You will only understand the complexity of the public/private health provision dilemma once you’ve experienced both for yourself. Yelling Lefties and bellicose Righties will pontificate forever on the subject, but only the experience of being a patient (and carer of the patient) will give any citizen the complete and honest picture of the task facing whatever real reformers come after the robotic idiot Lansley.
The key dimensions are these:
1. Both services contain hospitals, and hospital doctors. The former are Kafkaesque prisons, and the latter suffer from mild to acute idiot savantism.
2. Both services have woefully undertrained nursing staff, and organisational communications so hopeless as to be black holes into which vital information is sucked and then never seen again.
3. In the NHS, you will be patronised at primary care level, and forgotten once in hospital. In the private sector, you will be admitted to hospital with difficulty from primary care, treated like royalty while you are in hospital, and forgotten once you leave.
4. The NHS provides affordable health care which, with luck, won’t kill and might cure. The private sector offers affordable health care to the super-rich 3%, top corporates, and those who can afford private health cover on account of rarely if ever being ill. The flaws in both systems should be obvious to any pre-pubertal teenager, but represent a baffling enigma for all civil servants, politicians, and health provision managers.
5. Healthcare demand is infinite, but cannot be rationed. Nobody in public life has yet fessed up to this reality, let alone tried to deal with it.
6. The answer at five is to switch from trying to do everything (up to and including the secret of Eternal Life) over instead to a system designed – within strict limits – to improve quality of life during our allotted span.
7. Expenditure priorities as set by civil servants, hospital/practice managers and medical staff are job-creatingly complex, insane and Utopian respectively. Giving all three groups a say results in car parks with impenetrable payment machines, pay TV for every bed, and IVF on the National Health.
8. Government pussy-foots around poor diet, without baring its teeth at the sociopaths who sell double-size Mars Bars and megacheap 37.5% white spirits.
The answer is twofold:
a. Take the problem away from the Sir Humphreys and the Ed Milibands – and forever out of insurer/profit-driven hands – by mutualising health services on a regionally mutualised basis…complete with savings provision, like the old building societies.
b. Make food manufacturer levies part of the funding model.
That’s it. Thank you, goodnight, and enjoy the weekend.