Straws in the Windby Max TeichmannNews Weekly
, June 30, 2001
It's the poor that gets the blame
I have just been talking, by telephone, to the wife of an old friend of mine, in Oxford. He is very ill; among other things, a prostate which should have been taken out years ago, but for which he was first booked in last November. His operation has been announced, then cancelled quite a number of times, and has just been deferred again, until the end of July. No beds: this is England's National Health Service (NHS).
Meantime he has been having to wear a catheter, has had three infections because of it, and according to his wife, had a minor nervous breakdown, for a time, again, because of it.
Maybe the fact that he was taken prisoner by the Germans at Anzio, and finished the war as a slave labourer for I.G. Farben, making ammunition to kill his fellow Englishmen, hasn't helped. No nonsense about the Geneva Convention then. He is still awaiting his compensation as a slave labourer - when it comes, it may be four or five thousand pounds. So Gott Strafe England!
Were my friend - let us call him Gavin, for it is not his name - to get the operation and hospitalisation privately, his daughter when enquiring was told it would cost £4,000; i.e. $10,000.
Gavin and wife are a working class couple, who own a cottage and a small car. No capital. So no private op. A factory worker, retrenched at 56 when Leyland conked out, isn't into capital accumulation.
I see him as my twin - for we were born one day apart. He stayed as a factory worker/shop steward. I, born in Australia, could become an academic. He was as bright as I. And we were bosom friends politically; only Gavin, watching the entrenched injustices of his country, and the cynical, place-seeking, time-serving buffoonery of Labour, went more and more Left.
With Russia, then China disappointing, he was trying to convince me on my last visit, that Albania and North Korea were our last hope. Not stupidity - just desperation - and a stubborn refusal to give up principles, which he thought everyone around him was giving up. He forgave me ... I think. But it meant, among other things, that he abhorred private medicine, and insurance, and private education. So he wouldn't insure - on principle. Now it is too late. Anyway, it might have been too expensive - which is probably why most English are not medically insured, and don't send their children to private schools. Every year, every election, they are told the system's going to be fixed. Every year, it gets worse.
In fact the Tories - especially under Major - put more money into the hospital system then has Blair, though under Hague they chose for their own reasons, not to make health, or education (another disaster area) election issues: but instead harped about the Euro currency and illegal immigration. They might have done well on the latter, but like our Tories, they're too cowardly to say it as it was.
So Blair was able to give himself the credit for great reforms in health and education, while promising to do even better second time around. Chutzpah - but rewarded by a "landslide" - support from 25 per cent of the eligible voters, in the lowest electoral turnout for 83 years. A landslide built on sand, thanks to the worst Tory electoral presentation in modern times ... well since 1945, when half the Conservatives stayed at home.
But where does that leave my old friend in Oxford, and most English people? I'll just interpolate here that the familiar advice Australian travellers give out - don't get sick in England, for God's sake, but if you do, and it's at all serious, make tracks for Home - is even more true than 10 or 20 years ago.
I interpolate this because masses of young Australians are moving out of here, some to get better jobs, others to just get jobs, but very many in response to life in a closed society, where censoring out and dumbing down has removed just about every issue of moral, political, or existential importance from the public demesne. As it was earlier in their schools.
A young, close, male relative of mine, who has travelled fairly widely, said, "This country is shot". If or when he moves, I'll greatly miss him, but would understand. But most leaving us for indefinite stays elsewhere are asking, in essence, "Is this all there is?" The answer, of course, is no!; but in seeking it in my old stamping ground, the UK just remember the mounting drawbacks.
The Spectator is as good a guide to find out what's wrong with British medicine (and transport, education and criminal justice as any) so I'll draw on observations thereon, especially by its medical columnist, Theodore Dalrymple, who is a joy to read, and Christopher Sylvester's article (May 5, 2001) as to why doctors in the NHS are giving up. Patients complain of poor diagnosis, the neglect of the old; dirty conditions in hospital, rudeness from hospital staff, and above all - waiting, waiting, waiting. And the chances of hospital originated infections. As some of these factors start to appear in private hospitals, the affluent are starting to get treatment in Europe.
Doctors speak of overwork, under-pay - the difference between their peers in either law or accountancy is 50 to 60 per cent. A consultant needs six years medical school, and then eight to ten years post-medical school training, with many exams, together with the onus on ultimate patient responsibility. Nurses come and go - getting more money as agency part-timers. "Seeing that you can't attract the people," one consultant says, "and if there's no one to fill the posts, you can never fire any one for being bad."
So it still is possible to fire someone in the English health service for being incompetent or irresponsible; whereas I would doubt that that right was generally feasible in contemporary Australia, given the power, and the confrontational zeal or our medical unions. Naturally, the patients suffer.
In a journal, viz. The Spectator, so critical of union power in so many parts of English life, very little is said of union interference - the main target is administration, of which more in a moment. Nor, given the small private medical sector, compared with our or the American systems, is there much said about the perils of managed care - a very real force in our current system - although the fruits of the work of public hospital administrators in Britain seem as detrimental to the poor and aged as may emerge from our managed care philosophies in the private medical areas.
The fact is, The Spectator and English doctors seem baffled - as do our equivalents. They know things are going wrong, but don't know what to do. Victoria's current experience bears this out. Labor campaigned tirelessly for seven years about long hospital waiting lists, delays in getting operations, frequent cancellations, shortages of nurses - and promised to fix all this with much extra money.
Two and a half years on, the figures are worse than ever, while health unions are openly standing over administrators, including some of nursing homes. And this with 40 to 45 per cent in private medical hands, after Wooldridge's great drive. There should be more beds freed, shorter waiting times, less pressure on staff, more staff because more money. This hasn't happened. Why not?
Dalrymple puts it bluntly:
"Doctors and nurses have as a rule been dedicated people, but because of their allegiance to their professional standards, not because they are in the public service."
Yet successive governments "have tried desperately to destroy those traditions, in an attempt to transform doctors and nurses into the corrupt time-servers found everywhere else in the country ... The corruption of the British public service has been swift and thorough. The administration of the police, prisoners, schools, hospitals, housing departments and the social services is rotten through and through. Spin doctoring is now the queen of the sciences."
Recognise any of this here?
My friend Gavin will, I hope, get through his operation and post-operation OK; touch wood. But, having lost most of his sight over the past few years, he may later need a nursing home, retirement village or whatever. The situation there is far worse than the medical scene: nursing homes have been closing down while the population ages. Many surviving homes could not survive Bronwyn Bishop's requirements. Blair and New Labour were too busy; bombing Belgrade, blockading Iraq, arguing about the Euro, with Tony re-emphasising his eternal friendship with Bill Clinton. And stacking the House of Lords.
Now that Bush has ever so delicately indicated his lack of interest in Blair and his attitudinising, Britains may actually get a Labour PM concerning himself with conditions which brought about the birth of the Labour Party. Conditions - present conditions - which are starting to remind one of Orwell's accounts of life between the Wars, e.g. "How the poor die." But just as likely, Tony's Press Master will find all that boring, and unnewsworthy, and head him back to the world of spin - and baiting the Royals.