Bin the NHS

This rings the bell of personal experience: blood samples repeatedly lost, causing extra nights in hospital; no mechanism to push test results (or lack thereof) through to ward staff; staff wheeling pressure-testing machines around whose results can be transmitted automatically to a server but instead are written down by illiterates; random bits of paper hanging off the ends of beds and then lost or thrown away; staff carrying great paper files around; emergencies in the early hours based on cases of mistaken identity; the multilayered bleeping that makes sleep impossible; one department telling you you’ve missed an op while another congratulates itself on having carried it out; the curse of smartphones and Facebook, which surely cancel out any digital productivity gains…

All this in a hospital in one of the wealthiest and most lobbysome towns in England, with turnover of 300 million, with a CEO from the old-girl network on 185K basic and 18 staff earning more than that (in fairness the butchers are at least as good as they ever were), but hopelessly hobbled with what is essentially a 1980s, pre-digital administrative shambles.

That’s all 18 months ago. While I was waiting for them to let me out I read Mark Twain’s autobio. He lived for a while in London and rants memorably about the Royal Mail – like the modern NHS, frequently amiable but grossly incompetent:

In my village there are a lot of little postoffices and one big one—in Sloane Square. One Saturday toward dusk I visited three of the little ones and asked if there was a Sunday mail for Paris; and if so, at how late an hour could I mail my letter and catch it? Nobody knew whether there was such a mail or not, but it was believed that there was. They could not refer to a table of mails, for they had none. Could they telephone the General Postoffice and find out for me? No, they had no telephone. The big office in Sloane Square might know. I went there. There were two or three girls and a woman or two on duty. Yes, there was a Paris mail, they said; they did not know at what hour it left, but they believed it did. Were my questions unusual ones in their experience? They could not remember that any one had asked them before. And those people looked so friendly, and innocent, and childlike, and ignorant, and happy, and content.

I’ve seen the Spanish and Dutch mixed systems in action, I’m pretty sure both provide better patient care for less money, and I don’t think anyone would describe either country as a hotbed of neoliberalism. But we allegedly Godless Brits continue to sacrifice our young, ill and old to untouchable Molochs.

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