An unhealthy position
Dr Hamish Meldrum, head of the British Medical Association (BMA), said in a New Statesman article in January that said he “is anxious that the principle of ‘universality’ and ‘comprehensiveness’ on which the NHS was founded, are imperilled by the fantasy of The Health and Social Care Bill and the creation of a utopian marketplace in which private providers compete with state care”.
It seems that Meldrum and the medical profession he represents are not subscribing to reforms and therefore criticising them very heavily. Indeed, there is nothing wrong with that. Constructive and well-delivered criticism should be able to improve government proposals but only if there is a counter offer. So what proposals are coming from the head of the BMA? What can be done? – asks journalist Jason Cowley. “The solution is simple”, Meldrum says. “Get rid of the market in the health service.”
If the government is utopian in its proposal, at least it demonstrates an understanding of the concept of the market, because Dr Meldrum does not, but would like to get rid of it nevertheless. Nobody competes within the health sector but healthcare is universally and comprehensively delivered. I assume it is still sponsored by the government who decides how much and whom to pay. I can only presume that if budgets are tight the providers will be paid less with an expectation to deliver the same universal care. We could call it ‘healthcare communism’.
Nigel Lawson said: “The NHS is the closest thing we have to a national religion in this country.” But it is not a religion and doctors are not high priests/priestesses. Human life is sacred and constitutes the highest value. The same cannot be said about healthcare. Let us remove the NHS from its altar and place it in a rightful, important dimension of social duties. But let us not make a mistake, healthcare is not free, actually is extremely costly, and as such belongs to the marketplace.
Politicians try to guard fairness and transparency. More people are getting better health care today than ever before in European history.
An unbelievable amount of energy and resources are poured into the service day after day. It is not perfect and it never will be, but this is not what we are worried about, are we?
We have reached such an historical moment that we are seriously concerned whether we as a nation can afford the ever-growing demands put on the NHS without fundamental changes to its structure, procurement and financial models.
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Using your rationale, if healthcare was not extremely costly it wouldn’t belong to the marketplace. Is that the only reason for the marketplace to be appropriate? If so, it’s hardly a convincing argument. Some other countries which have healthcare in the marketplace, eg USA, have even more costly systems in terms of the effect on the country’s economy, plus other deficiencies such as pricing out key elements of healthcare to parts of the population,with which “human life is sacred” too; using your approach to labelling could we call this “healthcare capitalism”?
I think the question is fairly simple: is it right that obese drug-injecting drunken smokers on motor-bikes should be looked after by the taxpayer? Once you’ve answered that one, it all seems to me to get a bit easier.
Heres some intelligent comment on the issue
http://bengoldacre.posterous.com/what-will-happen-with-the-nhs-bill-in-5-tweet
The big question for the UK voters and government isn’t Ian’s, especially as it only covers a tiny number of people due to all the criteria he applied. The big questions have always been & will always be “Is all human life sacred or is just some human life is sacred?”, followed by if yes to the 1st part, ” How much are we willing to pay to service that?”
Roy: 1/”as such” refers to “not free”;2/ interesting point and to answer your question ‘healthcare capitalism’ does not sound right for all the reasons you have mentioned in your note.
Ian: I wish it was that simple. Healthcare also relates to the reasons why drug-injecting drunken smokers on motor-bikes should be looked after by tax-payer but expanding on thati would need to write a longer piece.
to ‘bitter and twisted’
I looked at your link and your comments are very perceptive. What I would say is that healthcare market need to be based on values to which healthcare providers will adhere at every step of the life time of service to every individual.This is where we struggle but it does not have to be a lost battle.
Good points in the link from “bitter & twisted”; lots of them with a procurement angle. Shouldn’t the procurement profession be making its views known on this key issue which affects everyone?
I agree. It would make a lot of sense.