who together make a more significant contribution than the NHS to the maintenance of good health, particularly in urban areas, are not included in the NHS figures, but are paid for separately by local taxation — most of which is also borne by the relatively poor.

It is significant that most of the questions in Parliament concern not the health of individual patients but dubious (and sometimes, as has recently been admitted, fraudulent) statistics about the length of time patients have to wait to "see" family doctors, to "be seen" by a specialist, or to "undergo" "operations". The Prime Minister's answers invariably quote strings of figures about the "investment" of billions of pounds his "caring" government are making in the NHS and the thousands of extra doctors and nurses who have recently been recruited — even if some of them hardly speak the same language as their patients. The PM's political friends constantly point to the gleaming new hospitals that have been built in their constituencies, but seldom have anything to say about the resulting effects on the health or happiness of their constituents.

Ordinary people expect their investments to yield a measurable financial return: when they do not, they look for a better application for their money. There is no possibility of measuring any return on the "investment" of money extorted from tax-payers by government from the long-suffering people. The only return that matters to politicians is the number of votes cast in an election, and elections happen too infrequently to make much difference — especially as all political parties have a vested interest in preserving the system which keeps them in what passes for work.

The care of the sick is too attractive as a political football to expect any major political party to leave the field and let individuals become totally responsible for the care of their own health and that of their dependants and neighbours. To do so would be to admit that politicians are irrelevant and to further feed the disillusion with party politics which is already endemic in the UK. Without the NHS, politicians would lose their influence over the millions of people employed directly or indirectly in the largest industry in the country, to say nothing of the donations political parties hope to receive from the hospital designers and builders, the manufacturers of hospital equipment, and the pharmaceutical companies. In the meantime, the people are pacified by an educational and public relations system which scoffs at Nature and extols instead the virtues of the "scientific advances" of which "modern" hospitals are a prime example.

But a time will surely come, and it may not be far off, when the taxes required to support this political patronage will surely be questioned. Let me stir things up a little.

The Costs

The raw financial costs of high-tech "health care" are obvious. Hospitals are built and equipped at enormous expense which will have to be met for many years by successive generations of tax-payers, most of whom are relatively poor and some of whom have not yet been born. Hospitals have to be adequately staffed before they can make any contribution to restoring sick people to health, and it seems there are not enough native people in the country who want to play mechanical doctors and nurses in people garages. So financial incentives are used to attract personnel from countries which have an even more pressing need for their services, but cannot afford to keep them. Thus the world-wide costs of sickness care are artificially escalated.

There are other, less obvious but potentially more serious, costs of current NHS practice. One such is congestion, because service provision cannot cope with demand. An apparently trivial instance, reported on the news recently, concerned an operation that had to be cancelled because the eminent surgeon who had been contracted to do the cut'n'paste job could not find a space in which to park his car. The discerning eye can detect in this incident a clue to why the large centralised hospital becomes a managerial nightmare rather than a practical facility.

A further, and probably more serious, cost is the increasing incidence of hospital-incubated disease. MRSA, a form of low life which is becoming increasingly resistant to being killed by antibiotics, is in the news again as I write this. The newly discovered Severe Acute Respiratory Syndrome (SARS) has rapidly spread from its home in the Far East by hitching lifts on international airline passengers. When large numbers of people suffering from various ailments are brought together in the same aircraft — or hospital — the risks of cross-infection are obviously increased. When these patients, one after another, receive contact treatments from the same attendant, infections are more likely to spread. When the patients in question have hospital-inflicted wounds from "routine" operations, Nature's defences against infection have been breached. When antibiotics have been administered to combat infection, Nature's immune system will have been sabotaged. So it is becoming increasingly common for patients who enter hospital with a relatively minor complaint to leave it with a major, and occasionally fatal, one. The statistics, if they are compiled at all, are not widely available.

Expectations having been politically exaggerated, less than totally satisfactory results encourage the disappointed patient (or the heirs of such a patient) to sue the NHS in the hope of receiving financial consolation for their sad loss. This constitutes a lucrative side-line for members of the legal profession. Would it be too cynical to enquire if this and similar considerations might help to explain why so many Members of Parliament are lawyers?

Waste

The most debilitating effect of the NHS is that it encourages people to be sick. The "free at the point of delivery" aspect is an open invitation to have as much delivery as possible. Doctors' waiting rooms are thronged with people who have no real need to be there. People who would formerly have taken an aspirin and gone to work, or stayed in bed until they felt better, go to the doctor instead because it is "free".

We are exposed in the media to a torrent of propaganda exhorting us to go for "check-ups" in case we may be showing signs of incipient trouble from all sorts of imaginary diseases with long names merely to frighten us into persuading ourselves that we are somehow not well.

People who are long past making a contribution to the national economy join the queue for "spare part" surgery and replacement of "mechanical" parts because they are encouraged to think it will make them feel more comfortable — and because it is free. Individuals who have ruined their own natural health by burning the candle at both ends expect the NHS to remake them as good as new so that they can continue their conspicuous consumption. Infertile couples who seem to think it is a "human right" to have children can freely obtain expensive treatment on the NHS and thus swell the numbers in our already over-crowded island. When outcomes are not what such people hoped for, they do not hesitate to sue for damages on the slightest pretext. Why should the tax-payer be forced to pay to keep people who can never be anything but a drain on the national economy and who represent nothing better than lucrative custom for the commercial concerns which sell the expensive life-prolonging pills, potions, parts, and peripherals?

The doctors and nurses who would in former times have visited the sick at their homes, and possibly shared a cup of tea and a chat with them, are now virtually confined to the production line at the hospital, surgery or clinic. No wonder morale in the NHS is low and still dropping. This is a spiritual sickness that the system cannot cure. Higher salaries will merely turn willing helpers into wage slaves.

Alternatives

Of course, there are still in our society many healers who recognise that the human body is not much use without the divine spark that animates it, and who treat the whole man or woman accordingly. But such "fringe" practitioners are despised by the establishment. At worst, they are dismissed as charlatans. At best, they may be acknowledged as practitioners in "supplementary" health care, even although, unlike the establishment, they are more concerned with health than with treatments. And even so, they are being threatened by the imposition of expensive "licences" which will either stifle them within the official fold or drive them out of legitimate existence.

Millions of people who have, through their taxes, already paid for their "health care", have so little confidence in "the system" that they scrape and save to "go private". Many have taken out private insurance to pay for treatment from sources other than the NHS: but given the now parlous state of the insurance industry, it is likely that such an alternative will soon become too expensive for all but the few who can bear the costs of their own treatments.

Thus, by the exercise of its politically engineered monopoly over the care of the sick, the NHS has practically driven genuinely viable alternatives off the map.

What Can Be Done?

Those of us who would, if they could, opt out of the NHS, find ourselves in a Catch 22 situation, because the money that we might willingly spend on making our own health care provision has already been taken from us in taxes. If there were no local NHS and no taxes to pay for it, this could save us at least 1,250 pounds per person per annum. We could all obtain quite a lot of health care for that, and have some left over for making charitable contributions to support the less fortunate members of society. In this context, we should note that if there were no centralised politically-driven "Social Security Services", we should have an additional 1,850 pounds per head left in our collective pockets, and we could afford to be really generous to the needy in our neighbourhoods if we didn't have such an enormous political tail to support.

But things being as they are, all we can do to start with is stiffen our traditional British resistance to all forms of taxation. The one tiny political freedom the current electoral system allows us is to refrain from voting for any candidate who is not overtly committed to reducing taxation and keep harassing any elected representative whose commitment does not survive election.

In the longer term, we must campaign to reform our system so as to introduce more genuine democracy. Please see Towards True Democracy.