Wednesday, August 12, 2009

Hawking and the NHS

(Originally posted by my husband at NRO-The Corner)
Following up on that silly IBD statement that Stephen Hawking wouldn't survive in the U.K., where of course he lives, I contacted Professor Hawking's office, and they sent me this statement he dictated yesterday:
I wouldn’t be alive today if it weren’t for the NHS. I have received a large amount of high quality treatment without which I would not have survived.
This is undoubtedly true. Many brilliant doctors and surgeons work for the NHS. So yes, there are indeed centers of excellence in the NHS. David Cameron, leader of the British Conservatives, has a favorable view of the NHS because of the wonderful, world-class care it gave for many years to his severely handicapped son, who sadly died earlier this year. A close friend of mine would have lost his handicapped daughter at birth were it not for the efforts of his local NHS hospital, which again provided world-class care. And this isn't world-class in the sense of "the NHS is the envy of the world," it is world-class in the genuine sense.

However, all this is true in spite of rather than because the NHS is financed the way it is. Professor Hawking in Cambridge and David Cameron in Oxford are lucky enough that their hospitals are associated with world-class universities. The trouble is that for every child saved, there is one or more elderly people left to die or literally killed by the NHS. One family I know lost two grandparents as a result of NHS incompetence, one of them having a feeding tube set at the wrong rate, with the result that they were fed so much they died as a result of the complications brought on. Just as there are excellent hospitals in the NHS, there are others that any informed person would avoid like, or even because of, the plague.

And much of the reason for the dark side of the NHS is clearly its funding structure. A relative of mine, an award-winning doctor, resigned from her job as head of a certain department at her hospital because she couldn't take having to make decisions every day over who lived and who died as a result of granting or denying treatment. The NHS is predicated on this model. That is why Theodore Dalyrmple, a doctor working within the NHS at the time, wrote as far back as 2001:
Just try going to the casualty department of an NHS hospital and telling them that you want to be operated on in another hospital! You will be lucky if they find you a bed in under 10 hours. Not far from Walsall, incidentally, is Kidderminster, whose hospital the Government closed down, despite the local appreciation of its care, its balanced budget, and the clearly expressed wishes of the town's population that it should be kept open. So much for consumer choice when it conflicts with the Government's plans.

I am far from supposing that all is well with the NHS. No one who works in the system could possibly suppose any such thing. It even seems to me likely that treatment in Walsall is not as good as at UCH.

But the real problem with the health-care services in Britain lies elsewhere, and we should not be diverted from recognising it by crude and sensational comparisons. What is needed is a subtle interplay of patient choice and professionalism, of the kind that can never now be achieved so long as health care in this country is funded solely by central taxation. It would take courage and honesty for a politician to recognise this, so it is extremely unlikely to happen.

Will that subtle interplay be encouraged or discouraged by Obamacare? All evidence points towards the latter, but that is the argument that has to be made.
All respect to my husband but what he neglected to mention regarding his friend's child was that the baby was found to be in the breech position and the NHS doctor went ahead with a vaginal birth, causing the infant to suffer the lack of oxygen which lead to her brain being damaged.

I know this because in the times after this tragedy I spoke with this friend quite frequently. When he described the events and I told him that in such situations, US hospitals would do a cesearan rather than continue birthing a breech baby vaginally - he was shocked.

So while my husband is right to defend the extraordinarily rare centers of excellence where the NHS accidentally gets things right, that by no means should be constructed as support for such a healthcare system anywhere. At least as far as I am concerned.

No comments:

Post a Comment