Not NICE Again!

Swansea city centre last Friday night. NICE!

Another one of these pejorative, interventionist (socialist) medical reports has just been released by one of the UK's many health scare professional quangos, this time calling for enforced national temperance. I have several bones to pick not just with this particular, latest piece of medical meddling in people's lives, but with these kinds of moralising "experts" and this sort of lifestyle intervention nonsense period. They seem to think that if something "costs the NHS" x-billions of pounds, they have the right to launch into moral crusade mode, as if the NHS is some sort of precious thing with a life of its own that must be protected as an institution over and above the people who pay a fortune for it and whom it is bloody well meant to serve, doubleplusungood lifestyle or not. These are the same clowns who helped give us the pub smoking ban, with no discernible impact on smoking rates anywhere seen so far as a result of it, but the destruction of the entire pub industry imminent thanks directly to it. Hewitt's and Labour's masterpiece.

I'm not going to rant too much about this latest here - haven't got the time this morning - but I will say two further things. NICE is the same quango that regularly fails to take on big pharmaceutical corporations to get the price of, for example, life saving cancer drugs down so they are affordable. Instead it simply rations them, but never objects when the NHS iniquitously refuses further free treatment to patients who opt to buy the drugs for thousands of pounds privately. Why does NICE behave like this? Well, I was unsurprised to find out from Private Eye not that long ago (no links, sorry) that a suspicious number of "experts" who work for NICE also have strong connections with big Pharma. Surprise surprise. So it is hardly surprising that I do not trust them when they start pontificating about how people should live their lives. Sure, drink related illnesses kill 10,000 people a year (so they say). But you know what? About 500,000 people died last year, many after prolonged periods of treatment for things like heart disease and cancer and most of those diseases were the product of old age rather than any specific, chronic lifestyle problem.

Of the 500,000 dead, most were over the age of 75 (some 66% of all deaths for 2009, says the ONS). So the real "problem" for the NHS is that better diets, hygiene, sanitation, inoculation, peace, affluence, antibiotics and yes, medical technology, means that Britain's annual death rate is plummeting. And that means the NHS is having to cope with tens of thousands more elderly and infirm bods each year - and guess what, it can't. But it can't talk about that so it allows one of its quangos to go into displacement activity overdrive by talking about binge drinking which, let's face it, is far more a social ("Broken Britain") issue than it is a health issue. Ask anyone who lives in any town centre anywhere in the UK.

That's the general point. The second point is that while there are lots of good reasons to encourage people to live healthier lifestyles, especially if they are drinking too much, smoking, not getting enough exercise and/or taking drugs, you have to give them a reason why. Attempting to force people to drink less by hammering them in the pocket and saying that a) it's for their own good, and b) it's for the good of the NHS (as if some patients are somehow more 'deserving' than others) has never worked, won't work today and will never work in the future. All it will do is hammer the poorest and those millions in Labour heartlands up and down the country living on benefits while annoying the hell out of the middle classes who have done nothing wrong generally speaking (although NICE or that moron Liam Donaldson will doubtless come up with another spurious, anecdotal study on middle class binging), but who will be forced to stump up another chunk of money to fund the biggest bottomless pit the world has ever seen - the NHS.

But that's what this is really all about, isn't it? The National-bloody-Health Service. Well, at least Andrew Lansley, the new health minister, has seen some sort of sense.

"Regarding Nice's recommendations... it is not clear that the research examines specifically the regressive effect on low income families, or proves conclusively that it is the best way to impact price in order to impact demand."

He went on: "The root causes of social problems lie not just in Government policies - although 24-hour drinking legislation has severely undermined clinician and police efforts to get to grips with this problem - but in social norms and peer influence.

"We must work across Government, society, communities and families to challenge negative social norms and promote the positives."

Between the sociology-speak lines, this is more or less a comprehensive rubbishing of the report and a libertarian reading of the causes of the binge culture. A cause for hope, then, if not for celebration. We finally have a health minister with a brain. Next thing he can do is use that brain again to save his department, and us, about, oh, potentially £70 million in 2011 by abolishing Labour's drug-rationing, talkative, 1999 brainchild altogether.

the Institute [has grown since 1999] from an organisation with no staff, premises, or bank account and a nominal budget of £8.5 million a year, to a body now employing over 270 people, with offices in London and Manchester, and an annual budget of £35 million which is set to more than double over the next few years.

...said one of its talking heads last year. Well, there's been an election since then and there will be no need for a shadow, unelected Department of Health, inventing work for itself and expanding its remit daily, from now on thanks all the same. Abolition should be imminent. Well, you decide. Here's its website. It looks suspiciously like another Department of Health to me. So, and I say this with unabashed relish, this report should be that particular expensive quango's swan song.

'NICE' to have known you as they say.

Brown Thanks The Patients

It's difficult to sit through a Brown speech at the best of times, but the one he's just making in Corby, another sad, preaching to the dwindling converted effort, is so notably bad that I felt it was worth a post. Oh, and compare and contrast: Brown relying on three autocues and a heavily spun speech, speaking to small room of carefully chosen party members, Cameron earlier speaking virtually off the cuff in the open air to large crowd of people and engaging them in the debate, shirt sleave order.

Anyway, first, the lies. Brown says the Tories would cut the NHS, and apparently his goons trotted out Dan Hannan's ancient interviews and speeches on how we can solve the problem of the bottomless pit that nationalised health care has become under Brown as evidence of an evil Tory plot. This is an out and out, barefaced lie, of course. Rightly or wrongly, the Tories have ringfenced health spending. It's in the manifesto. But maybe the print's too small for Brown to read - or, more likely, he just doesn't care because it doesn't fit with his divisive, perfidious Brownian narrative.

Second, his tax on jobs. As many in the saner parts of the mainstream media have said, not ramping up National Insurance taxation means you're leaving 6Bn quid in the economy. The tax on jobs means removing badly needed capital from the productive bit of the economy. I genuinely believe that in the world of Brownomics - the economics of mismanagement and collapse, of debt-fueled booms and gargantuan busts - this simple reality is not comprehended.

Finally, the bizarre. Early in the trainwreck speech, when he was going through his usual politbureau-style list of disingenuous 'thank-yous' (cue applause from the roomful of activists - and Devon Malcolm, oddly), he decided to thank, er, the patients.

Huh? What for? For being ill?

After all is said and done, and all the reams written about this weird man, I've finally come to the earth-shattering conclusion that, simply put, Gordon Brown is definitely bonkers.

National Care Service? Not In My Lifetime

Listening to Andy Burnham on the way to work this rainy Tuesday morning was one of the less pleasant experiences of my life. What a load of tosh that idiot spouts, and in that ridiculous yob voice of his. I've never heard such a giant stream of steaming waffle, hissing piffle and stalling widdle in my entire life!
Life! Ah, life. Yes, indeed - life. As in 'long life' - and getting longer. My five year-old nephew, so we are told, can reasonably expect to live to the age of 100+. However, I think that figure could be even higher. The generation of my family born at the turn of the last century almost all died in their 80s. What is more, we read today that a horny old goat (who is 75) has just impregnated a woman.

It wouldn't be unfair to imagine, therefore, that with medical technology advancing at the rate it is, my nephew, who will hit the royal telegram age in the year 2104, can 'reasonably expect' artificial organ replacements, bionic limbs and eyes, anti-aging gene therapy and, above all, a cure for cancer. And every bit of it will be available on the NHS (honest). With all that intervention, he can 'reasonably expect' to live until he's 200 - and actively, too. He could be the first centurion daddy.

So what, I hear you scream, is the point of all this? I will tell you. The point is that the problem of care for the elderly is a problem we are facing now. It's my parents who very soon will need the kind of care that only children and expensive professional 'carers' can provide. There are elderly people now who are on their own and struggling to cope, or have lost their life savings and equity to pay for the privilege of being neglected in some dump of a care home. (This was the result of one of the most iniquitous laws ever passed, in my view. But that's another story).

It seems to me that all I heard from Burnham was a piece of pisspoor procrastination on a social issue that he doesn't seem to get (well, he's only young himself). Let's set up a commission and see what they say in five year's time, he suggested. Thank the Lord for the Big Ideas, eh readers? So, after his Death Tax suggestion was rightly rubbished, and ruled out by Darling, this whole thing appears to have been kicked into the very long grass by Labour, simply because it's too big a challenge for them to confront.

The Conservatives, by contrast, have a plan that can be implemented now. Lansley was excellent on Radio 4. Sure, the insurance plan might not help people who are already in old people's homes today, but it would certainly help my parents, who are heading in the same direction; give it a decade. By the time they need it, the system would be well-established - mature, even - and well-funded. The Labour grand plan for a National Care Service would, by that time, you can guarantee it, have been delayed, would be billions over-budget and just about to be scrapped. The Conservatives are telling us what's do-able, and how to do it.

Labour just gives us pie-in-the-sky pipe dreams that wouldn't work anyway. 'Twas ever thus.

So the Tories had better win the next election - if nothing else, then for my parents' sake! As for my nephew, well, he won't be needing a National Care Service. He'll be taking part in the Olympics when he's 150 (in 2154 - I believe they're being held in Kandahar that year).

Don't get me wrong, care where care is needed is a decent idea. But it should be the duty of children to provide that care. That's the real sign of a healthy society. I would expect, however - demand, even - that that sense of duty finally be recognised, and financially rewarded, by a Tory government. As for the State, well, its duty is clear: where there is no alternative, i.e., where there are no close family members who can provide support for their elderly or infirm loved one(s), or where that family, motivated by some form of perverse selfishness, has abrogated their duty and abandoned the needy member, the State intervenes.

Where the care becomes too difficult for the dutiful family, however, that's when the Conservatives' insurance scheme really will come into its own. It is not merely a step in the right direction - and Labour and Liberal Democrats won't even admit that, remember - it is an excellent solution to a problem confronting Britain now. The Lib Dem spokes-idiot said that a similar scheme in France only had a "20% uptake". What the Lib Dem spokes-idiot probably doesn't know (or would care about if he did) is that the other 80% in France look after their own families. Always have, always will. So the problem of how we mend Britain's broken society, where grown-up children turn their backs on sick or elderly relatives, is a separate, massive problem, you see, and one that no fantasy 'National Care Service' is going to fix.

The National Care Service is, therefore, a red herring (surprise surprise). Rather than opposing it with the expression "over my dead body", however, (which seems to be tempting fate), I'll just make a prediction: "National Care Service", laugh out loud. Not in my lifetime. Not in anyone's lifetime, for that matter. Certainly not my nephew's. He won't need the stupid thing.

And neither do we.

Burnham's NHS Bluster

Having been bed-ridden with some kind of stinking cold for the past few days, I thought it appropriate to do something on health tonight. That's not the only reason, of course, nor even the main one. The main one is Labour's latest attempt to steal Tory policy thunder with an announcement by their child of a health minister, Andy Burnham, that filled this morning's front pages, to rig NHS waiting list figures by making taxpayers pay for other people to go private.

Aside from the fact that this is an admission of abject failure, and that this sudden pledge, designed as it obviously and dishonestly is somehow to "Tory-proof the NHS" (as one Labour apologist put it) in an area where they are making significant headway with some excellent policy commitments of their own, some might be tempted to argue that making use of surplus capacity in the private sector in this way is a good idea. They would be entirely wrong.

Three of the central reasons why they would be wrong are that, first, private health care is preferable to NHS care, and many millions of people choose to pay the extra cost, because the spare capacity, deliberately made, creates a better service and zero waiting times. The spare capacity itself is made possible by high levels of properly managed investment and best management practice. The NHS - and government - has a lot to learn from private health care. The effect of the government intervening and paying private hospitals effectively to solve the problem of over-demand and inefficiency in the NHS will be to spread the disease: it will kill spare capacity in the private system leading, inevitably and quickly, to price hikes. In the end, private patients will actually be squeezed out of the market by government subcontracting. Perhaps this is the Labour party's real aim.

The second of the central reasons why this is such a bad idea is partly a moral one. It's not just private patients who will end up being clobbered by a government that once again seems willing to rig the market to mask its own total incompetence. It's the taxpayers as well. Who does this government think it is? It must think people are astonishingly stupid if it thinks they will not notice that they will be paying for the same health service (already the most expensive and inefficient in the world) twice if, God forbid, this government actually won the next election and brought these measures in. It is not only an insult to the electorate's intellegence, however, it is morally wrong for a government to use legislation to fleece the population for political and dishonest motives. Those motives? 1. To massage waiting list figures; 2. To further the notion that "entitlement", in the socialist sense, is some sort of moral absolute and is something that only the state, not the market, can fulfil; 3. To embarrass the Tories (though I'm not sure how they expect this policy announcement will achieve that); 4. Possibly to gain some control of the private healthcare system by, effectively, buying it off. Some might have their doubts about this last one, but people should never forget that it has always been a long term aim of the Left to kill off all competition to the state provision of services, particularly in the areas of education and health.

The third central reason why this is such a bad idea is, of course, the most simple to grasp and straightforward to explain - and it's the most powerful: it's Labour's idea and it would be a Labour ministry trying to enforce it. The past 12 years tell us very clearly, especially when it comes to PPP or PFI or subcontracting arrangements with and within the NHS (and everywhere else), that it would be a full-scale, monumentally costly catastrophe.

Health care is never free, but at least with the Tories there's a chance we might get a bit more value for money. If this Labour government is re-elected all we will have is less and less for more and more - and Burnham's blustering policy announcement proves that point perfectly.

National Health Sulkers

NHS staff: Not worth the money

The problem with the NHS is not the commendably egalitarian principle upon which it is founded: universal health care (not, you will note, "free" health care), but the appalling behaviour of vast numbers of the people it expensively employs. I felt absolutely certain that my own, generally terrible (with one exception) experiences of British hospitals are by no means unique. So you can imagine I was pretty relieved to find there's at least one honest journalist left in Britain, who is unafraid to challenge the Labourist myth, which has taken such a firm grip of the British imagination, that the overall performance of NHS staff, 'carers' and managers alike, is anything other than below average. I'm not the only one, it seems, that knows NHS staff are often rude and/or incompetent, overpaid and quite frequently do more harm than good, particularly but not exclusively to the elderly; that its disastrous management practices and overmanning has bled treatment budgets dry; that its costs are now completely out of control.

I'm not the only one, it seems, who has lost a member of his family as a direct consequence of if not malpractice, then mistreatment, by medical staff.

Other than all that, I do concede: it really is the world's best health service.

Christina Patterson in today's Indy is the honest journalist in question. While she does (inevitably) pull one or two punches thanks to her inexplicable left-slant, the thrust of her piece is sound and self-evident: the National Health Service does not adequately serve the people who pay for it.

Since I don't twitter or tweet or cheep, I can't, alas, add to the patchwork quilt of warm, cosy feelings to which Sid_Goon, LimeJellyTeddy, Flopsydaisy and a certain Gordon Brown have contributed lovely little crocheted squares. But it's hard not to be a little bit touched by the British response to the Americans who will fight to the death to preserve the right of 40 million of their neighbours to die without medical treatment because they are – spit the word – poor.

While our transatlantic cousins dig deep into their pockets to fire javelin or hellfire missiles at their Joker president and his plans to swap the current system of private health insurance for communist death camps, we're responding with the battle equivalent of macramé catapults and pots of home-made jam. Sarah Brown, who has, apparently, attracted a massive Twitter following for her comments about nice weather, strawberries and trips to the zoo, was in Hallmark mode. "#welovetheNHS" she said, making impressive efficiency savings on spacing, "more than words can say".

Andy Burnham, the 12-year-old Health Secretary, indicated post-political aspirations to reffing by declaring himself "over the moon about strong support for NHS", but felt obliged to add that his primary allegiance as New Labour new lad was to Everton FC. And "PM" (not, thank God, the one whose moobs have recently been subjected to massive media scrutiny) thought he'd kill two birds with one stone by drafting a Twitter-length foreword to his next book on courage. "NHS often makes the difference," he said, "between pain and comfort, despair and hope, life and death. Thanks for always being there." Or perhaps it was intended as a text message to Sarah.

And then, of course, there's the public. Civilians, non-celebs, non-politicians, ordinary people (but not, please God, "hard-working families") boring on about how they had cancer and the NHS saved their life. Well, let me add to them. I had cancer and the NHS saved my life. I'm extremely pleased to be alive, and I'm very, very grateful. But the process, it has to be said, lacked grace.

I will not bore you now with the contradictory statements by consultants, or the three-hour waits for appointments that were cancelled, or the invitations to appointments for dates which had passed. I won't bore you with the lost files, and the lost X-rays, and the mammogram that turned out to be an X-ray of an ankle, or the surgeon who told me that he thought my approach to a mastectomy (which I didn't, in the end, have) was "a bit heavy". I won't bore you with the nurses who sighed and sulked and were soldered to their chairs, apart from the one who asked me, in a rare fit of bewildered humanity, why I was crying. Er, because I've got cancer and I'm still in my 30s? A teensy bit upsetting, non?

But I will tell you this. The big problem with the NHS is the people in it. Maybe they start out wanting to help their fellow human beings, to lift them, as our dear leader says, from pain to comfort, from despair to hope. Maybe they fill out a form in triplicate (two of which get lost) saying that they want to help people, and get sent off to training schools: the consultants to one where they learn to flick through a file with a sense of harried self-importance and turn to you briefly and sneer; the receptionists to one where they learn to regard the arrival of a patient as a nasty intrusion in a nice day's chatting, and one to be punished with a lengthy wait; and the nurses... It would be frivolous to mention Abu Ghraib. But tempting.

And as for the managers, some of whom earn more than the Prime Minister, more even than a GP... Well, let's just remind ourselves that a group of them, from Liverpool Primary Care Trust, have suggested this week that children should be banned from seeing 101 Dalmations because they might catch a glimpse of a cartoon cigarette. How about forgetting being Stalin and sorting out your IT and your files?

There are exceptions. Of course there are exceptions. And in the six years since I found that little lump in my breast, a lot has got better. Waiting times for my check-ups are now much shorter. The waiting room is much, much nicer and at Christmas you get mince pies. So when, a few weeks ago, one of my friends found a lump in her breast, I hoped things would be better for her. She was diagnosed quickly, thank the NHS; she was operated on quickly, thank the NHS, but the nurses were sulky and lazy and rude. One of them, she said, spent all day at her computer, writing religious poems.

We seem to be living in an age when everyone wants the security, and holidays, and sick leave of the public sector, but there's one little problem. They don't like the public. They don't like nursing them; they don't like filing their X-rays, and they don't like representing them in Parliament.

So, let's be clear. Universal healthcare, paid for by taxes, is the hallmark...of a civilised society. But there's another hallmark of a civilised society. And that's showing a bit of kindness to people at their most vulnerable. If you can't do it, do something else.

Precisely.

The Burnham Test

Andy Burnham, our Health Secretary (no, really, he is), has accused Dan Hannan of being "unpatriotic" - presumably for failing to support the current US government's healthcare policy. Curious definition.

With Blair it was illegal Bush wars, with Brown it's madcap Obama health nationalisation plans.

So we now have what we might call "The Burnham Test": if you don't support a US government policy a Labourist UK government happens to like, then you're somehow anti-British. That's a pretty odd test of patriotism - and one that will attract only richly deserved contempt from our "partners" in Europe and beyond.

As for the NHS - well, I have to assume this is the same "world class" health service that failed to spot my aunt's two broken fingers three weeks ago and fobbed her off with a couple of packets of cocodamol (the NHS's drug of choice). Oh yeah, the broken fingers were in the original radiology notes. But the doctor treating her apparently failed to notice them because he could barely speak English. Nothing controversial about that. It's just a fact - and one which was acknowledged today after she went back to the hospital - in agony - to complain that her hand was not healing and a doctor who could read English immediately discovered the "mistake". "Oh, Mrs ---, you've got two broken fingers!"

Lucky she wasn't being tested for cancer the first time around, I guess. She'd probably be dead by now - like so many others.

World class indeed.

Sorry for sounding so "unpatriotic", Andy.