A FWer has asked me privately: <<<< Was the NHS always so overwhelmed or can you point to a period of time when it served patients well? >>>>
The post-war Labour Government nationalised 1,000 voluntary and 2,000 local authority hospitals in 1948. Aneurin Bevan, our Welsh firebrand Minister of Health, had the greatest difficulty in bringing it off because of the resistance of the British Medical Association and also the Royal Colleges of various specialities. He only got their support by finally allowing surgeons to carry on their lucrative private practice (and using NHS hospital facilities to do so!) asking only 10/15 hours per week to serving the NHS. (It's now about 20 hours, I think.) The great myth of the time (believed by everybody -- public, medicos and politicians alike, so no one's to blame) was that there was a "lump of illness" (a myth rather similar to the "lump of labour" fallacy pronounced repeatedly by some FWers unfortunately). Once this lump of illness was coped with -- by pouring vast funds into the existing hospitals -- then the overall burden of illness would decline and the NHS could become much smaller. For this reason, no new hospitals were built in 1948, the existing Victorian mouse-ridden edifices were retained, and new services were added as temporary cabins in the grounds of the hospitals. (Almost all hospitals in England are still like this. I was treated for prostate cancer in one such.) But, in actuality, there was no "lump of illness". The amount of illness rose as expectations rose, new remedies discovered, and the elderly entered the portals of illnesses that hadn't been important pre-1948 'cos they'd simply died (at sensible ages, like mine now) with no fuss. The brief answer to your question is that the NHS has always been overwhelmed. On the other hand, it seemed as though it was coping in the very early years after 1948. Until my prostate treatment of this year, my only other experience of a NHS hospital was an emergency appendectomy in 1949. My vague memory of this is that the food was wonderful -- far better than the food that my parents could afford. I even had chicken as a normal meal! This was something that I never ate between Christmases. Ah! And those wonderful Irish nurses! I was in raptures in my recent post-puberty years. (Large numbers of Irish nurses were recruited in those days. Nowadays, the NHS recruits from the Philippines and most everywhere in the world [depriving poor countries of valuable people] 'cos about 25% of English nurses leave the NHS immediately after training. The same for newly-trained doctors.) The restrictive practices of the British Medical Association and the Royal Colleges proceeds apace and, in order to keep up the enormous earnings of surgeons, denies opportunities for sufficient numbers of General Practitioners and Consultants to be trained. If Aneurin Bevan had his time over again I think he might have persuaded Prime Minister Attlee to outlaw this survival of medievalism. But he didn't and no Prime Minister since has had the courage. The point is that highly complex functions cannot be controlled by rigid centralism (whether private or governmental) and so the NHS is now falling apart. Political considerations mean that Prime Minister Blair is still desperately hoping that it can be held together by throwing more money at it but, like State Education, it will have to privatise sooner or later. After all, before 1948, with the 3,000 hospitals around the country, 90% of the population had access to reasonably full health and hospital care by paying a modest few shillings every month into their local medical panel. (The rich 5% could afford full-blown luxury medical attention as the need arose, and 5% of the population were improvident and drank their shillings away.) Aneurin Bevan would have done much better for the health of this country since 1948 if he had outlawed the restrictive practices of the medical profession. Then the private system would have been a genuine free market and we'd have the sort of efficient, and reasonably priced, health care that Harry Pollard often talks about in the US. Hope this suffices. I could rant on and on . . . and on. Keith __________________________________________________________ �Writers used to write because they had something to say; now they write in order to discover if they have something to say.� John D. Barrow _________________________________________________ Keith Hudson, Bath, England; e-mail: [EMAIL PROTECTED] _________________________________________________
