An oncologist working at London’s Royal Marsden Hospital once told me that the NHS really stands for ‘Nasty Health Service’.
Proving the physician’s point, his co-worker Joseph Meirion Thomas, one of the world’s top cancer surgeons, has been pushed out for daring to criticise the NHS in print.
Professor Thomas’s expressed concerns about the scale of health tourism, and also complained that GPs don’t provide “even remotely personal service” because they hardly ever see the same patient more than once.
That, according to the Royal Marsden, brought the hospital into “disrepute”, making Mr Thomas’s continued employment there untenable. The action was triggered by the torrent of abuse from GPs, accusing Mr Thomas of lying.
Yet the real problem his detractors had with Mr Thomas wasn’t that he was lying. It was that he was telling the truth.
However, their indignation gave the hospital administrators a pretext for claiming that Mr Thomas’s accusations weren’t “evidence-based”. Well, if it was evidence they sought they should have talked to any Londoner. I for one would have volunteered information with alacrity.
For many years my local practice was run by a superb GP, who at the beginning of our relationship (in the course of which he played a key role in saving my life) was an ideological champion of the NHS. Then, as his administrative load was getting heavier and the time he could devote to patients was getting shorter, his enthusiasm somewhat abated.
In the end he couldn’t take it any longer – red tape was throttling him. This excellent doctor had to retire at age 50 two years ago, when he could still do for hundreds of patients what he had done for me. Since then the practice has gone exactly the way Mr Thomas described – and, for those familiar with the notion of ‘postal-code healthcare’, my postal code is among the best.
Nevertheless it takes a fortnight to get a GP appointment now. Of course the patient doesn’t get charged for the privilege, which is heart-warming – unless, of course, he’s bleeding too fast.
And indeed, a patient hardly ever sees the same GP twice. As any doctor will tell you, this absence of on-going contact isn’t just cold-blooded emotionally. It’s also detrimental therapeutically, for regular observation of a patient may reveal some subtle changes that would be imperceptible from the case history on the computer screen.
But then the NHS isn’t mainly about treating patients, which is its declared mission. Being a socialist enterprise, it increasingly operates to benefit those who run it, not those to whose wellbeing the service is supposedly dedicated.
Front-line medical staff are being routinely cut, along with the hospital beds they service, and the funds thus freed up go to pay the burgeoning throng of Directors of Diversity, Facilitators of Optimisation and Optimisers of Facilitation, all on six-digit salaries.
One gets the impression that patients get in the way of the NHS discharging its real function: increasing both the size of the state and its power over the people.
When doctors who are horrified by what’s going on try to protest, they are treated the way Mr Thomas was. “If the NHS can treat a senior cancer surgeon this way, what chance does a nurse or a junior doctor with grave concerns about the health service have?” he asks. A rhetorical question if I’ve ever heard one.
In Mr Thomas’s case too, it’s the patients who found themselves on the receiving end. He had to miss two vital operations on patients with diabolical cancers. And he can no longer be involved in a potentially life-saving clinical study on 90 people with deadly skin malignancies.
It’s a mistake to think that, as our government claims, the NHS would be perfect if run more efficiently. It wouldn’t be. The NHS is so hopeless not because it’s run by wrong people in a wrong way but because it’s based on a wrong ideology.
Its implicit object is to provide not excellent medical care but the same care for all, and the two desiderata are mutually exclusive. Both history and common sense tell us that it’s only ever possible to equalise down, not up.
In any case the equality provided by socialism is like that seen when looking down at a crowd from the roof of a skyscraper. Everyone in the crowd, dwarf and giant alike, looks the same height.
This metaphorical vantage point is in our lives occupied by the state, with us as the identical ant-sized creatures down below. As long as the state can keep the people in the street and therefore equal, with itself looking down at them from its great height, it won’t care about their lives.
That’s how Britain, supposedly a first-world country, has ended up with a third-world health service. And that’s why any public critic of the socialist NHS has to be silenced, so far only administratively.
Mr Thomas ought to be grateful he’s still at large. Oh well, give our government a few more years…