NHS: Cameron's Rhetoric is Wearing Thin

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NHS: Cameron's rhetoric is wearing thin | openDemocracy

Speaking on the Today programme yesterday the Prime Minister claimed to be committed to what he called our ‘precious’ NHS. He said he wanted it to go on succeeding, free at the point of use. But unless he is still not paying attention to what is in Lansley’s Bill (which is possible, as Cameron often seems curiously indifferent to the detail of his government’s policies) he is being completely disingenuous.

The crucial point is this: the Bill relieves the Health Secretary of his existing responsibility for providing a universal and comprehensive health service, and doesn’t allocate it to anyone else. It leaves it up to unaccountable local GPs grouped in Consortia to decide what services their particular patients will be entitled to, and what they will have to pay for, and how much, and this can vary from one consortium to another – goodbye both comprehensiveness and universality. It leaves an unaccountable healthcare market regulator (Monitor) to decide what private companies can offer NHS patients, and whether they can underbid NHS hospitals on price, and it mandates Monitor to promote competition – goodbye free care at the point of delivery.

The whole thrust of the Bill is to create a competitive market with a large expansion of provision by companies focussed on shareholder value. To pretend otherwise is, frankly, to insult the public’s intelligence. And it doesn’t make it any better to declare, as Cameron did, that because the population is ageing, the NHS ‘has to change’. That sort of rhetoric has lost all traction with the growing number of people who have woken up to what is going on. Change is constantly necessary in all services. The question is how handing over the NHS to market forces is supposed to improve it. The evidence points decisively against competition in health care and by now everyone knows it.

In March the BMA came very close to declaring outright opposition to the Bill. The nurses at their Liverpool conference in April repudiated the Bill and Lansley with it – by a majority of 478 to six. Unison and Unite are massively opposed. Cameron now says he would like ‘more full-throated support’ from the NHS workforce. Even his capacity for spin is getting seriously overstretched.

The name of the game for Cameron and Lansley now is to appear to be making ‘substantive changes’ to the Bill which will in fact leave its aims intact. The patently deceptive Future Forum ‘listening’ exercise with its Panel of five, chaired by a notoriously pro-market GP, plus 40 handpicked medics and managers, is designed to give a fig-leaf of legitimacy to what will actually be a behind-the-scenes search for amendments that look major but are not. These will not include the ‘essential amendments’ proposed by the Lib Dem rank and file after the Sheffield conference; those amendments are incompatible with the aims of the Bill and Lansley will not be accepting them. Whether the Lib Dems will tolerate yet another abandonment of their principles remains to be seen.

The task for everyone who is genuinely committed to the principles of the NHS is to ensure that the true aim of the Bill is kept clearly in view, and to insist that the media don’t collude in the lazy sort of misrepresentation that Cameron is hoping to get away with.

This article is published by Colin Leys, and openDemocracy.net under a Creative Commons licence.

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Market Forces: Coming to a Prison or Hospital Near You

The steady erosion of the public service arena continues apace with two developments this week either side of the Atlantic.

In Arizona, a state commission is recommending the privatisation of the state's parks and prisons, in an attempt to reduce a $1 billion budget deficit in the state.

In the UK, meanwhile, a private firm has been selected to take over the running of an NHS general hospital (Hinchingbrooke Hospital in Huntingdon) for the first time in the history of the health service in Britain. Circle, the new "franchise holders" are a co-operative company.

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Responding to Jerry Bowyer on Healthcare

The current debate, if it can be called that, about health care in the United States is one that I have generally avoided taking part in on this blog. The following video, however, has proven too strong a provocation for me to resist.

In it, radio broadcaster Jerry Bowyer misuses our beloved British National Health Service in order to give support to his own position on healthcare and in doing so expresses disrespect for an institution which is held in high regard here in the UK. More significantly, Bowyer makes a number of statements that are simply untrue or which appear designed to mislead and sow fear among his listeners.

Specifically:

1) He states that UK doctors are low paid. However, recent figures compiled by the British government's Department of Health and reported in the British Medical Journal here reveal that the average pre-tax salary of a British General Practicioner (equivalent to a local family doctor in the US) was £106,000 per year ($175,000) in 2007. Commenting on this figure, the British Medical Journal suggests that "there is a groundswell of opinion [in Britain] that GPs are being too generously rewarded."

The same article from the BMA compares average salaries among doctors internationally and reveals that British doctors are higher paid than their peers across Europe and trail behind only American doctors on an international comparison of medical salaries.

2) He states that physicians in the UK are "civil servants" comparable to post masters, without the same level of prestige as doctors in the US and that this fact makes the profession less attractive to British citizens as a career choice, opening the door to foreign-born doctors from Muslim majority countries.

As a British resident, I can assure Mr Bowyer that his view of British doctors is way off the mark. It is a highly respected profession and doctors are routinely among the most trusted individuals in their community. A recent poll rated them as significantly more trusted by members of the public than teachers, academics, judges or church leaders.

Furthermore, applications by British students for medical degree courses at British universities are hugely oversubscribed every year. Over 1000 applicants applied recently, for instance, for the 40 available medical training places available at Bart's Teaching Hospital in London.

It may be difficult for Mr Bowyer to appreciate - and this may reveal a cultural difference between the two countries - that "prestige" in a British context cannot be equated solely with salary in the way that he might assume to be the case in the United States. Medicine is very much seen as a vocation rather than a business in Britain - as it happens, a well paid and well respected vocation.


3) He states - ably assisted by the un-professionalism of anchorman Neil Cavuto - that the number of foreign Muslim doctors in Britain increases the probability of terrorist attacks taking place in the UK.

Fox News illustrates Mr Bowyer's thesis with images of Dr Bilal Abdullah who drove a car loaded with gas canisters into the front of Glasgow Airport in 2007, causing 5 injuries.

The message is that, since Dr Abdullah worked in the National Health Service and was a muslim, Americans can expect to be attacked by foreign Muslim terrorists with increased frequency if the current health care reform bill is passed.

That an educated man such as Jerry Bowyer could publicly make so stupid a statement almost defies belief.

Mr Bowyer is aware, I presume, that Dr Bilal Abdullah was born in Aylesbury, Buckinghamshire - a more traditional English town would be difficult to imagine. His father was a doctor and Abdullah trained for medicine in Baghdad.

More informed sources than Jerry Bowyer have conducted factual research into the nature and extent of Islamic terrorism in recent years. An extensive investigation into the number of terrorist attacks by Islamists worldwide between 2001 and 2006 was carried out by Peter Bergen and Paul Cruickshank of the New York University School of Law and published in 2007.

The facts reveal that, whereas there were no attacks on European soil between 2001 and 2003, the number of fatal attacks rocketed after 2003 - the year that British and American forces invaded Iraq - and that 297 civilians died in these attacks.

What do Bergen and Cruickshank conclude about the reasons for this upsurge in terrorist violence? More Muslim doctors, perhaps? Surprisingly not. The report's authors state that,

"We are not making the argument that without the Iraq War, jihadist terrorism would not exist, but our study shows that the Iraq conflict has greatly increased the spread of the Al Qaeda ideological virus"

and that

"the Iraq War has generated a stunning sevenfold increase in the yearly rate of fatal jihadist attacks,
amounting to literally hundreds of additional terrorist attacks and thousands of civilian lives lost"

and

"our survey shows that the Iraq conflict has motivated jihadists around the world to see their particular struggle as part of a wider global jihad fought on behalf of the Islamic ummah."

Mr Bowyer also fails to mention that in the United Kingdom, national health doctors are required to treat the entire population, not only those who can afford health insurance. 100% of British citizens have a legal right to healthcare, free at the point of delivery. It really would be an excellent thing if our American neighbours caught up with us.

In the meantime, we must put up with this nonsense. Watch if you can bear it.

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