InstaPatrick

The National Health Service isn’t very good

What do you mean by good?

Difficult to say really (and my general views of what good means don’t seem to be a great help here). It’s one of those know-it-when-you-see-it kind of things. I suppose a lot of it has to do with how it measures up to the things around it: things in the private sector generally, things in the private health sector, health services abroad and what we know of the past.

OK then, what makes you think it isn’t very good?

The queues
The quality of care (or lack of it)
The super-bug
Apparently outcomes are worse in Britain than other Western countries
My own experiences and those of my friends and family
The buildings and the general atmosphere
(Organisationally-speaking) it doesn’t seem a patch on what went before.
it compares badly with the private healthcare sector
it lies about the scope of the treatment
other horror stories
various stories of managerial incompetence

Tell me about the queues.

You must be a foreigner. As every Briton knows, there are queues to see your GP, there are queues (known as waiting lists) for operations and there are waiting lists to get on the waiting lists.

But didn’t you find it easy to see your GP last time?

Strangely enough, yes. And a few years ago (same GP) I had to wait four weeks. Even so, I got the impression that I was lucky when I got to see my GP without much of a fuss.

So, it’s getting better then?

Well, hold your horses. My understanding is that it is not quite as simple as all that - though my memory fails me as to quite why that should be.

So, the quality of care?

I’m drawing on my own experiences and those of the people I know but it seems that staff are often indifferent if they are there at all.

Yeah, but isn’t there more to healthcare than whether people smile or not?

First of all, I think smiling (being a superficiality) is very important. But, sure, the quality of the treatment also matters. It’s just very difficult for me to judge.

Why’s that?

Because, I tend to be wary of the statistics and so all I have to fall back on is what people I know have experienced. By and large, the experience is a bad one.

So, what’s the story with the super-bug?

Thousands of deaths every year as a consequence of dirty hospitals.

But maybe the NHS’s failings are down to it not having enough money.

That might have been a plausible explanation in the past but not now. In recent years - starting in about 2001 the NHS has had huge amounts of cash thrown in its general direction but with very little to show for it.

Well, maybe it just needs some more time for the money to bed in.

Jam tomorrow in other words. But this is always the excuse made for the NHS. The NHS has had countless reforms over the years and yet it keeps on getting worse. At some point you have to accept (or, at least, accept the possibility) that its not the reforms but the NHS’s very founding principles .

You say it isn’t as good as the private sector, but isn’t it the case that the private sector is so much better because it has so much more money?

Well, it is certainly one of the reasons. But I also believe it is just better managed. There are far fewer bureaucrats and targets (as James Bartholomew points out). It is also far better at keeping its hospitals free of infections like MRSA. I can’t believe that that has much to do with the amount of money involved. There are also far fewer stories of waste in the private sector. Now, that might have something to with the NHS being publicly funded so people feel they have a right to know what goes on and so newspapers are far more likely to report on it. But, then again a private hospital that wastes money will have to charge its patients more and hence lose competitive advantage.

You mention the horror stories but what do you think they prove?

I think what they point to is an unhappy organisation. This doesn’t sound good.

But, maybe, everywhere else has its horror stories.

I am sure they have some horror stories - every organisation does. Just not as many - or so it would seem.

OK, then, assuming the NHS is as bad as you say, why is it so bad?

I wish I knew. Well, in a sense I do - lack of freedom, state interference, call it what you will. It’s probably for the same reason that all state-run services are so bad (not that I know the answer to that either).

So, the buildings and general atmosphere…

Where does one start? They are all so depressing. The buildings are often in poor condition. The signage is often in poor condition, inaccurate or completely missing. The staff often don’t seem to give a damn. I find that really depressing because I am quite sure that many of them would just love to do a good job. They’re just not allowed to. That’s very much the impression you get from a casual reading of Dr Crippen or Reynolds the ambulanceman.

But aren’t things like the state of the buildings and signage all rather superficial.

Perhaps, but I think superficialities matter.

It lies about the “scope of the treatment”?

Yes. The classic example of this is long-term care. As James Bartholomew points out although the NHS is supposed to look after stroke and Alzheimer’s patients it finds ways of weaseling out of the commitment

Permalink • Health • Last Updated: 10 January 2007

Feedback

Nothing yet but you never know...

The trackback URL for this entry is: