A Eulogy to the NHS

June 6, 2014 8:58 AM

Harry Leslie Smith describes his despair at the coalition's dismantling of the welfare state
posted by Ned G (39 comments total)

That was moving and very sad. Thank you for posting it.
posted by YAMWAK at 9:19 AM on June 6, 2014

“The NHS will be shown no mercy" says Cameron health adviser"
posted by marienbad at 9:25 AM on June 6, 2014

Intense and well-written. It's given me a lot to think about. Thanks for posting.
posted by St. Peepsburg at 9:48 AM on June 6, 2014

“The NHS will be shown no mercy" says Cameron health adviser"

Good lord. A system designed to ensure the health of a nation's people at low cost overall and without prejudice as to someone's social standing will be shown no mercy? The system that enables poor folks to live healthily (who do they think they are, anyway?), ensures universal access to care, and generally honors the democratic principles of modern free society in one of the most tangible and efficacious ways possible will be shown no mercy? Big fucking man, taking an axe to the neck of such an institution, how brave and strong he is.
posted by clockzero at 9:50 AM on June 6, 2014 [19 favorites]

Also, a system which expropriates the rich and powerful, those higher up on the great chain of creation down from God to Man, to give to the unworthy parasites and moochers. And under neoliberalism, with the market being by definition a perfect arbiter of truth, it follows that the wealthy are more deserving than the poor. So it is an affront that money be taken from the rich and worthy, and even more that it's given to help the poor. (As in the US, it would be preferable to take twice as much from the rich if it were used to punish the unworthy rather than help them.)
posted by acb at 10:00 AM on June 6, 2014 [1 favorite]

I read this while eating lunch. I couldn't finish eating.
posted by The Underpants Monster at 10:02 AM on June 6, 2014

The people of Britain have gotten the government that they voted for -- or didn't vote against -- and rightfully deserve.

Clearly, they know that the Conservatives in Britain have close ideological and financial ties to some the same people supporting the Republicans in the US, don't they?!

The Tories owe their financial survival to just 50 key sources that account for 51 per cent of their donor income. And when you consider that in the third quarter of 2009, the Conservative Party received £5,269,186 compared to the Labour party receiving £3,045,377 in donations... well, that's a BIG difference. It is a very rare US presidential campaign that is so financially lopsided... but when they are that lopsided, invariably, the one who has such a big advantage wins.

The NHS is going bye-bye because moneyed interests bought votes... and that's often just as simple to do as hiring people to help get people out to vote that are already leaning in your ideological direction.
posted by markkraft at 10:04 AM on June 6, 2014 [1 favorite]

So, this September, Scotland is going to vote on separation from the UK. The Tories are insisting on making it a pure up/down, yes/no vote, not a "more autonomy within the UK" (which apparently is more popular than total separation and thus more likely to succeed -- at least that's my understanding).

The SNP (Scottish National Party) is a very strong socialist party (at least in their words, I don't know how it is when it comes to their deeds), and they seem to be, from what I gather, very popular. When I read /r/Scotland, there is a very strong socialist sentiment there, and even the naysayers against separation still seem to be a lot more fair minded and level headed than I would expect. The conversation is fairly civil (at least there). That indicates at least some moderation and sympathy to the left-side cause, at least more so than the US Tea Party/Right-Wing influence we hear non-stop in our politics across the pond.

Anyways, it seems to me that a statement about waging full out war against the NHS is just one more push for the more socialist/left elements of Scotland to desire a policy of separation, more than mere devolution of powers.

This shit sickens me. Far as I'm concerned, you have no fucking right to talk about Christianity or being a Christian Nation in any sense of the word if you don't strongly support helping the less fortunate AS A NATION.

The whole "Big Society" bullshit - what a fucking con. And fuck the LibDems for selling out. It really says something when LABOUR is more left-wing than you are.
posted by symbioid at 10:15 AM on June 6, 2014 [6 favorites]

Welcome to the reprehensible Fox News/American view: Your brother's keeper? Your brother's a moocher!
posted by kgasmart at 10:16 AM on June 6, 2014

Not all back to back terraces are so awful. I've lived in them on and off all my life; live in one now in fact and they're warm quiet little houses.

YMMV, and possibly Barnsley back to backs were of a lower quality to those you find in Leeds and it's environs, but as a point of data, this is not my experience.
posted by zoo at 10:21 AM on June 6, 2014 [1 favorite]

The people of Britain have gotten the government that they voted for -- or didn't vote against -- and rightfully deserve.

I've always hated the "you got what you deserve" trope. I have yet to vote for a winning candidate except by accident and I do not feel I or my fellow citizens deserve the results we have gotten. (Of course, I live in America, and we are exceptional, so there is that.)

Fun statistics - Health expenditure as percentage of GDP

UK: 9.4%

US 17.9%

Most of western Europe is a tad higher, but no one tops America! Make of that what you will.
posted by IndigoJones at 10:26 AM on June 6, 2014

Make of that what you will.

Rich person: "Here's a way to 'disrupt' healthcare that both ensures the poor get poorer (or, preferably, die, once they've given us what little money they have) while allowing us to skim off the top via middle-men and for-profit health centers!"
posted by maxwelton at 10:31 AM on June 6, 2014

The people of Britain have gotten the government that they voted for -- or didn't vote against -- and rightfully deserve.

pretty sure nearly everyone deserves health care regardless of whom they voted for, my guy

hence the tragedy
posted by Rustic Etruscan at 10:32 AM on June 6, 2014 [1 favorite]

"pretty sure nearly everyone deserves health care regardless of whom they voted for..."

... and yet, The Labour Party, supposedly its guarantor, did such a lousy job of defending the British people against the corrupting influence of big moneyed interests, leaving them about as prepared for the gutting of the NHS as the French were for German panzers plowing through the Ardennes. Indeed, the level of financial disclosure in British politics is arguably worse than in the US.

It's bad enough that Murdoch buys the news there to a degree that exceeds his influence in the US, but that's not where it ends... and most of the white voters have fled London and are voting for these kinds of policies.

And the person who mentioned the Scots as being socialists were half-right. The Scots are sane, enlightened voters. If they leave, things will look very dark indeed for what used to be Britain. But, like I said, they really did bring it on themselves, in large part because they saw new Labour as somethng other than a realignment of the party with the moneyed interests who are now trying to devour the public sector and loot the private citizen.
posted by markkraft at 10:50 AM on June 6, 2014 [1 favorite]

:/
posted by tilde at 11:16 AM on June 6, 2014

This is what it's all about: Fury as Tory party donors are handed NHS contracts worth £1.5BILLION under health reforms.
posted by urbanwhaleshark at 11:19 AM on June 6, 2014 [3 favorites]

Labour’s Shadow Health Secretary Andy Burnham, who ­uncovered the figures, fumed: “Nobody I wish I knew what you were all thinking when you collectively gave David Cameron ­permission to sell the NHS to his friends.

“It’s shocking totally unsurprising to anybody who has paid attention to politics for more than five minutes over their whole lifetime that the same Tory donors who ­bankrolled the development of their NHS reorganisation policy are now ­profiting from the sell-off of NHS services.”

Fixed that for him.
posted by flabdablet at 11:28 AM on June 6, 2014 [1 favorite]

How the fuck is any appearance of impropriety not immediate cause to have someone fired or thrown out of the house. Hell, how the fuck is this scale of disrespect for Her Majesty's citizens not grounds for her to immediately dismiss the PM and his government?
posted by Talez at 11:30 AM on June 6, 2014 [1 favorite]

Because only Labour has money scandals. Tories have sex scandals. Selling off the NHS to its friends is therefore completely within the rules for a Tory Government, because something something private sector something efficiency hem-haw something.
posted by flabdablet at 11:38 AM on June 6, 2014

General Election next year, and "Save the NHS!" is always a rallying cry for the Labour Party, of which the Guardian is the "house newspaper".

• These reforms apply only to England, not Scotland, Wales or Northern Ireland. So not "Britain".
• Spending on the NHS is up in nominal terms and stable in real terms: that is, it's doubled per head since 1997 and it's stayed there. Nuffield Trust
• The problem appears to be that that the NHS requires 5% real-term growth every single year or it's in complete crisis. Which can't go on, since the economy doesn't grow at 5%.
• Every government for the last twenty years has tried to introduce private-sector involvement and reform, and every government has been accused of "privatising the NHS", including the Labour Government.
• Other successful European healthcare systems use the private sector where possible, and have perfectly good health outcomes.

I believe in a health service (not a national one, because Scotland etc.) that's free at the point of service and responds to need. I am horrified by the stories you hear from the US about the split between the haves (usually on Government subsidy, like Medicare) and the have-nots (the working poor, especially non-white people.)

However, this secular religion obscures the fact that it cannot deliver healthcare outcomes we need as the population ages. I don't think the Tory "privatise the whole thing!" is a good policy.

But this kind of chest-beating angst is only good for selling newspapers and getting the left-wing vote out, not improving healthcare delivery.

And for goodness sake, you couldn't get antibiotics before 1948 because we didn't have antibiotics before 1948. Before then you'd just have died from your TB, NHS or no NHS.
posted by alasdair at 11:39 AM on June 6, 2014 [5 favorites]

Hell, how the fuck is this scale of disrespect for Her Majesty's citizens not grounds for her to immediately dismiss the PM and his government?

If she tried it, there wouldn't be a monarchy for very much longer.
posted by junco at 11:44 AM on June 6, 2014

"Fury as Tory party donors are handed NHS contracts worth £1.5BILLION under health reforms."

Politics are a sound investment!
posted by markkraft at 11:44 AM on June 6, 2014

this secular religion obscures the fact that it cannot deliver healthcare outcomes we need as the population ages.

If the NHS, which as a single-payer healthcare funding scheme is demonstrably at the more efficient end of the spectrum, cannot deliver the healthcare outcomes needed as the population ages: how is a necessarily more fragmented private scheme supposed to do so?

Look at total cost vs health outcomes anywhere in the world and you will find publicly funded systems performing better than those relying more heavily on the private sector. And that's just taking total cost into consideration, not even touching on equity.

The right wing's obsession with shooting itself in the foot for no better reason than to keep the poor in their place never ceases to amaze me.
posted by flabdablet at 11:48 AM on June 6, 2014 [9 favorites]

General Election next year, and "Save the NHS!" is always a rallying cry for the Labour Party, of which the Guardian is the "house newspaper".

"Citizens have votes. Newspapers do not. However, if the Guardian had a vote in the 2010 general election it would be cast enthusiastically for the Liberal Democrats." - The Guardian, April 2010, in an editorial entitled 'General Election 2010: The liberal moment has come.'
posted by reynir at 11:58 AM on June 6, 2014

The dramatic privatization of the NHS is completely down to the New Labour government's policy of public-private investment, where government buildings were constructed by private companies in exchange for long, high interest payoffs to the builders. It is a huge catastrophe, because it has meant that services are being cut at a local level in order to cover loan costs because it is not the central government which is saddled with the debt but the local hospital's trust.

Can you imagine the amount of flap if the American government gave over the building of VA hospitals to private companies and then saddled the VA with the debt on a local level? It would drive a president from office.
posted by parmanparman at 12:06 PM on June 6, 2014 [2 favorites]

Public-private partnerships are all the rage in Australia as well, and they make no sense here either - except to the same kind of pointy-haired boss who sacks all the workers and replaces them with private contractors because that lowers the wages bill, thereby "justifying" a "performance bonus" that jacks up the business's total running cost even more than the contractors' outrageous consulting fees, which are somehow not counted as wages.
posted by flabdablet at 12:26 PM on June 6, 2014 [1 favorite]

"Citizens have votes. Newspapers do not. However, if the Guardian had a vote in the 2010 general election it would be cast enthusiastically for the Liberal Democrats." - The Guardian, April 2010, in an editorial entitled 'General Election 2010: The liberal moment has come.'

Well isn't their face red now.
posted by Talez at 12:27 PM on June 6, 2014 [4 favorites]

Most of western Europe is a tad higher, but no one tops America! Make of that what you will.

That they have one of if not the worst health outcomes relative to health spending?
posted by zombieflanders at 12:31 PM on June 6, 2014

If the NHS, which as a single-payer healthcare funding scheme is demonstrably at the more efficient end of the spectrum, cannot deliver the healthcare outcomes needed as the population ages: how is a necessarily more fragmented private scheme supposed to do so?

It may not be able to be done.
posted by corb at 12:50 PM on June 6, 2014

It may not be able to be done.

There is plenty of money. It just happens to be in the hands of the rich.
posted by maxwelton at 1:03 PM on June 6, 2014 [1 favorite]

Oliver Letwin (UK government minister): "NHS will not exist within 5 years of a Tory government": http://www.independent.co.uk/life-style/health-and-families/health-news/letwin-nhs-will-not-exist-under-tories-6168295.html

And whilst the Tory posters stating that "there would be no top down reorganisation of the NHS" were still up, the Tories, two months after the election, published a bill reorganising the NHS to such a degree "it could be seen from space". You don't produce a bill that significant in two months.

Without any mandate the Tories *finally* have been able to pull the NHS apart, something they've wanted to do since the NHS was born. They hated the NHS being formed (they opposed it tooth and nail), and they hate it now.

This is nothing to do with modernisation or economics - it's pure vicious hatred, and greed.
posted by rolandroland at 1:29 PM on June 6, 2014 [3 favorites]

It may not be able to be done.

Aah, there's that can-do spirit and inventiveness of entrepreneurial capitalism and conservative vision.

Very odd kind of pessimism, that would always display itself whenever social progress was underway. "Abolish child labor??", why, industry and society would collapse, however desirable, it may not be possible! And so on for Every. Single. Piece. Of. Progress. - doesn't matter whether by private industry "25 miles to the gallon?? Unfortunately, may not be able to be done!" or social forces "women in the workplace, doing 'men's' work??" etc., etc., etc., etc., ad nauseum.

Decent healthcare for an aging population, that doesn't leave vast numbers of people to die in the streets? What's the very first instinct, before examining the options, before any innovative approaches or analysis - "it may not be able to be done". The intellectual bankruptcy of the conservative vision.
posted by VikingSword at 1:30 PM on June 6, 2014 [11 favorites]

"It may not be able to be done."
> There is plenty of money. It just happens to be in the hands of the rich."

"Hampstead palaces left empty for decades"

"Last year, the real estate firm Savills found that at least 37 percent of people buying property in the most expensive neighborhoods of central London did not intend them to be primary residences."

Clearly, these people need someone to help them spend their money, because they apparently can't figure out a single noteworthy thing to do with it.
posted by markkraft at 1:44 PM on June 6, 2014

"The intellectual bankruptcy of the conservative vision."

Obviously, whenever someone asks the exceedingly rich to pay their fair share, the only thing they can believably cop to is intellectual bankruptcy.

"Hm. Sorry old chap... I seem to have misplaced my wallet in the Bahamas!"
posted by markkraft at 1:51 PM on June 6, 2014 [1 favorite]

Also, at the risk of continuing to harp on a single point: claiming that the NHS will be "shown no mercy" implies that there's some kind of battle or war going on, doesn't it? You don't go about making claims of merciful treatment when there's no threat, or when the use of force isn't already on the table for some identifiable reason, after all. It seems to imply a scenario where the NHS has committed some kind of aggression and has to be dealt with like a criminal. Doesn't that seem starkly bizarre?
posted by clockzero at 3:35 PM on June 6, 2014

It seems to imply a scenario where the NHS has committed some kind of aggression and has to be dealt with like a criminal. Doesn't that seem starkly bizarre?

Obviously yes to you and me, whose basic understanding of the world proceeds from a fundamental assumption that fairness, equity and care for those who need it ought to be the basis for any just society.

Not bizarre at all to those who actually truly believe the line that any genuine Tory will spin: that it was purely their own hard work and enterprise that got them where they are today, ergo anybody not similarly advantaged must perforce be shiftless and lazy and therefore utterly undeserving.

Also not bizarre to the economic libertarians, who will tell you with a straight face that any attempt by a government to spread wealth more equitably must necessarily make things worse for everybody because Obvious Reasons (never explicitly stated, though you're clearly just an idealistic fool if you disagree and by the way where do you think you get off trying to undermine the fundamental basis for the economic system that's produced the very wealth you want to redistribute you poor deluded socialist idiot).

It walks like greed and it quacks like greed to people whose thought processes I can personally relate to. But it's a very rare Tory indeed who will openly admit to being straight-up greedy. Most of them generally don't consider themselves greedy; they consider themselves correct and those of us who disagree with them naive and wrong.

Look at the triumphalist sloganeering coming out of the Australian Tory coalition after last year's federal election: "Australia is open for business" and "the adults are back in charge". Both of those things are genuine reflections of how these people think.

What I find frankly amazing is the ease with which the fucking silvertails seem to be able to manage to make vast numbers of otherwise fully functional people agree with them. It's like every few years all the chickens talk amongst themselves and come out in support of Colonel Sanders.
posted by flabdablet at 7:02 AM on June 7, 2014

I really can't get that excited about the NHS reform. The critical element about the NHS (that is not under threat or even really under discussion) is that it's free at the point of use. I think that's really important and a great thing about living in Britain.

This discussion is purely about how government money is used to deliver healthcare, a significant but ultimately pretty technocratic debate. Lots of countries have private provision of healthcare, even those darn socialists in France have a lot of private sector involvement. The private sector works in some areas, why not healthcare?

There are many ways to run a health system, and the NHS model shouldn't be sacred.
Here's an interesting article on how Singapore does it.

I can see that public sector unions would be upset by the current changes, but as a citizen I'm pretty relaxed. (Of course, you can argue that the changes will/have been botched or won't work, but that's a technical rather than a political argument).
posted by greytape at 5:07 PM on June 7, 2014

Clearly, these people need someone to help them spend their money, because they apparently can't figure out a single noteworthy thing to do with it.

As non-UK citizens, they are unlikely to be much interested in funding UK expenses.

Anyway, London real estate is not their spending money, it's their wealth maintenance money. Diversification for the cosmopolitan super rich is especially important if you are from a country where a new government might seize all your more liquid holdings, up to and including your factory, your Swiss bank account, and your home base house. Harder to take the London real estate or anonymously bought modern art that you stash outside the country. Sure, it might lose some value, but it won't go down to zero, which is the whole point.

Unless of course the UK drafts some confiscatory laws, which I suppose is possible. The previous owner will weep from his other house in Singapore and you will fund the NHS for - a few weeks? A few days?

You'll need a plan b.
posted by IndigoJones at 2:33 PM on June 8, 2014 [1 favorite]

This is nothing to do with modernisation or economics...

It does have a lot to do with Neoliberalism though, because Britain's Tories are closely tied to the international network of think-tanks fostered by the Mont Pelerin Society, and this kind of effort to turn public systems into privately-controlled "free" markets is their stated goal.
posted by sneebler at 6:33 AM on June 9, 2014