Should We Privatise the NHS More?

The emergence of the deliberately low-key 'Monitor' Agency is I suppose an acknowledgement that fighting NHS privatisation as such is a lost cause. Monitor is a competition regulator, integrated into the new UK Competition Network that saw the Office of Fair Trading and Competition Commission abolished and replaced on April Fools' Day. Like other regulators of privatised utilities, it seeks to monitor 'upstream' competitive delivery of NHS procurement and services and 'downstream' competition in outsourcing. It is, of course, old hat to suggest that the upstream/downstream division that was keeping the anarchic and mercurial forces of EU competition law away from the NHS is therefore weakened to snapping point.

A health system represents a country as much as its housing system does. Some countries have systems that emphasise the individual, some that benefit corporate lobbies, some are socialised, some are a developmental mix of immediate payment for accidents plus insurance. Very few are fully presented as free at the point of delivery and funded exclusively by taxes. I should put my cards on the table and say that I like the German system most, from what I've heard. There is a basic provision for good insurance that can be topped up by the responsible working and middle classes, who are rewarded for starting early, and private but reasonably regulated hospitals and medical professionals in competition. No one can game the system, it doesn't attract benefit tourists, and the standard of care is extremely high. It also doesn't seem to fetishise the murder of vulnerable people, whether old, irreperably sick or in pain, or unborn.

In a sense, the NHS, which to the sort of middle-class people who haven't really benefited that much from it in a long time, is a kind of cult. It hasn't obviously failed like other British cults, nor quietly passed away having done a little good amidst the harm, unlike, say, comprehensive schools, global governance, or multiculturalism. Like some sort of Blakean idol or Golden Bull, it can be relied upon to provide the nation with warm feelings and the opportunity for a collective moan. The National Insurance principle, which was in reality a kind of Lloyd-George dodge, is scaffolding for the delusion that there is a kind of reciprocity between the tax monster and the citizen, and allows for all those 'if only the Queen/Leaders/proper managers/workers could revolt and get the politicians out of the way' thoughts that make moral disasters bearable. The security provided from tales of rapacious and murderous US Insurance companies (never German or Canadian ones, I notice) leads to a certain glow.

People can be reassured that the constant propaganda and brainwashing means that we mean well, despite the fallacies. Failed five a day fruit campaigns, failed sex education, weird mental health agendas, failed anti-drug movements, the weird morphing of nursing, the clear reckless murderousness of Doctors' prejudices about caesarean sections, effective euthanasia, the widespread dissemination of abortion on demand, the vehicular transportation and celebration of lunatic and irrelevant atheism, the burning of dead babies, miscarried remains and human detritus to heat hospitals and celebrate Gaia-Baal--all these are forgotten.

It's very British. You almost wonder if William Blake is somehow being kept alive, his animated corpse pressurised under an iron lung, pressing Urizen, Los, Orc, and Urania buttons to turn the people into shadows and teach them that being is becoming. Because, in a sense, the NHS always was a way of managing the working class; firstly, and briefly by appearing to place the fear and outrage at Victorian and Edwardian callousness behind us, then as a cover for the middle classes stinting on insurance. Then, the NHS was a vehicle for their emasculation and destruction.

But back to the real world. The NHS is now substantially devolved.Competition and private procurement are installed. The National Insurance contribution, which is a symbolic tithe of earnings from employers and employees, and really a tax, has been merged with the tax system, large chunks of everyday healthcare are now available privately, and more importantly people and values have been privatised. This last point is in some ways the most real; to prevent 'suffering' (in reality to prevent the doctors and families of victims from emotional disturbance), large numbers of people are being chemically 'helped on' every year. A further number are traditionally killed in large bursts of negligence every August and weekend. Everyone knows this. No one cares. At the other end of the scale, babies are not only being murdered on a scale that would unclass a biblical tyrant, but their remains are literally being ceremonially burned for benefit. The organisation doing this has convinced people not involved with it to turn immediately on anyone who questions it.

Those who know are quietly adapting or preparing for the full, gradual privatisation of the service amidst a welter of complaints about the medical tourism of immigrants, the extended rights of the disabled, and some specious and no doubt soon-to-be-accelerated nonsense about the rising cost of drugs. We are one good epidemic or useful crisis away from Obamacare, frankly.

This country can usually be relied upon to get the balance between public and private wrong. The vast majority, for instance, want some of the benefits of private schools, and I have never really seen the case for the universal, tax-based funding of colleges and universities. Or major roads, Or the Arts. Or the BBC. On the other hand, I can't really understand why Britons are incapable of running an effective set of socialised utilities and railways,where the economic arguments against natural monopolies and monopsonies suggest that they should.

Perhaps this makes me a useful idiot of the people who want the privatisation without any public bodies at all, but I shouldn't really let that hold me back. I'm my own tool, as it were* . It just seems to me, from personal mixed experience of the system (it took my tonsils out, saved my sister, fixed my foot and provided me with coronary care, albeit when I didn't need it on the one hand, but probably murdered my mother on the other) that the NHS is fairly near the dark ethical void that is modern Britain's singularity. I don't know if it is the hole into which those bourgeois not rich or connected enough to work for charities poured their remains of their souls, or if the crack developed from the self-alienation of the lower middle classes and working people in the face of the aristocratic destruction of their dignity. But it's there, and it's getting bigger and it doesn't really work.

So I wonder, would Obamacare, or some variant of the German or Korean systems, work better here, or, like the Bank of England, should we keep squinting and covering our eyes and just get some Canadians in to try to make what we have run properly?

*(I wish that there were some proper equivalent of the text-acronym "lol". Rudolf Hess, the one officially acknowledged lunatic of Germany's sometime Satanist leadership,was amongst a number of Nazis who had a family code for laughing in his letters, which confused the authorities checking his correspondence during his long and deserved stint at Spandau. A blog is, however, a kind of letter to myself since no one else is going to read it and not the place for text speak or codes)


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