There is more than a little irony attached to the Obama administration’s determination to pursue socialist, EU-style “solutions” to America’s problems, even as the European Union is coming to grips with the bitter realities such socialism produces. And while Greece and its financial problems receive some media coverage in the United States, there is a much bigger story flying under the mainstream media radar: in Britain, Prime Minister David Cameron has introduced a bill seeking to partially privatize the National Health Service (NHS). Why? Because the British government is “hoping to avoid a Greek-style financial meltdown.”
The system’s defenders are upset. The Times of London is reporting that Health Secretary Andrew Lansley is in the eye of the storm. “Andrew Lansley should be taken out and shot,” said an unnamed “Downing Street source.” “He’s messed up both the communication and the substance of the policy.” The source further contended that Lansley was “a disaster” and “a law unto himself.” The British Medical Association and the Royal College of Nursing also want the bill withdrawn, as do members of the Royal College of Pediatrics and Child Health, the Royal Medical Colleges, including the Royal College of GPs. Unions, including the Royal College of Midwives, want to “kill the bill” as well, while Labor Party leader Ed Miliband accused Mr. Cameron of failing to listen to the experts.
Cameron refuses to back down, insisting there’s too much bureaucracy in the system, and that it interferes with patient care. “If we were as good at treating cancer as the average European country, we would save 5,000 lives a year,” he contended. He further noted that reform will create “a fair system that stops the private sector from picking off contracts and the public sector from providing an inflexible monopoly.” Yet he insisted that “health care for all, free at the point of use, unrelated to the ability to pay” will remain the animating features of the system.
Such euphemisms are at odds with reality. Last November, the NHS’s Hinchingbrooke Hospital in Cambridgeshire, running at a loss of $8 million a year on revenues of $143 million, was given over to Circle, a private health care company. Circle was brought in to cut bureaucracy and improve efficiency, and it is the first private company to take over an entire British hospital. Earlier this month, an NHS “watchdog” at the National Institute for Health and Clinical Excellence (NICE) ruled that a breakthrough drug used to extend the lives of men with late-stage prostate cancer was too expensive to be included in the system. NICE makes calculations based on the “cost of the drug to the NHS according to the number of men likely to be treated.” NICE will pay for some end-of-life drugs for rare diseases. But the current, though unofficial, threshold for QALY (quality-adjusted life year) drugs has been $80,000 for renal cell carcinoma. “Therefore the £63,200 ($101,000) cost per QALY for abiraterone would still not be deemed a cost effective use of NHS resources,” said a NICE statement.
Such rationing–and it is rationing–is nothing new. A 2011 report revealed that independent medical providers were experiencing a growing number of patients choosing to pay for their own care after having treatment delayed or denied altogether by an NHS primary care trust (PCT). A survey of 101 influential industry figures revealed that 34 percent believed “budgetary pressure in the NHS” was the principle cause. At the annual meeting of the Chartered Society of Physiotherapy (CSP) earlier this month, members contended that they were “increasingly being asked to make decisions based on financial rather than clinical reasons and to ration their care,” further noting that such rationing “was on a scale that had never been seen before across both acute and non acute NHS services.”
Last November, such rationing reached a scandalous level. A study by the Co-operation and Competition Panel (CCP) revealed that Primary Care Trust (PCT) heads were imposing arbitrary spending caps, denying patients treatment for procedures such as hip replacements and cataract removals–and that waiting times for services were being deliberately extended “so that patients would go private or die before they were seen” to slash costs. Secretary Lansley was furious. “For too long, Labour turned a blind eye to unfair practices within the NHS which harmed patients,” he said. “No right-thinking person could possibly understand how anyone could delay a patient’s treatment unnecessarily. If patients need treatment, they should get it as soon as possible, and where they choose.”
“As soon as possible” is yet another euphemism. Brits have a legal right under the NHS Constitution to start their hospital treatment–within 18 weeks after a referral by a GP. Yet referrals require diagnoses, and the wait for those is increasing as well. The Guardian reports a 92 percent increase compared to last year in the number of people waiting more than the NHS’s recommended six-weeks for a diagnostic test at an NHS hospital. In other words, even under optimum conditions, people suffering from afflictions such as heart disease and cancer will face more than a five-and-a-half month wait before getting the treatment they need.
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