“The NHS will provide a universal service for all based on clinical need, not ability to pay; the NHS will provide a comprehensive range of services.”— credo of the National Health Service

I have always admired the Brits and their great tradition of post-war humor–from Peter Sellers in ‘I’m All Right Jack’ to Monty Python’s Department of Silly Walks, to Terry Pratchett’s Swiftian satire masquerading as fantasy: British humor is without peer. And I have always wondered at the source of this great gift. I think I’ve found it: they have better raw material than anyone else. Take the National Health Service, for example.

Please.

Fifty years ago, it started out as a grand dream, a secular faith-based initiative which, like so many other socialist schemes, had its heart in the right place and its head up its ass. Today, it is quite literally a farce and on the verge of imminent collapse. What went wrong? A brief search of “NHS” in the the Times and Telegraph newspapers pulls several suggestive pages, all written within the last two months.

In a recent Times op-ed piece Scottish journalist, Gillian Bowditch, writes:

There is nothing national about the health service these days. The past decade has seen the balkanisation of healthcare and for many that means living in the medical equivalent of Albania….

The long-standing criticism of the NHS is that it is a statist, centralist and monolithic institution and there is truth in that diagnosis. Almost 50,000 people work for the NHS in Scotland — one in every 17 adults in paid employment….

Nowadays it is routine to hear of pensioners having to plunder their savings or local communities having whip-rounds for sick children to pay for the care they need. In an era of 24-hour banking and round-the-clock shopping, an eight-month wait for an essential medical procedure is an eternity….

Politicians rarely experience the service that many of their constituents have to tolerate. It does not take them weeks to make an appointment with their GP or months to see a specialist. Their medical notes are not incomplete. Their test results do not go missing and their operations are not repeatedly cancelled at short notice. Nobody is going to leave the first minister languishing on a trolley in a dingy corridor.

The key problem here, of course, is that government’s strong suit is not creating prosperity as the Left would have you believe; it’s creating monolithic bureaucracies that like to give the impression of creating prosperity by moving wealth from one pocket to the other. With any luck, some one else’s.

In the NHS, the UK has loads of material worthy of a great satirist:

1) It’s up to its neck in medical specialists, yet can’t afford to hire any of them. Those who are employed, hate it.

…the NHS is in desperate need of all their skills – but it simply cannot afford to employ them. In some areas, waiting lists for physiotherapy stand at six months and for speech and language therapy, up to a year.

2) The quality of care you receive depends on how you vote.

The survey, which identified 177 hospitals already affected or likely to be affected by cuts, revealed that Conservative and Liberal Democrat seats are 2½ times more likely to be affected by cuts than Labour seats.

3) Whether you receive a treatment depends on what amounts to the flip of a coin.

A long time ago it was the doctor who decided which drug would be best for their patient, basing their decisions on the research, their knowledge and their experience. But health care became more expensive, hospitals and health authorities started getting short of cash. Stricter budgets were introduced and it was down to the personality and attitude of the consultant as to whether the patient got the better drug or not.

But in the cash-strapped NHS, rationing already exists: in some areas, health authorities restrict access to certain treatments, using their own rules to decide who will be eligible.

4) Fewer children go to the dentist and many are flat-out refused care.

Up to two-thirds of children in some areas of England are failing to get regular dental treatment as thousands of youngsters have been dropped by dentists no longer willing to provide free National Health Service care.

5) Expensive procedures are rationed, forbidden or just not developed. An inexpensive mammogram competes with a colonoscopy. Your ‘lifestyle’ is factored into whether you receive treatment or not. Your health is in the hands of an accountant.

As Dr Tessa Whitton, a physican diagnosed with a deadly stomach cancer said:

“They told me that they did not fund this treatment, there was insufficient evidence of efficacy, the cost-benefit ratio was inconclusive and there were no exceptional circumstances,” says Tessa. She was furious. “I’m 39 years old with 20 years of useful work ahead of me,” she says.

With a dispassion that’s Orwellian, she received this response from the NHS:

“The exceptional funding panel will look to see if there are any grounds as to why one person should be treated differently from patients with the same condition,” says it’s spokeswoman, Vicky O’Loughlin.

And Dr Whitton summarises it this way:

“We are the fifth richest country in the world, but years of chronic underfunding in health care have knocked innovation on the head. Our cancer survival rates are some of the worst in Western Europe.”

Obviously, if your job is not important to society, you are going to die.

6) The waste is so great that they have 574 different types of unneeded hip replacement parts.

7) The place is overun with expensive management consultants who duplicate efforts.

“What extra can these trusts be getting from duplication of management costs by employing outside management consultants without significant NHS backgrounds, apart from huge bills?

“If you had made this up, you would be laughed at.

8) In some regions, the doctor will give you tonsilectomy whether you need it or not. In other regions, there are no emergency rooms. Or you have to wait in an ambulance for 4 hours before being conveyed into the hospital.

A prominent physician states:

…while the government has mainly succeeded in meeting its NHS targets, the underlying picture is one of “little or no evidence of improvement in NHS performance, which ranks among the worst in the developed world”…

…the emphasis on targets has resulted in what the report calls “gaming” — other services being neglected in order to achieve targets. In some NHS trusts patients have been kept waiting in ambulances until managers were confident they could meet the four-hour waiting-time target inside the hospital…

Britain is virtually the only advanced country not to have recorded an improvement in mortality rates from strokes in recent years, and fatalities are twice the level recorded in Australia, Canada, Japan, Sweden, Switzerland and America.

9) Many medical procedures are just useless.

Patients are being forced to undergo painful, unnecessary and ineffective treatments because of widespread inequities in the NHS that are wasting billions of pounds a year, according to the Government’s chief medical officer.

So desperate is the situation that he recommends this course of action as a corrective to unnecessary medical treatment:

…computers in hospitals and GP surgeries could be programmed to block a doctor from prescribing a treatment that had little or no evidence of its worth.

Emphasis, mine. Now there’s a solution for ya.

Of course, I also found the obligatory letter to the editor from a concerned Times reader–Arthur Pewty, perhaps–who still believes that the NHS, whatever its transparent failings, is superior to the American system with its evil competition:

Dear Sirs:

The US now spends 16 per cent of its GDP on healthcare, yet 46 million Americans are without any health insurance; Britain spends half that, and the NHS covers everyone.

Sincerely,

Arthur Pewty (deceased)

He must just read the comics.

Update:

As if on cue, Doctor Feingold.

Feingold’s bill will probably lead to a vicious circle of higher health insurance costs. Give people previously uninsured access to relatively generous health insurance benefits, and they will overuse health care. When they overuse health care the price of health care will increase, leading to higher prices for health insurance. As the price of health insurance climbs, more employers will drop their coverage. As more employers drop their coverage, more employees will opt for the State programs established under Feingold’s bill. Wash, rinse, repeat.