By Laurie Penny / @pennyred
This article was first published on the Huffington Post.
My partner suffers from a joint disorder which requires regular operations, paid for by the British NHS. His most recent procedure was performed without anaesthetic by a drunken surgeon wielding a rusty hacksaw. As I forced a mouldy rag between his teeth to stop him screaming, an official wearing Nazi insignia burst in and informed us that limbs were not considered an NHS spending priority, so dirty chisels were employed to remove both his legs and one of his arms. My partner is now a triple amputee, and I am forced to prostitute myself for heroin to numb the pain of living in an Orwellian super-state. God save the Queen.
This decidedly made-up story is hardly more ridiculous than the lies that Republicans have been peddling about the NHS all week. To set a few spluttering records straight: patients over 59 are not denied heart surgery; Professor Sir Stephen Hawking has come forward to say that he would not be alive without the NHS; and Republican hysteria over 'death panels' reflects more accurately the situation in the United States than in Britain. On both sides of the Atlantic, lofty officials get to choose how best to allocate a finite amount of healthcare funding - the difference is that the NHS bases decisions on its analysis of how best to deliver equitable healthcare for all, rather than basing decisions on the interests of its shareholders.
Brits all over the world have been stepping forward to defend the NHS, with 'WeLoveTheNHS' becoming a trending topic on Twitter this week, surely the ultimate signifier of public passion. The British are proud of our healthcare system, and even members of the right-wing Conservative party have pledged to defend it, knowing that without promising to uphold socialised healthcare their chances of election success would vanish.
What President Obama is proposing is not a simple transposition of the NHS setup, although it will make for a fairer system if it passes Congress. He is right not to base his plan on the British system: the NHS has its flaws; it's not a simple case of NHS good, Medicare bad. The reality, as ever, is much more complex, and is being obscured by half-truths, frothing right-wing paranoia and outright lies.
My partner's illness, however, is real - so let me tell you what really happens.
Whenever he needs an operation, my partner receives top-quality care from our local hospital - eventually. Because his debilitating, agonising condition is not life-threatening, he normally has to wait several months for the free operations, and the process of consultation and aftercare varies on a sliding scale from risible to non-existent.
On the other hand, his disability makes him unfit for most work, and were we US citizens my meagre half-salary would doubtless put us amongst the 43 million Americans with no healthcare cover at all. We can and do complain about the NHS - being British, it's one of our favourite hobbies - but the specialist painkillers he needs to get through his worst days are free, and they will remain free for the rest of his life.
It isn't easy for my partner, being 25 years old and facing a lifetime of pain and limited mobility. He worries about his future; I worry, among other things, that any children we decide to have will inherit his condition. But one thing we never have to worry about is being able to afford those vital operations, or the medication that keeps him stable.
Moreover, if I were to fall pregnant tomorrow, even on my low-income I would be treated to regular check-ups, help to quit smoking with free NHS classes, ante-and-post natal care, and food vouchers so that I could afford to drink milk, eat vegetables and take supplements to safeguard my health and the health of the foetus. By contrast, staggering inequalities in the US healthcare system mean that the United States has the highest infant mortality rate in the developed world.
I'm proud to live in a country with 'socialised' healthcare. For all its faults, its shoddy waiting lists and its dreadful dental care, the NHS system erases health inequalities and relieves millions of people, rich and poor, from the burden of constant anxiety about medical bills and sudden sickness. Even more importantly, it creates the progressive impression that the physical and mental health of the nation is the collective responsibility of all its citizens. In the process, without making a fuss about it, the British NHS truly upholds the principles of life, liberty and the pursuit of happiness for all. If that's socialism, then sign me up.
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...Twitter this week, surely the ultimate signifier of public passion...
...it creates the progressive impression that the physical and mental health of the nation is the collective responsibility of all its citizens...
...the British NHS truly upholds the principles of life, liberty and the pursuit of happiness for all.
Is the girl deranged?
Strange how people who find it hard to start up religious schools and who do not believe in indoctrination, will stamp on anyone who questions the entirely human NHS!
"We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
So as well as Law and Order, and Defence, the founding fathers realised that the General Welfare was an essential precondition of liberty. Most would put Universal Education now as part of the general welfare. Universal healthcare naturally follows. How can individuals pursue their own freedom if they are handicapped by lack of access to healthcare or education?
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are a State Controlled Health Service, Life, Liberty and the pursuit of Happiness.
By the way, I'm a fan of the NHS.I just don't like drivel.
It is a shame the Republicans who consider themselves Nationalistsic have no real interest in standing beside thier fellow American and help shoulder the shared burden in overcoming the economic and social problems they face. So much like Hannan and the Conservatives. The whole G20 stand together to address the economic issues (inclusive of Conservatives in countries like Korea) but Tories like Hannan and the US Republicans shy away from helping thier own people in terrible times. When times are tough you truly learn who the people are who care about thier country and who can see past thier own noses.
And dear Peter Jukes, could you please stop writing such, frank, dreadful TV?
Love and Kisses
I believe in individual liberty, but someone has to create the playing field where talents can thrive, and without universal healthcare and education, you've basically fixed the game in advance. This is where left liberalism and socialised provision come together.
this is an nhs promo video for the american market
Just joking.
The article?
Nice.
Makes me feel very proud and very moved. The US has very little to teach us here and the overwhelming popularity of the NHS is not more better signified by the fact so many are using it. It's greatest weakness, it is a victim of it's own success.
Thanks Laurie. I am sorry about your partner but it is really moving to hear some of the stories people have to tell. My experiences with the NHS have only been good, as for the waiting...well as I said, it's popular, if it wasn't there wouldn't be any waiting....
I applaud the good work they do as Bill says below and Thomas put it perfectly "the NHS is always there if it is needed". Hear hear!
As people have said though there is an over abundence in one hospital I worked at and other issues that others have raised, but for me overall the argument for/against an NHS is a farly mute one, long live the NHS!
I may complain a bit about how the NHS dealt with me after my tumour, but the other day they did something for me which was amazing. My son went in because it is unknown whether my tumour is hereditary, so he was made an appointment with my surgeon. Less than an hour later he was being scanned with a personal consultation afterwards and he is clear.
The NHS may well have its faults, but they've managed to put my kid's mind at rest that he could have the same problems I had, and to me I am over the moon that he won't have to go through what I went through. When the NHS get it wrong, we should speak out and challenge it, but when they get it right they should be thanked and celebrated for the work they do.
Excellent piece. Much better than we often get from supposedly more experienced journalists who contribute.
I guess the main point is we know the NHS is always there if it is needed.
From my own experience. It was awful being in an ambulance with my then four year old son who had suddenly developed breathing problems. Maybe we take it too much for granted about how easy it is to dial 999 and get straight through the A&E entrance and into treatment straight away if it is needed.
Worrying about what to do in those types of circumstances is something we are very fortunate in this country not to have to deal with.
It's a lifeline for which no alternative exists in this country. Not even in the private sector.
That's why people were getting so upset about A&E departments being closed a few years ago.
About the US situation. They need something sorting out quickly. As an example pretty much the biggest liabilities that General Motors and Chrysler had at the point they went bankrupt were connected with medical insurance/support for their employees and pensioners.
A couple of years ago it was estimated that around USD2000 of the car purchase price was just to cover those costs.
Is it any wonder they couldn't compete on price with imports. (Japan has a fantastic health care system, which the NHS could learn from)
It's difficult to see how the Republicans will win the argument on this as not having a working Health Care system has crippled a major sector of the US economy and cost the US taxpayer a small fortune. The whole of big business in the US is affected by this issue. The absence of a decent health system is effectively a tax on jobs.
Pity to spend so much of the start of your post with such made-up stuff.
Firstly it is discourteous to your readers who were initially accepting it as bone fide.
Also it makes me wonder if Robert Naether's post might be in the same vein.
Finally, you don't need the NHS to convey the two most important health messages: wear a seat belt and don't smoke. You just need common sense.
I thought "His most recent procedure was performed without anaesthetic by a drunken surgeon wielding a rusty hacksaw" was a bit of a giveaay.
You just need common sense.
The fact that the second paragraph starts with "This decidedly made-up story..." should have given you a clue.
My complaints are: one, that the unique characteristic of the NHS is not that it offers "free" health care to the poor, but that it offers free IVF to millionaires. As medical costs soar in coming years and we means test pretty much everything else, I'm not sure I'm convinced of the case for this.
Second, in France and Ireland - two other health care systems I've had experience of - the set up seems to ensure that there's a recognition on the patient's side that the treatment costs money (even though their national insurance is picking it up) and, among the medical staff, that the patient is paying (albeit indirectly) for the service they are receiving. The result in my experience is a greater respect and better attitude on both sides.
You could save yourself a lot of typing if you just changed your screen name to "I hate poor people".
And why does not necessarily thinking the NHS is the best system mean I hate poor people? Poor people also get free treatment in France and various other European countries that have insurance based systems.
I'm open to being convinced that the NHS is the best system in an imperfect world - especially as insurance based systems also struggle with more expensive treatments. It probably isn't, though, going to be by someone who claims that anyone who questions the NHS hates poor people.
It seems you can't open a debate about whether the current NHS model is anything other than utopia on earth, without being accused of being hitler and Pol Pot's best mate on this site. Look at the last few NHS threads where I've tried.
People on here are happy to call Dan Hannan 'scum' and 'lower than vermin' and to call for him to be strung up from a lamp post (all from comments on Labour List over the past cpl of days), then to twitter 'ilovethenhs' and think that constitutes a debate.
As you just found - question some of the procedures currently available to all for free such as IVF for millionaires, and you are accused of hating poor people!
However I'd say most people on here are open to ideas and realise that whilst the NHS is a good thing and we should do all we can to keep it, it does need to be looked at and if it can be improved, then it should be.
However, if people want the choice of paying to go into a BUPA hospital, why shouldn't they? Maybe I am wrong but surely that frees up a bed (and money) for someone that can't.
Also, if the private hospitals all closed tonight, would the NHS cope?
Mainly you just got my back up with the idea that people don't understand that healthcare costs money and that we'll somehow be more "respectful" if you specifically label the deduction as Health Insurance on my paycheck.
Nor am I suggesting we specifically label the deduction as Health Insurance on people's paychecks (which for some reason prompted you to claim I must hate the poor) - rather that people pay a proportion up front for which they can then get reimbursed or/and pay for private cover for the proportion not covered by the State, as happens in France and other countries. I've been in both - on a low income which nevertheless sees me contributing - and I know which I prefer.
Your personal story shows that despite the waiting times and prioritisation of the NHS, free care is crucial and can
not be taken for granted. Whatever the problems associated with illness the NHS removes worrying about money as a factor,
when a fellow citizen is not well our common humanity dictates an interest in their wellbeing.
My gripe, is that when compared to the additional trillions pumped into health care, we have not seen a corresponding level of improvement.
Given the amount we spend on health - we should have all singing, all dancing Bones from Star Trek style health facilities.
As it stands, health care in the country seems to have stood still over the last 12 years. Where has all the money gone?
(Actually, make that every 3 out of 4 managers).
I could go on and on but all I really have to say is its very very very expensive to buy these scanners. To summarise its a bit like going from normal mail to email. A massive leap from the 19th century into the 21st and all thanks to labour. Amazing considering MRI and CT have only become common place recently. (at about 500,000- 3 million quid a pop excluding staffing and running costs.)
The national debt makes all numbers look paltry, we are so used to big numbers these days, but £269 Billion is a lot of extra money.
Since 1997 the number of managers in the NHS has doubled from 20,000 to 40,000, whilst the numbers of NHS staff has grown by only 20%.
During the same time the number of beds in the NHS has shrunk from 250,000 to 180,000 - or from 12 beds per manager to 5 beds per manager. Surely this drop in managerial efficiency is unequalled anywhere else in public services?
So yes - there have been some successes, such as the digitalisation of radiology. Yet money has been squandered in vast sums and I haven't event started to examine 'overlapping Quangos', PFI deals, spending on failed IT systems and extravagant spending on consultancies.
So - the NHS Twitter war with the US means that the whole country is sticking up two fingers to the US and reminiscing about how well our Gran was looked after when she fell over - but that just serves to mask the true debate: How do we improve the NHS and spend our money more wisely.
I still ask - where has all the money gone?
I had a procedure before Xmas last year which was done in the morning and I was home in time for The Simpsons. The same procedure ten years ago meant I had to stay overnight and so less beds doesn't always equal a worse service. In my case it was much better.
Not to say there isn't a lot in the NHS that could be changed for the better, but those people who are making a straw man out of this Twitter thing have got it wrong. It's not the end of the debate, it's just a response to the negative one sided diatribe of Hannan on Faux News.
I know my issue with the Twitter thing was the way it appeared to be taken over by the politicians and the wannabe politicians to score a few points.
One of them was going on about Cameron obviously didn't love the NHS as he only said he was proud of it. I think most of us know how much he has relyed on the NHS with his son before he died so to me it was a very cheap point.
Any suggestions from one who obviously sees it from the patient side on aregular basis?
A friend of mine is a doctor treating drug addicts. She was moaning recently that much of her time with patients is spent not in diagnosis or treating them or encouraging them in their treatment programme, but in gathering data which the Department of Health insists on having. This data then goes off to the DoH, who have hundreds of people collating the data, analysing it, reporting it to ministers and then filing it. I'm sure much of the rest of the NHS is the same - a lot of the extra money has been spent on bureaucracy, central control and governance, rather than frontline services. The government have also made some strange decisions - many doctors now get paid a lot more for less work, under their new contracts which pay them more but don't require them to do out of hours care.
The same is true in education. Back in 2003, the government changed teachers contracts so that they get 10% of their time - half a day a week - out of the class to do planning, preparation, marking. (Previously, they would have done it in the evening or during the holidays. Most teachers would have done it willingly, not just because they appreciated that their annual holiday was more than most peoples, but from a sense of dedication and professional pride.) Their class is taken by a teaching assistant or sports coach or another teacher for that half-day, so the cost to schools for staff also increased by 10%. But has that increase in costs, the reduced workload for teachers, led to better results for pupils? No, it hasn't. As a school governor, I track our pupils progress, and, if anything, the change has slightly reduced pupil attainment.
Some of the extra money spent during 13 years of Labour government has been spent wisely. There are new hospitals, new local health centres, new schools, new drug treatment clinics. But some of it has also been squandered, on complicated government, more central control, changes which pay civil servants more but don't increase provision. And when you look at what has been taken away to allow that squandering, such as the decimation of working peoples company pensions by Brown's removal of the reclaim of dividend tax by pension funds, then it looks incompetant.
Darling has already admitted that we're wasting £5billion a year on unnecessary bureauracracy, which might run to £50billion over the time Brown has been running government finances. Our challenge for the future - whichever party win power, the challenge is the same - is to deliver at least the same, but ideally better, public services at a cheaper cost. More money needs to stay in people's pockets (bring back the 10p tax band!) to increase the wealth of the country, but more money needs to be spent on frontline public services and benefits. The only way to do that is to reduce bureaucracy, cut central government, reduce the number of ministers, give control and budgets back to the people who run the services.
I was then sent home in the back of a car with a broken leg and told take some pain killers, you will feel better. But a massive fit and some real pain my GP sending me back into another hospital where four years later I was told whoops we missed that one, you have a broken back, whoops we missed that your bowel and bladders not working whoops we missed that you have a lesion of the spinal cord.
Under Labour things have picked up now I get seen normally within a month and yes my pain killing drugs are free they were not always free. I now know if I had been treated as a trauma patient I might well have walked out of the hospital with all my problems cured it did not happen, because the cut backs under the Tories and the waiting for four hours was to much.
We must spend as much as it takes to keep the NHS, but can I work yes I suspect if Labour found enough help for me I could do something , but what, I cannot walk I mess my self, I wee my self I need morphine and opiates to keep my self going, so doing what.
I've spent five years under labour new deal, pathways to work, and now work fare and was told go home for god sake we cannot find employers.
Many people my could easily be mis-treated if they do not speak up for themselves.
My experience at the fracture clinic today was good but only because my husband and I spoke up.
When the consultant examined me and told me to go home and rest my ankle some more my husband asked him about the break on my ankle.
The consultant said that he would go and review my xrays (obviously he had not even checked them before seeing me),and he returned and prescribed a new cast for a minimum of 4 weeks.
If we had not spoken up I could have been walking around, doing mroe damage to my ankle and not be on track to receive physio etc. I am able to speak up for myself but many are not and what service do they receive?
The fact is you had your treatment your foot is in plaster so stop moaning about if.
If you are poor and break your foot in Germany or France youu will get better treatment on average and across the board (there are exceptions everywhere) tan you would here.
For a start, you would not have to wait for 3 hours and 55 minutes in A&E while bee stings are treated ahead of you before they 'breach'. (Do you know what that means? It is the single most important consideration for most A&E staff, and it is ludicrous!).
With a fracture if you keep still it isn't going to get worse, just hurt a lot. If you have a car accident and break a few bones then basically you'd might as well accept that its going to bloody hurt, If you get stung by a bee and it causes anaphylaxis then you may well be in need of a coroner & undertaker.
Which outpatient would you rather be, the one that's screaming or the one that's stiff?
If they are screaming and crying it means they may be in pain but they are alive.