Wednesday, August 17, 2005

Not national, not healthy and not a service…..

A few posts ago, I was severely slapped on the knuckles via the comments box for sharing my cash dodging experiences of how to get out of Hospital car parks without paying. The reason I do this is because of my fervent belief that it is fundamentally wrong to charge people for visiting a hospital – especially as the public transport system would shame a banana republic. I see absolutely no difference between car park charges and charging people at the door to get in through a turnstyle. We go there as patients or as visitors to see sick friends or relations – we don’t go there to do the shopping. I see these charges and others like them as creeping and insidious tax top-ups dreamt up by the BMW pinstripe brigade of strategic health officials.

I don’t think charging people for ‘extras’ was part of Nye Bevan’s utopian vision of free health care for all. Mind you, I reckon Bevan would be horrified to know that the NHS is no longer ‘National’ …… and to be honest, not much of a ‘Service’ either really. The NHS has degenerated into a collection of fiefdoms, run by such ‘indispensable’ middle and senior pen pushers that were all but non-existent 25 years ago.

Ever anxious to make every square yard in the hospital ‘pay its way’ at any cost. Creative thoughts from red braced power thinkers on more ways to wring even more cash out of patients that have already paid their dues via the tax system seems to be the order of the day. They have already earned the right to their treatment – ideally free of charge.

It started in the mid eighties, with the arrival of Healthcare Trusts as profit centres, actively selling and buying skills and equipment time from other like minded organisations. Pretty soon, senior management began to look at realising assets that were not theirs to realise. First the car parks were rented off to a third party to ‘administer’ and maintain them – for an annual fee, obviously. It has moved onto excessive call rates for the use of the ward phone and a particularly insidious and nasty charge to view the ceiling mounted ward televisions at exorbitant rates. These examples are small potatoes compared with the selling off of ‘redundant’ buildings to developers, however.

By ‘redundant’ I’m talking about 'unfashionable'. By 'unfashionable' I'm talking about 'assets to be flogged'...... Buildings like old people’s homes and period nursing homes suddenly being declared unsafe. The residents kicked out and re-housed in some God awful gulag – the unsafe building, usually an Edwardian Mansion suddenly being converted to executive apartments….

Such an episode happened in my own part of the world about 3 years ago. A group of old people, living in a beautiful Edwardian country house within its own grounds were suddenly being moved ‘for their own good’ to an overcrowded '70's hovel in a nearby new town. The excuse from the health authority was that it would cost too much to refurbish – and in spite of wide spread protests, the closure of the home went ahead. Within 3 days, 4 of the old people had died, within 3 weeks, the ‘dilapidated’ mansion was put up for auction. It was even featured on one of those daytime TV property programmes. The slimeball property developer thought he’d got a real bargain, paying £700,000 for the house, he reckoned that he could squeeze some 11 apartments out of it. He said the building was very, very sound – and the only work he would really have to do would be the sub division of the house into apartments. He said he would make about 2.5 mill profit….

Thankfully, local feeling and the downturn in the housing market has meant that he hasn’t sold any…… the last time I past the building he was offering substantial reductions on hastily daubed property boards.

The whole concept of the NHS providing a service – for the benefit of the people that have paid money to finance it seems to have been left behind as some sort of old fashioned reactionary nonsense. The whole concept of everyone receiving the same level of healthcare, no matter where you are and how important you deem yourself is further away than ever. Damning evidence is provided via the Government’s own figures – England predictably fare the worst of the 4 home countries, Scotland come away with most money spent per head of population.

"But why do we have to pay? Didn’t we pay for the building of that car park out of our taxes?" Shouldn’t that MRI Scanner be financed via the Treasury? This country should be sophisticated and savvy enough to organise and optimise healthcare for all throughout the length and breadth of the land. A formula of 1 MRI scanner per so many thousand of the population should not be an insurmountable problem to solve.

But the NHS isn't fair, or free or reliable is it? Live in the South East of England and you get much better cancer care than the North West. Drugs available as a right in Norwich but not in Newcastle, some hospitals are virtual death sentences, such is their awful reputation..... And then there’s the devolution debacle – free prescriptions for all in Wales by next year, nudging seven quid in England. Free dental check ups in Scotland, going up to sixteen quid in England, (if you can find a dentist in England). Fantastic old persons care in Scotland, non-existent except via pernicious means testing in England. And who knows, patients in Scotland and Wales probably get free car parking to boot!

My own local Health authority has just announced losses of 6.5 million quid. They have committed to savings of £13 million over the next 2 years in an effort to balance the books…… They rather laughingly declare that services will not be affected.

It’s all part of the Government project to get out of properly funding the NHS. I notice they have started to put their grubby little digits into the National Lottery coffers – the word from them, (from the Right Hon’ Peter Hain no less) is that apparently, the people of this Country want the lottery cash spent on Health and Education. As ever, from the mouth of Peter Hain, not true, an absolute lie. John Major’s Lottery Bill, passed in Parliament with the specific proviso that none of the money should be spent on Health or Education. He has recently accused the Government of stealing the cash – and rather wearily stated that he thinks the Government have opened the safe and will find it impossible to limit themselves to a reasonable amount. They’ll just keep going back, taking ever more outrageous amounts with them until the Lottery is renamed. – The National Health Lottery……

But the Government know they are on solid ground. They only have to ask whether money should be spent on an extra nurse or a piece of Tracy Emin modern art. Guilt and wanting to say the right thing means the question is a no brainer, but it doesn’t make it right. Adequate health services should be financed from the central purse, not from dodgy car park deals, dodgier property flog offs or planetary scale pilfering from the National Lottery.

Not paying for hospital car parks at the point of exit is my way of protesting that I’ve already paid, through my taxes.

Nye Bevan must be spinning in his grave – presuming he still has a grave and it hasn’t been flogged off for a bit of executive car parking……


wonkotsane said...

Alfie, as usual, you are spot on with your analysis.

We have already paid for the car park through our taxes and we pay for its upkeep through our taxes. Why should we pay again?

Considering LAbour is supposed to be socialist, they seem hell bent on destroying the NHS.

Mike Da Hat said...

It wont be long until we're all forced to have private health plans.

The Crafty Cruiser said...

Spot on Alfie. I hope you get into parliament next time. We NEED people like you.

Anonymous said...

All true Alfred, and how about the latest 'rip-off'...Private and expensive bedside TV, telephone and internet services ?

Shooting Parrots said...

Nope, not going down that root-canal argument again ;0)

Jennytc said...

I have to agree with everything you say, Alfie. Here in North Wales parking is free (whether you can actually find a space or not is another thing) but there is talk of charges being brought in soon. As for NHS dentists, it is now impossible to find one in the whole of North Wales who has vacancies for new patients.

Son of Groucho said...

As someone who works in the NHS, I agree with virtually everything you say Alfie.

I think one of the worst aspects of current policy is the purchase of hospitals, and othe health care facilities, by means of PFI-type arrangements. We're all told that it makes much more sense to buy our homes rather than pay someone else exorbitant rent for years, but somehow the same logic doesn't seem to apply to important public buildings.

Alcibiades said...

Oh dear. I'm not going to be the only one to dissent am I?

If I sat in the Treasury and presided over a service that more than doubled in cost over 7 years, I'd be looking to ensure that every penny went on want I got elected to do. Improve health.

I'd bite the bullet and agree healthy pay rises for my key workers, Consultants and other clinical staff so that there would be more of them.

But I'd want to see evidence that the Trusts were looking after their end. Better outcomes for patients, shorter waiting times and better environments to be treated in. I'd want to see more staff. I'd want new hospitals to be built fast, if that's what will improve services and I'd want to build them now and defray the cost over the years (isn't that a bit like a mortgage?)rather than pay cash from tax receipts for outright ownership of fewer hospitals.

If I go in to hospital, I want the best possible treatment, using the most modern equipment and most highly trained staff. I'd also want my own telly when I'm recovering; I'd want a personal phone and a single sex ward, or better still private room.

I'd also want security guards to protect me and my car from the bastard lowlifes who seem to think that the NHS is a big free take-away and that any car on site is fair game because the driver's going to be a while...

But not enough of us want to pay the going rate for it. A (bare) majority of us have voted to increase NI and agreed to growth in funds for the NHS, but with all this extra tax we are still only just up to the European average of state health expenditure. To give more funding to the NHS requires more tax. and not enough of us want to pay it.

So, money's still tight. Who pays to have the car park patrolled, making sure your car is safe? Who pays for security staff to protect staff and patients from the violence and theft that seems to be endemic in our society?

Your car parking charge. What's wrong with that?

Would Bevin be turning in his grave at the sight of his beloved NHS doing things better than they've been done before? Or would he be turning in his grave in despair at a society which values rights over responsibilities?


That's better.