NHS: the sacred cow has run out of milk

AmbulanceFive hours ago 45,000 junior doctors went on strike in protest over the new NHS contract on offer.

The contract doesn’t look half-bad: a 13.5 per cent hike in salary and a cut in the maximum weekly hours from 91 to 72. However, to comply with the campaign promise of a seven-day NHS, the government proposes to pay the hours worked between 7 am and 7pm on Saturday at a normal rate, rather than the premium doctors currently receive.

The heirs to Hippocrates and Florence Nightingale like the first part, but hate the second. That’s why they’re on strike, with ambulance paramedics to follow in short order.

Health Secretary Jeremy Hunt reminded TV audiences of the campaign pledge. The NHS must be available seven days a week, he said, making one wonder what had happened to anguished patients on weekends before that promise was made.

Then Jeremy added a touch of melodrama. People will die, he confidently predicted, and their deaths will be on the greedy strikers’ hands. The NHS is skint. Jeremy is already throwing an extra £3.2 billion into that bottomless pit, and what do those greenhorns suggest he should use for even more money? He stopped just short of charging the strikers with multiple attempted murders.

Actually, if the experience of Belgium is anything to go by, things aren’t as bad as all that. Back in the 1960s, all Belgian doctors went on strike for several months. Counterintuitively, the mortality rate during those months showed a statistically significant decrease, prompting the oddball Austrian philosopher Ivan Illich to opine that all diseases are iatrogenic, meaning caused by doctors.

So people probably won’t die just yet, but the NHS surely ought to. Every day, strike or no strike, vindicates my belief that any giant socialist project, even if supposedly dedicated to public service, will end up dedicated to personal self-service.

The strikers are a case in point; the oath they took isn’t so much Hippocratic as hypocritical. They want their overtime pay and, if they don’t get it, those patients may bleed on the A&E floor for all the medics care.

Want to find some extra funds, Jeremy? I have an idea: fire 90 per cent of the administrators, those directors of diversity, optimisers of facilitation and facilitators of optimisation, all on six-figure salaries.

Not so long ago, a hospital was run by the head doctor and the matron, with a backroom accountant doing the sums. Now administrative staffs come close to outnumbering frontline medics, with hospital beds routinely cut to accommodate yet another director of diversity.

This stands to reason: any giant socialist project must spawn a vast freeloading bureaucracy taking care of the business at hand. That, contrary to the traditional belief, isn’t medical care any longer. The purpose of the NHS is the same as that of any other giant socialist project: increasing the state’s power.

Frontline medical staffs are not only extraneous to that purpose but can be downright threatening to it, and even those NHS employees who aren’t intelligent enough to realise this rationally feel it viscerally.

Hence the selfishness of the striking doctors. And hence also the generally pathetic state of our medical care, placing Britain firmly into the third world rubric.

It’s not just secondary care either – GP practices are nothing short of useless now. A mere dozen years or so ago I could get an appointment the next day or even, with some grovelling, the same day, and I always saw the same doctor.

These days it takes a fortnight if I’m lucky, and then I have no choice of which of the five GPs (and God knows how many locums) I’ll see. Any doctor will tell you that continuity of care is a significant factor: it helps if a doctor knows the patient inside out. Continuity is out of the window now, closely followed by care.

Ex-Chancellor Nigel Lawson quipped once that the NHS is the closest most Brits come to a religion. If so, and I do think he was right, they’re worshipping a false God.

An otherwise intelligent doctor (his intelligence slightly dimmed by a few glasses of Burgundy) once screamed at me that the NHS is the envy of Europe. If so, those envious Europeans must use up every ounce of willpower not to follow our example: ours is the only comprehensively socialised health service on the continent.

Every other country has a mixed system of public and private care. This is much more effective than the NHS – and much cheaper than our private medicine. But yes, I know that deep down they’re all turning green with envy.

As I keep saying, the NHS isn’t a disaster because it’s badly or corruptly managed. It’s a disaster because it’s based on a bad, corrupt idea, one that has been shown up for what it is everywhere it has been tried in earnest.

Underneath it all, this issue, as well as just about all others, isn’t technical but moral – and therefore also technical. The powerlust of our governing elite is as robust as ever, which is why the udders of this sacred cow have run dry.


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