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October 18, 2007Yes, but it's still free.Undoubtedly, there are better and worse single-payer health care systems, with varying degrees of access to private health insurance and consumer choice (i.e., France, Germany, Switzerland). But the NHS in the U.K. is in a special category all its own. From the Christian Science Monitor: On the eve of his election victory in 1997, Tony Blair famously declared that Britain had 24 hours to save its derelict National Health Service. So it is acutely awkward for his successor, Gordon Brown, that, 10 years on, his government is scrambling to fend off accusations of crisis in the NHS following a damning report about hospital infections that critics say is symptomatic of a wider malaise in British healthcare. Health Secretary Alan Johnson was forced to apologize in Parliament this week after it emerged that at least 90 patients in southeast England died as a result of infections picked up in the hospital. The Healthcare Commission, a national watchdog, blamed safety lapses and overcrowding. It painted a bleak picture of teeming wards where overworked nurses didn't even help patients to the bathroom. Government officials have sought to portray the crisis at hospitals in the Maidstone and Tunbridge Wells district as a one-off. But opposition members of Parliament and health-service experts say the cost and staffing pressures affecting the trust are widespread, and that many other "primary care trusts" that manage local health services are struggling. "The problem is not just Maidstone and Tunbridge Wells," says John Lister of the Health Emergency pressure group. "The outbreak ... exposed a weakness that exists in trusts up and down the country, given the way they are forced to run." Dr. Lister says government-imposed targets have instilled a commercial culture, resulting in "perverse" imperatives like cost-control and "productivity" driving decisionmaking in hospitals. "It's the burger-bar style of efficiency – the more you can do with fewer staff the better," he says. "But patient safety seems to come at the bottom of the list.... The Hippocratic oath has gone out of the window." It is true that cost-control and productivity are hallmarks of markets, but so are quality and customer service, two attributes that are distinctly missing from the NHS. But they have government mandates in abundance, apparently. Posted by Paul Howard at October 18, 2007 02:40 PM |
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