Sunday, October 17, 2021
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Reset the NHS – privatise it

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THE National Health Service has lasted some 70 years, but it has long since forfeited any respect, notwithstanding the ridiculous clapping ritual.

The seeds of its demise were there from the start. It began with two myths, one about the past and one about the future.

It is always assumed that before the NHS there was no health care for the poor. This is quite untrue. Those of you who have watched Call the Midwife (and observed its decline into Leftie wokery) realise that there were places like Nonnatus House long before 1948 in the poorest parts of London. Charitable hospitals existed from earliest times – nearly always Christian foundations. In fact the NHS was created by nationalising many of these institutions.

This brings us to the second myth. The dogmatic socialism that created the NHS was profligate in the use of taxpayers’ money. The initial outlay on setting up and running the Health Service was huge, despite the post-war debt already being out of control. This spending was justified with the following extraordinary piece of cognitive dissonance. The NHS founders believed that after just a few years the cost of health care would drop to a low level. They argued that once people saw a doctor and had their ailments put right, they would remain healthy and hardly need to see a doctor again. I don’t know which ‘government scientists’ told them this, but nothing changes there. (Incidentally a similar kind of argument lay behind Lloyd George’s state pension (1911) but the other way round: it was thought that after retirement few workers would survive many more years, so the costs would be low).

Many doctors were against the NHS concept, not because of greed (‘I stuffed their mouths with gold’ was Aneurin Bevan’s boast) but they genuinely feared that it wouldn’t work well. Many backed a different approach: the costs of doctors and hospitals (whether charitable or private) would be paid for by the government out of ‘National Insurance’. The government would not try to run the actual health care system.

But there was no telling the socialists: they still believed in the ‘wonders’ of state control shown in Russia, extolled by the Webbs and others in the 1930s.

So the great State behemoth was created and it was in many respects downhill all the way. When the hospitals were nationalised in 1948 there were about 450,000 beds available. After 70 years and almost limitless funding there are now 150,000 beds for a population that has increased from 49million in 1948 to 68million today.

In the early years most hospitals were still more or less self-governing and the concept of an NHS manager hardly existed. In the early 1970s there were perhaps 700 people who would be so described in the whole of the UK. Today there are 44,000 managers, each on a salary of about £100,000 (add another £100,000 for pension costs); that’s one manager for every four beds! Their total cost is nearly 10 per cent of the NHS budget and they don’t even empty a bedpan.

Those of us who have had to use the NHS know that there are, of course, some excellent front-line nurses and doctors, but they are sadly not the rule. Doctors’ surgeries are often places where patients are perceived as a nuisance. There are notices saying ‘the staff will not tolerate abuse’ etc. No such notices are available for patients who are often at the receiving end of casual rudeness or even contempt.

It is not like that at private clinics and hospitals. Granted, they don’t perhaps have the pressures NHS staff may have, but whose fault is that? To some degree a private clinic knows you have a choice.

Which brings me to a possible solution. The P-word – privatisation.

Let us go back to the discarded option put forward in 1948. Here the hospitals, surgeries etc remain either charities, trusts or in private ownership, but the government foots the bill leaving the patients to choose where they are treated and by whom. Bad hospitals will go to the wall or get their act together; useless managers and other employees will be removed, as in any business worth its salt. Patients will no longer feel that they are a nuisance.

Ah, but we are told the NHS is ‘the envy of the world’. Really? I’ve never heard a foreigner say so. Most Western countries run their health system along the lines outlined above. Most citizens do not ‘worship’ their health services but treat them much more like we treat supermarkets – they go where they choose. Their attitude is far more healthy!

‘Great Reset’ or not, privatising the NHS would be genuinely beneficial.

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Philip Foster
Revd Philip Foster MA (Nat.Sci. & Theol.)

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