Let's take the "NHS is perfect but the Tories are destroying it" argument at face value. Is a healthcare system which is so vulnerable to being ruined by crap governments really such a brilliant model? An institution cannot simultaneously be the envy of the world and on the brink of collapse. Every other European country has conservative governments from time to time, but no other European country has waiting lists that balloon whenever those right-wing governments are in power. Everywhere else's hospitals chug along unfazed regardless of who's in charge.
I fear we are sleepwalking towards a scenario where both parties acknowledge that healthcare reform is the only way of escaping the current cycle of constant crisis, and yet neither party will be able to do it. Tories can obviously never be trusted by the electorate to do it, while Labour are terrified of meddling with what is generally seen as the greatest achievement in their history. Labour will win the next election, will flood the system with money, and yes, waiting lists will go down again. (Actually that's another reason Labour will want to keep the current system around - "24 hours to save the NHS" is a very useful rallying cry.) But the underlying problems will remain. I don't know how long we'll be able to paper over the cracks, but it's not forever.
'How to argue with a moron about the NHS. Best not to bother, really.'
Then you go right ahead and bother, by writing 1,000 words & including 7 graphs. Concluding with:
'By this point you will have realised that it is pointless arguing with morons about the NHS.'
Not quite as pointless, perhaps, as setting up a series of Aunt Sallys so you can get a kick out of calling them - and, by implication, anyone who disagrees with you - 'morons'. Quite the most moronic thing I've read today.
You want your writing read with respect? Show some.
It's not a healthcare system, it is only an emergency service and barely that now. I receive no medical care for the condition I have, instead mostly what I have received from the NHS is abuse , lies and astronomical incompetence which on top of severe and chronic pain caused by my condition is a pretty disgusting way to treat someone. THis abuse from NHS staff has led to having to me having to make several waste of time complaints processes . THe default position with complaints is to fob you off to the ombudsman who are just another breastfeeding baby of the UK regime. As for the funding, that disappears in waste and corruption. Waste of time attempting to reform this out of control monster now, just delete it forever. I always say to people if you were offered a choice of two boxes of matches, one of which were working matches at a cost £1 and the other was 'free' but were dud matches which would not light, which would you choose? Having a free but useless service is of course what a moron wants.
If only the Attlee government had recognised in 1948 that food is as important to well being as health and created the National Food Service to operate alongside the NHS. Today we would all be boasting about our queues for meagre rations of State determined products as being the envy of the world, while at the same time holidaying in the rest of the world and enjoying their cornucopia of comestibles.
hi! what's this article about? it';s far too dense for me, and with really boring pictures — like some old used up hair combs. In any such "arguments" I'd be in the first place interested to know how old the criticist is, what's their health like, and how much disposable income is normally available to them. (all purely rethorical, i'm not really interested in this data {insert friendly face emoji})
Focusing your argument on repudiating moronic strawmen does absolutely nothing to strengthen it. The Tories’ debacle in charge of the health service comprised:
- A spectacularly ill-conceived reorg under Lansley that decimated strategic leadership for the NHS, both institutionally (removal of SHAs) and individually (as many of the best leaders and managers left in despair)
- The decimation of public health, prevention and primary care, as the first of those moved to LAs who had no incentive to protect the budget and no expertise in delivery, and as hospitals gobbled up an increasingly large percentage of the spend because they had so much more power than CCGs, many of whom couldn’t distinguish between arse and elbow anyway
- A 14 year de facto hiatus in capex investments, which resulted in — surprise — opex going through the roof (quite literally in the case of building repair costs)
These are just the three failings that spring fastest to mind. There were legions of others, driven by the Tories’ unique combination of incompetence and malice.
If you want to be actually impressive with a disagreement, try doing a substantive response to Sam Freedman’s recent report on how best to fix the NHS.
Incidentally, your understanding of how non-UK healthcare systems are organised appears to be fixated on finding meaningless differences, while studiously ignoring important similarities. The Spanish and Italian and Finnish health systems all have public servant, salaried doctor models, working in publicly funded institutions, providing care that’s free at the point of delivery to the bulk of the population, just like the UK. Same goes for Norway, Denmark, and many others. Some of them provide *a broader scope* of state-delivered services, eg primary care is not delivered through an independent contractor model.
I remember Chris well, as Comrade Joyce on Twitter I spoofed a health advert regarding the level of sugar in various products and, fair play to him, he asked me if it was genuine.
He also asked me for a cocktail recipe with white rum, but I got banned before I could get back to him.
Good essay. When critics present false arguments about the Tories, they aren't precise enough about their criticisms, What they should state is that back in the sixties some form of actuarial back of the envelope calculation about aging populations was made, which argued that spending in needed to increase by 3.8% per year in real terms, just to keep pace with increasing demand.
This is clearly insane and unsustainable. What's missing is market mechanisms. The average coke can today contains 7 times less aluminium than its forbears and costs 30% less energy to produce- where is the comparable efficiency in medical markets. Nowhere. Not even in private systems, because insurance unfortunately suffers from the same type of incentives against market efficiency as government, though not as bad. Insurance companies make money from the size of the insurance pot underwritten and profits made from investing the sum in the period before a claim is made- what Warren Buffet has termed the float.
But here's an interesting titbit. It's worth reading the KIng's Fund as a source on medicine. Although I couldn't find the source, at one point the King's Fund did a comparison between Australia and the NHS. Apparently they had seven times as many hospital beds as we did here in the UK, although other sources will very likely contradict this source. They also happen to top most leader boards using slightly important metrics, like whether or not a patient is likely to die after receiving treatment.
The easiest way to enact change is through legislation that makes digital docs admissible in court. Manager and admin staffing levels in the UK are comparable to other countries, but what gets missed in the huge amounts of bureaucratic process doctors and nurses are forced to complete as a part of their job, for admin purposes and for the purposes of liability shielding.
Fascinating data. So, what is the problem? Is it just inefficiency, lack of qualified doctors and nurses, pay and conditions, poor bargaining with pharmaceutical companies?
One of the many problems is what we focus on. As Cally says above, the NHS is fixated on acute care, because that’s where things reach crisis point. Which means primary care - where the big gains in health rather than sickness are to be made - gets shoved aside (and let’s not even start on mental health).
*This was the direct result of the Tories’ first policy decisions in 2010*. The Lansley “reforms” abolished SHAs and instituted CCGs who had absolutely no power relative to acute hospitals, and what’s more, were crippled by concerns about conflicts of interest if they did move pathways out of hospital and into the community. Plus public health was sent to the LAs, where it has absolutely withered. We used to spend a reasonable percentage of the health budget on primary care, which is why people used to be able to see a GP and GPs could act as gatekeeper and risk manager for local populations. That all got shat on post-Lansley. I remember there was a GP who used to wear a bow tie who was very excitedly pushing for getting hold of commissioning at that time. He said “our time has come” and some conference of GPs who wanted to commission and got a big cheer. And then they all tried their hand at it and found out that it’s really hard, requires decent managers (who amazingly aren’t available for salaries of say 60k for thankless roles where they get called pen pushers by the Mail), and that the acute Trusts are pretty good at throwing their weight around and getting the budget. I’ll bet his bow tie has sagged now
The biggest step this country can take in separating religion from state is by abolishing the NHS
Let's take the "NHS is perfect but the Tories are destroying it" argument at face value. Is a healthcare system which is so vulnerable to being ruined by crap governments really such a brilliant model? An institution cannot simultaneously be the envy of the world and on the brink of collapse. Every other European country has conservative governments from time to time, but no other European country has waiting lists that balloon whenever those right-wing governments are in power. Everywhere else's hospitals chug along unfazed regardless of who's in charge.
I fear we are sleepwalking towards a scenario where both parties acknowledge that healthcare reform is the only way of escaping the current cycle of constant crisis, and yet neither party will be able to do it. Tories can obviously never be trusted by the electorate to do it, while Labour are terrified of meddling with what is generally seen as the greatest achievement in their history. Labour will win the next election, will flood the system with money, and yes, waiting lists will go down again. (Actually that's another reason Labour will want to keep the current system around - "24 hours to save the NHS" is a very useful rallying cry.) But the underlying problems will remain. I don't know how long we'll be able to paper over the cracks, but it's not forever.
Brilliant as ever. If the NHS is so amazing why don’t we run our supermarkets using the same system? Because people wouldn’t put up with it that’s why. See what I mean here. If it’s ok to post https://open.substack.com/pub/lowstatus/p/alternative-medicine?r=evzeq&utm_campaign=post&utm_medium=web
'How to argue with a moron about the NHS. Best not to bother, really.'
Then you go right ahead and bother, by writing 1,000 words & including 7 graphs. Concluding with:
'By this point you will have realised that it is pointless arguing with morons about the NHS.'
Not quite as pointless, perhaps, as setting up a series of Aunt Sallys so you can get a kick out of calling them - and, by implication, anyone who disagrees with you - 'morons'. Quite the most moronic thing I've read today.
You want your writing read with respect? Show some.
It's not a healthcare system, it is only an emergency service and barely that now. I receive no medical care for the condition I have, instead mostly what I have received from the NHS is abuse , lies and astronomical incompetence which on top of severe and chronic pain caused by my condition is a pretty disgusting way to treat someone. THis abuse from NHS staff has led to having to me having to make several waste of time complaints processes . THe default position with complaints is to fob you off to the ombudsman who are just another breastfeeding baby of the UK regime. As for the funding, that disappears in waste and corruption. Waste of time attempting to reform this out of control monster now, just delete it forever. I always say to people if you were offered a choice of two boxes of matches, one of which were working matches at a cost £1 and the other was 'free' but were dud matches which would not light, which would you choose? Having a free but useless service is of course what a moron wants.
If only the Attlee government had recognised in 1948 that food is as important to well being as health and created the National Food Service to operate alongside the NHS. Today we would all be boasting about our queues for meagre rations of State determined products as being the envy of the world, while at the same time holidaying in the rest of the world and enjoying their cornucopia of comestibles.
hi! what's this article about? it';s far too dense for me, and with really boring pictures — like some old used up hair combs. In any such "arguments" I'd be in the first place interested to know how old the criticist is, what's their health like, and how much disposable income is normally available to them. (all purely rethorical, i'm not really interested in this data {insert friendly face emoji})
Absolutely spot on.
Focusing your argument on repudiating moronic strawmen does absolutely nothing to strengthen it. The Tories’ debacle in charge of the health service comprised:
- A spectacularly ill-conceived reorg under Lansley that decimated strategic leadership for the NHS, both institutionally (removal of SHAs) and individually (as many of the best leaders and managers left in despair)
- The decimation of public health, prevention and primary care, as the first of those moved to LAs who had no incentive to protect the budget and no expertise in delivery, and as hospitals gobbled up an increasingly large percentage of the spend because they had so much more power than CCGs, many of whom couldn’t distinguish between arse and elbow anyway
- A 14 year de facto hiatus in capex investments, which resulted in — surprise — opex going through the roof (quite literally in the case of building repair costs)
These are just the three failings that spring fastest to mind. There were legions of others, driven by the Tories’ unique combination of incompetence and malice.
If you want to be actually impressive with a disagreement, try doing a substantive response to Sam Freedman’s recent report on how best to fix the NHS.
Incidentally, your understanding of how non-UK healthcare systems are organised appears to be fixated on finding meaningless differences, while studiously ignoring important similarities. The Spanish and Italian and Finnish health systems all have public servant, salaried doctor models, working in publicly funded institutions, providing care that’s free at the point of delivery to the bulk of the population, just like the UK. Same goes for Norway, Denmark, and many others. Some of them provide *a broader scope* of state-delivered services, eg primary care is not delivered through an independent contractor model.
I remember Chris well, as Comrade Joyce on Twitter I spoofed a health advert regarding the level of sugar in various products and, fair play to him, he asked me if it was genuine.
He also asked me for a cocktail recipe with white rum, but I got banned before I could get back to him.
Good essay. When critics present false arguments about the Tories, they aren't precise enough about their criticisms, What they should state is that back in the sixties some form of actuarial back of the envelope calculation about aging populations was made, which argued that spending in needed to increase by 3.8% per year in real terms, just to keep pace with increasing demand.
This is clearly insane and unsustainable. What's missing is market mechanisms. The average coke can today contains 7 times less aluminium than its forbears and costs 30% less energy to produce- where is the comparable efficiency in medical markets. Nowhere. Not even in private systems, because insurance unfortunately suffers from the same type of incentives against market efficiency as government, though not as bad. Insurance companies make money from the size of the insurance pot underwritten and profits made from investing the sum in the period before a claim is made- what Warren Buffet has termed the float.
But here's an interesting titbit. It's worth reading the KIng's Fund as a source on medicine. Although I couldn't find the source, at one point the King's Fund did a comparison between Australia and the NHS. Apparently they had seven times as many hospital beds as we did here in the UK, although other sources will very likely contradict this source. They also happen to top most leader boards using slightly important metrics, like whether or not a patient is likely to die after receiving treatment.
The easiest way to enact change is through legislation that makes digital docs admissible in court. Manager and admin staffing levels in the UK are comparable to other countries, but what gets missed in the huge amounts of bureaucratic process doctors and nurses are forced to complete as a part of their job, for admin purposes and for the purposes of liability shielding.
Fascinating data. So, what is the problem? Is it just inefficiency, lack of qualified doctors and nurses, pay and conditions, poor bargaining with pharmaceutical companies?
One of the many problems is what we focus on. As Cally says above, the NHS is fixated on acute care, because that’s where things reach crisis point. Which means primary care - where the big gains in health rather than sickness are to be made - gets shoved aside (and let’s not even start on mental health).
*This was the direct result of the Tories’ first policy decisions in 2010*. The Lansley “reforms” abolished SHAs and instituted CCGs who had absolutely no power relative to acute hospitals, and what’s more, were crippled by concerns about conflicts of interest if they did move pathways out of hospital and into the community. Plus public health was sent to the LAs, where it has absolutely withered. We used to spend a reasonable percentage of the health budget on primary care, which is why people used to be able to see a GP and GPs could act as gatekeeper and risk manager for local populations. That all got shat on post-Lansley. I remember there was a GP who used to wear a bow tie who was very excitedly pushing for getting hold of commissioning at that time. He said “our time has come” and some conference of GPs who wanted to commission and got a big cheer. And then they all tried their hand at it and found out that it’s really hard, requires decent managers (who amazingly aren’t available for salaries of say 60k for thankless roles where they get called pen pushers by the Mail), and that the acute Trusts are pretty good at throwing their weight around and getting the budget. I’ll bet his bow tie has sagged now
Please can we get this hate speech cancelled
Masterful. Not sure how you stay sane.
Spot on