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Home > Politics

The NHS: Pain, Profit and Loss

16 June 2006

We were in hospital last week. A friend, taken hideously ill, was rushed to the local NHS concrete-and-vending-machines casualty unit (Jug-eared Crisps? Coke? In a casualty waiting room? Are you sure?), where she was seen in extraordinary time, drugged up to her eyeballs and discharged, a tick in the box for Ealing NHS Trust's performance targets. We were hugely impressed.

It matters very little to the statisticians, then, that they completely misdiagnosed her, leading to all kinds of near-fatal complications; an evening in casualty becoming several days of acute observation under another NHS Trust, but targets were met, and as far as business managers were concerned, everybody went home happy.

Such is the rush to clear the waiting room, one has to ask: is the business of the National Health Service no longer about treating patients effectively, or it is more about running a business? How, in the name of open heart buggery, did we end up here?

In the last week, Health Secretary Patricia Hewitt reported record losses of 512 million within health service trusts. This is the same minister who declared the NHS was enjoying its 'best year ever', an assertion up there with 'This'll be the best Christmas Walford's ever seen' as Most Wrong Statement Ever, if you'll excuse us for stealing one-liners from Doctor Who. As Best Years Ever go, hardly a view shared by the 12,000 health workers who have lost their jobs, nor those hit by cancelled operations and ward closures. God help us all if we ever have a bad year - it'll be a return to barber-surgeons and little old ladies brandishing coat-hangers.

Sweeping statement: the whole rationale of NHS patient funding is wrong. In most cases, the patient hardly notices that they are simply product passing through the system like a small, cheap car on a production line. It is when they become seriously ill, or their treatment requires a new, budget-busting drug that finance trumps clinical need.

Even with its newly-approved status, breast cancer drug Herceptin will continue to haunt NHS managers. A course of treatment costs approximately 20,000. The drug is hugely expensive because it cost Roche millions to develop, and although they're in the business of manufacturing life-saving drugs, they're hardly a charity. One Herceptin patient might be the equivalent of a dozen other life-saving treatments. With a limited budget, and an arcane NHS accounting system that actually punishes overspent Trusts twice over, which, as a clinical manager, do you choose?

It's that old, old question: cure the pillar of community with cancer, or the privatised bus-load of tramps with scabies. Statistics, eh?

This government's obsession of exposing public services to free market conditions has become just as extreme as the administration they replaced, only with a lack of competence that makes us wonder why they bother at all. Free markets are one thing, but then restricting the market to a closed list of preferred suppliers who then charge as they please is quite another. Sensible financial management, yes. Profit and loss, certainly not.

The clue's in the name. Public. Service. The NHS is not a business, and should not be run as if there are shareholders to please. But as long as successive governments feel this way, it is only fair to go the whole hog and privatise everything. So, we've thought long and hard about this and have submitted a list of other free market schemes for government consideration:

* Sub-contracting our next big invasion to the cheapest bidder. India's far closer to Iran that our little island, and it's only a small step from opening a call centre in Bangalore to a full-scale airborne assault on Tehran with troops fully briefed with the latest happenings in Albert Square.

* A radical reassessment of the failing Scotland football team, putting the entire business into 'special measures' with a new management team. Should Scotland continue to fail, it might be worth educating customers into following another, marginally more successful team, such as England.

* The Fire Service. Naturally we can't leave this vital service in the hands of a bunch of freeloading lefties, while there's a huge profit-making potential behind a privately- owned pay-per-burn facility. Competitively priced on a sliding scale, from fifty quid for cat-up-a-tree to twenty grand, a night with your wife and the rights on any progeny for a full-on inferno, with a Tesco Value version for council estates with a three month waiting list. Just like dentists, then.

* The Police. Cunning one, this. The Old Bill like to be visible around many of our country's housing estates. Allowing Police Service provision to fall under the management of Stagecoach and First Group means they will achieve this objective, and get a shiny big bus into the bargain, which can double up as a Black Mariah on Friday nights. A Black Mariah that charges offenders 1.20 for a single trip to the police garage, or a 60 quid on-the-spot fine. Detection rates up and guaranteed income. It's a win-win.

We're still waiting for a reply. Perhaps it's lost in the privatised post.

Comment on this article: letters@thefridaything.co.uk

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