By Lew Knee,
Gun control. What right have the government got to tell me whether I can or cannot keep a semi automatic rifle under my bed? What right have the government got to tell me that I shouldn't be able to walk around with a concealed handgun on my person? What right have the government got to tell me I shouldn't be able to shoot an intruder who enters my house without permission? I have no history of mental illness and no criminal record after 49 years living on the planet, so who are the government to tell me that I cannot walk around dressed to kill? What is freedom if you cannot walk into a High Street Store and buy a semi automatic weapon, especially if you are a truly fine citizen of the state? Freedom is all about taking personal responsibility. Guns don't kill people, people kill people. We don't have people control legislation, so why do we need gun control legislation. God Bless America and Burnt Oak.
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I guess this opening paragraph is not quite what Barnet Eye readers were expecting to read. Nope, it's not really a guest blog at all. I was reading some American blogs earlier this evening and I thought I'd give my fellow Barnetonians a taste of what our cousins across the pond seem to think are sensible rational points to raise in blogs.The views stated above are not extremist in the USA. The right to bear arms is part of the constitution and to even start to question it is viewed as a virtual act of heresy.
So does the Barnet Eye think that the citizens of Burnt Oak should be walking the streets of the Watling with an Uzi? Does the Barnet Eye think that Colindale would be better with a Kalashnikov? Strangely enough, nope. Oddly enough, this blog would like to see unlicensed possession of a firearm punished with a minimum mandatory sentence of five years. The same for possession of a knife. Pro gun campaigners in the USA make a myriad of claims, seeking to justify the lax gun laws, but at the end of the day, look at the statistics for gun related crime in the USA.
However, I'm not really interested in gun control arguments. In the UK there is pretty much a consensus on this. I've never met anyone who has seriously argued for lax gun control. Ever. What I am interested in is the fact that Conservative politicians in the UK regularly take their lead from US conservatives. Where has this lead us? To the current ridiculous situation with Andrew Lansley's "reforms" of the NHS. I've just watched Mr Lansley on News at Ten "arguing his case". Sadly he hasn't really got one. As I understand it, his sole justification for all of the changes he's promoting is "Trust me, I'm a Tory". There are three possible reasons for making changes to anything,
1. You'll get better services for the same or less money.
2. You'll help more people for the same or less money.
3. You will stop a system which is failing from falling apart.
It really is as simple as that. Has Mr Lansley proven beyond doubt that his changes will do any of the above? I believe that US right wing politicians hate and despise the NHS. Why? Because it works and because anyone who understands the way it works can see that their arguments for a private system are the modern day equivalent of snake oil salesmen. I was in the USA in the run up to Obama's election. Conservative politicians were on the TV every day denouncing the NHS. Some claimed that the UK was a communist state because it had a system of social medicine. I have many friends and family in the US. Those familiar with the UK, know our healthcare system delivers more for the money. It may not be perfect, but you get treated if you need it. The US system does not have that guarantee.
The hard right of the Tory party are in awe of uber rightists who would soundly agree with every word in the opening paragraph. These are the people who the likes of Lansley look to for political inspiration.
Without the NHS, I would have died at birth, my mother would have died aged 45 in 1970 of cancer, rather than aged 83, my nephew would have died of meningitis aged 8, my auntie would not have just had her cataracts done. Lansleys changes will put health care professionals out of work and create jobs for accountants and lawyers. In an open market, everything is subject to contract and invoice. You wouldn't want a bunch of bonkers right wing looneys writing our gun control legislation, so why on earth would you want them destroying the NHS?
Showing posts with label NHS reforms. Show all posts
Showing posts with label NHS reforms. Show all posts
Wednesday, 29 February 2012
Wednesday, 25 May 2011
NHS reform
Is it possible to have a sane and rational discussion about NHS reform? Let's try shall we?
Ok, so what sort of system of healthcare do we have in the UK. I would say we have one of the very best in the world. If you are poor, you won't be thrown to the wolves because you can't pay for it. If you are middle class and you get a long term debilitating illness, you won't be bankrupted, when your healthcare plan runs out and they kick you off. If your children become ill, you might worry about how they respond to treatment, but you don't worry how you pay for it.
There is also one aspect that is never discussed. If you are stinking rich, what do you get? Well you get all the above + you get the ability to pay for a healthcare plan and jump the queue. This is why I get really sick of millionaires sticking their oar in and moaning about the health service. It wasn't designed for them. They will be alright whatever the healthcare system we end up with. I just saw on the news that the government wants to introduce more choice. This is utter bollocks. How does this supposedly work. "Mrs Jones, you've got cancer. You can go and see Dr Black who is really crap and you'll die in two weeks or you can see Dr Burgundy who is great and you'll live till you're 116, which would you prefer?" What would your choice be? Sounds like a great system, this internal market, doesn't it?
Nope, sorry that's not how it will work. It will work like this. Your GP will know that sending you to Dr Black will cost his budget £50,000 and sending you to Dr Burgundy will cost his budget £100,000. The choice is his, not yours, because you don't have the facts as to who is better. Who do you think your GP will send you to. If he sends you to Dr Burgundy, that's £50,000 less in his budget to pay himself a bonus. What do you think he'll say?
Or look at how private corporations may run wards/services. Just suppose the Barnet Eye wants to go into provision of Health care. Barnfield General want me to take over some provision of services. They give me the choice between running the A&E department or the oncology department. Which would I, as an astute businessman rather run? Simple really. The one I can make most money from. So how do I do this? Well they agree a menu of prices for services and I then look at how I can provide them as cheaply as possible. Just suppose I happen to know that Dr Burgundy is the worlds greatest oncologist and he's working there. Because he's so marvellous, the Wellfishy trust pay him £250,000 a year and he has a whole team of highly trained, long term staff who know what they are doing. I look at this and say "Dr Burgundy is charging £100,000 for a course of treatment. Dr Black in Walford General only charges £50,000 and so he's getting more business and the hospital make more money". What do I do? Do I say "but Dr Burgundy is the finest oncologist in the world". Do I hell. I sack him and break up his team and get Dr White in, who has no track record whatsoever, but can provide the treatment for £40,000. Then I undercut Dr Black. Who suffers? Not me, I make shedloads of money. What do I care, happy days are here.
But three years down the line, when the survival rates start to drop, the consequences become apparent and the true cost is revealed, it is too late. Dr Burgundy has long gone, his team have been scattered and the damage is done. What happens then? That is how "internal markets" work. That is how private companies conduct their business. I'm not saying that all private companies are always bad, or that all health care trusts will act with complete disregard for the patient as described. Of course their are SLA's and quality targets. It's just that at the end of the day, private corporations exist to make profits. If prices are fixed, these can only be maximised by cutting costs. Cutting costs forces out the best people. Where do they go? Into private clinics where rich individuals can afford to pay a premium.
I don't believe that quality of medical care should be purely driven by the ability of the patient to pay. I believe that in a civilised society, we should all expect, as a right, the best quality healthcare. This may be expensive, but if we got rid of the managers, lawyers and accountants who run the internal market, it would be a damn sight less expensive than the current system. I guess the difference between myself writing this and Clegg/Cameron who will actually decide is this. They are millionaires so the effects will never hurt them. Neither of them has ever run a business, so they have no idea what decisions you make on a daily basis to make your business efficient. Perhaps the biggest difference of the lot though, unlike Mr Clegg and Mr Cameron, when I last visited a hospital, I didn't get red carpet treatment because I was an important politician. I wouldn't want it, but how on earth can they pretend to know what sort of treatment the rest of us get?
Ok, so what sort of system of healthcare do we have in the UK. I would say we have one of the very best in the world. If you are poor, you won't be thrown to the wolves because you can't pay for it. If you are middle class and you get a long term debilitating illness, you won't be bankrupted, when your healthcare plan runs out and they kick you off. If your children become ill, you might worry about how they respond to treatment, but you don't worry how you pay for it.
There is also one aspect that is never discussed. If you are stinking rich, what do you get? Well you get all the above + you get the ability to pay for a healthcare plan and jump the queue. This is why I get really sick of millionaires sticking their oar in and moaning about the health service. It wasn't designed for them. They will be alright whatever the healthcare system we end up with. I just saw on the news that the government wants to introduce more choice. This is utter bollocks. How does this supposedly work. "Mrs Jones, you've got cancer. You can go and see Dr Black who is really crap and you'll die in two weeks or you can see Dr Burgundy who is great and you'll live till you're 116, which would you prefer?" What would your choice be? Sounds like a great system, this internal market, doesn't it?
Nope, sorry that's not how it will work. It will work like this. Your GP will know that sending you to Dr Black will cost his budget £50,000 and sending you to Dr Burgundy will cost his budget £100,000. The choice is his, not yours, because you don't have the facts as to who is better. Who do you think your GP will send you to. If he sends you to Dr Burgundy, that's £50,000 less in his budget to pay himself a bonus. What do you think he'll say?
Or look at how private corporations may run wards/services. Just suppose the Barnet Eye wants to go into provision of Health care. Barnfield General want me to take over some provision of services. They give me the choice between running the A&E department or the oncology department. Which would I, as an astute businessman rather run? Simple really. The one I can make most money from. So how do I do this? Well they agree a menu of prices for services and I then look at how I can provide them as cheaply as possible. Just suppose I happen to know that Dr Burgundy is the worlds greatest oncologist and he's working there. Because he's so marvellous, the Wellfishy trust pay him £250,000 a year and he has a whole team of highly trained, long term staff who know what they are doing. I look at this and say "Dr Burgundy is charging £100,000 for a course of treatment. Dr Black in Walford General only charges £50,000 and so he's getting more business and the hospital make more money". What do I do? Do I say "but Dr Burgundy is the finest oncologist in the world". Do I hell. I sack him and break up his team and get Dr White in, who has no track record whatsoever, but can provide the treatment for £40,000. Then I undercut Dr Black. Who suffers? Not me, I make shedloads of money. What do I care, happy days are here.
But three years down the line, when the survival rates start to drop, the consequences become apparent and the true cost is revealed, it is too late. Dr Burgundy has long gone, his team have been scattered and the damage is done. What happens then? That is how "internal markets" work. That is how private companies conduct their business. I'm not saying that all private companies are always bad, or that all health care trusts will act with complete disregard for the patient as described. Of course their are SLA's and quality targets. It's just that at the end of the day, private corporations exist to make profits. If prices are fixed, these can only be maximised by cutting costs. Cutting costs forces out the best people. Where do they go? Into private clinics where rich individuals can afford to pay a premium.
I don't believe that quality of medical care should be purely driven by the ability of the patient to pay. I believe that in a civilised society, we should all expect, as a right, the best quality healthcare. This may be expensive, but if we got rid of the managers, lawyers and accountants who run the internal market, it would be a damn sight less expensive than the current system. I guess the difference between myself writing this and Clegg/Cameron who will actually decide is this. They are millionaires so the effects will never hurt them. Neither of them has ever run a business, so they have no idea what decisions you make on a daily basis to make your business efficient. Perhaps the biggest difference of the lot though, unlike Mr Clegg and Mr Cameron, when I last visited a hospital, I didn't get red carpet treatment because I was an important politician. I wouldn't want it, but how on earth can they pretend to know what sort of treatment the rest of us get?
Monday, 11 April 2011
The Barnet Eye : An Apology
Before the last election, this blog suggested that due to his own personal experiences, David Cameron valued the NHS and would not destroy it. How wrong could I be? I apologise and urge everyone to wake up to the fact that the NHS is being systematically destroyed.
Tuesday, 15 March 2011
Professor Dexter Whitfield on Outsourcing
Europe's leading expert on Public Sector outsourcing gave a presentation to the Barnet Alliance for Public Services tonight (Tuesday 15/3/2011). It was most illuminating. I've prepared a brief video report of the event, highlighting some of the fundamental flaws which Dexter has identified in the strategy of local and national government.
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