Dying man pleads to police for help.

Kane Gorny was just 22-years-old, he was a patient at one of the main "teaching hospitals" run by England's National Health Service. His problems started when he was diagnosed with brain cancer but the therapy weakened his bones leading to the need for a hip replacement. With that operation he was unable to get out of bed.

He also required medication three times per day, without which, he was warned, he could die. The NHS staff apparently ignored Kane. They didn't give him his medication and they refused to give him water, even though he repeatedly asked for it. When he became insistent staff had security guards restrain him.

Unable to get water himself the desperate man called the local police begging them to intervene. He told them: "Please help me. All I want is a drink and no one is helping me."

Without his medication Gorny became incoherent. His mother gave him something to drink but didn't know how severely dehydrated he had become. She called in nurses who told her that her son was fine. A doctor told her not to worry. She sat there crying until another physician came by, looked at her son, and called for emergency care. She was sent out of the room and one hour later her son died from severe dehydration, all while under the care of the NHS. But it was free!

The NHS rushed to offer counseling—to the nurses who had neglected the boy, not to the family of the victim. They also said they apologized and wrote up new policies saying this won't happen again. Somehow I would have thought that the NHS would already have policies about starving patients to death, or allowing them to dehydrate to death. The BBC says the police are investigating the case at the request of the coroner.

Apparently the new policies are none too soon. Actually they are too late for many. The Express reports that a government commission found that:

HUNDREDS of patients are starving to death in hospital every year, a report revealed yesterday.
The highly critical study also revealed that up to 50,000 patients who died from illness or old age were suffering from malnutrition.

The Labour government sat on the report for almost a year, before releasing it. The government quickly announced that they were taking action—they are abolishing the commission that wrote the report. Other studies of the NHS are equally as bad. The Telegraph reports that a study found that government solutions to the long waiting time for NHS care worsened problems. The government, stung by the inability of the NHS to offer timely care to patients, as a result of the rationing which helps make British health care "so cheap", put into effect rules that hospitals had to admit patients within a certain number of hours. The rules did nothing to provide more beds so the hospitals "ignored basic hygiene to cram in patients to meet waiting-time targets." This lead to increased deaths due to poor hygiene.

The Telegraph reports: "Filthy wards and nurse shortages led to up to 1,200 deaths at Stafford hospital. They report that the Institute for Healthcare improvements was hired to study British care. IHI reported:

“The patient doesn’t seem to be in the picture.” It adds: “We were struck by the virtual absence of mention of patients and families ... whether we were discussing aims and ambition for improvement, measurement of progress or any other topic relevant to quality.

“Most targets and standards appear to be defined in professional, organisational and political terms, not in terms of patients’ experience of care.”

Imagine that! But, considering that the funds for the NHS are not provided directly by patients, but are are decided politically, is it any surprise that NHS care focuses now what the bureaucrats and politicians want, to the detriment of patients. The patient doesn't pay for his health care, at least not directly. Prof . Briama Jarman, an expert on hopsitals standards, said: "These reports have never seen they light of day. We desperately need a better monitoring system for the NHS which actually works." But a spokesman for the Department of Health said they never wanted these reports to have "wider circulation." No, I suspect they wouldn't.

Yet, in recent years, the NHS was showered with new funds by the Labour governments. Lord Warner, who was a Labour minister of health says that the tw0-thirds of the new funding was used to increase salaries. He says that Gordon Brown, now prime minister "reverted to the traditional line in health, which was to support the unions who are the paymaster of the Labour party in the runup to the election." In other words, the extra funds weren't used for more health care but to make the trade unions happy so that the unions would be there when Laabour needs the in an election campaign. This shouldn't surprise Americans as this is precisely how the Democrats treat the education system here. American education exists to make the teacher's unions happy so that the unions, in turn, support the Democratic Party. In politically provided services, employees and teachers, come before patients and students.


Warner says that between 1997 and 2007, under Labour rule, "inputs—by that I mean cash—went up by 60%. But NHS outputs went down by 4%."

Honor killing in Arizona & Let the baby die.

There are two stories that caught my attention and both are worthy of mention.

The first is the sad story of Noor Almaleki who immigrated to the United States with her Muslim family from Iraq. Not long ago the father took Noor to Iraq for an arranged marriage, one which Noor rejected. She returned to the Phoenix, Arizona area and left her family and moved in with her boyfriend.

Her father, Faleh Almaleki, felt his daughter's actions brought dishonor on the family and in accordance with his "traditional family values" and his "religious convictions" used his car to run his daughter down when she was walking in a parking lot. She was with her boyfriend's mother who was also seriously injured in the attack. Noor died.

The father then fled to Mexico where he caught a plane to London. British authorities apprehended him when he landed and sent him back to the United States where he is now in custody. The brother, Peter-Ali Almaleki said he was sorry his sister suffered seemingly tried to justified the execution by saying: "One thing to one culture doesn't make sense to another culture." No, it may not. But murder is murder and any culture that condones murder is barbaric and unworthy of survival.

Yes, traditional family values and religion can be used to do awful things to people. Oddly Americans can understand that when the evil is perpetrated by Muslims. Tomorrow Christian voters will go to the polls in the hopes of stripping the equal rights of gay people away. They do so in support of traditional family fvalues and their religious beliefs. The principle is the same, only the degree is different.

Let the baby die?

A child is born with a serious neuromuscular condition. It is one year old and has been in hospital since birth. The child can see,hear and respond to his parents. He can play with toys but can't breath on his own. The insurer tells the parents that the plug has to be pulled and the baby should be left to die.

Ask yourself if this is an example of the evils of private medical care and private insurance schemes? Isn't this sort of case precisely the reason that we are told that state medical care is necessary and compassionate. With the state behind the care, and with universal coverage, then infants like this child won't be left to die. So we are told.

The problem is that the infant is not American but British, and the insurer is the socialized medical system in England. Doctors for the National Health Service have decided that the quality of life for the infant is not good enough to warrant living. They believe that medical care ought to be removed and the child left to die. The boy's father is going to court to try and stop this.

It appears that life support has been withdrawn from children, without parental consent, when brain damage existed. But no such damage is present in this case. A loss in court could substantially change the powers that physicians have over life and death in the British national health system.

Photo: Noor Almaleki.

Is this the future we will face?

The drive to impose a nationalized health system on the US is a major goal of the far Left. They really are quite rabid about it. I've previously discussed the failures of all health systems and why I think the US is the least worst of the lot. I'm no defender of the muddled system we currently have where various laws and regulations horribly distort the system and limit choice. But I couldn't possible embrace the nationalized system that the UK has, for example. Consider these two recent cases in the British press.

Matthew Millington enlisted in the British military at the age of 16, some 15 years ago. While stationed in Iraq he was diagnosed with a lung illness and it was determined he needed a double lung transplant. But the National Health Service gave him the lungs of a man who had been a heavy smoker and which contained cancer. Because Millington was taking drugs to surpress his immune system the cancer had a field day and spread rapidly.

Remember, the NHS hospital gave Millington lungs infected with cancer during his transplant. They also gave him drugs to suppress his immune system which allowed the cancer to grow. And when the cancer was discovered they said he was ineligible for another lung transplant because the hospital's rules. I quote the Times of London: "Because he was a cancer patient, he was not allowed to receive a further pair of lungs under hospital rules." The cancer he had, which made him ineligible for a second transplant, was literally given to him by the hospital.

The Times reports: "The cancer was discovered only six months after the operation, because of a lack of communication between radiographers and consultants. The tumour had grown from 9mm to 13 mm in that period." The hospital admits "a string of problems, including difficulties with communication, record-keeping and patient handover."

Hazel Fenton, 80, came down with pneumonia and was placed in the local NHS hospital. Doctors determined immediately that she was terminally ill and placed her in a controversial NHS program "to east the last days of dying patients." The program is actually something else entirely. When a patient is placed in the program the hospital ceases to feed the patient and given them care, allowing them to die.

And that is what the NHS was doing to Hazel. They refused to feed her, to ease her last days, by ending her life. Hazel's daughter, Christine Ball, was there to fight for her mother. She fought the hospital for days before finally getting them to begin feeding her mother again. Nine months later, the woman the NHS deemed in her "last days" was alive and well in a nursing home near her daughter.

The Times reports: "Doctors say Fenton is an example of patients who have been condemned to death on the Liverpool care pathway plan. They argue that while it is suitable for patients who do have only days to live, it is being used more widely in the NHS, denying treatment to elderly patients who are not dying." Miss Ball was equally blunt: "My mother was going to be left to starve and dehydrate to death. It really is a subterfuge for legalised euthanasia of the elderly on the NHS."

Ball says that while she was trying to convince the hospital her mother was not dying a nurse asked her for instructions on what to do with her mother's body.

The Times also writes: "In a separate case the family of an 87-year-old woman say the plan is being used as a way of giving minimum care to dying patients." The daughter of the woman in question says that her mother was put on "the plan" and "her medication was withdrawn. As a result she became agitated and distressed." Justified as a way to make the last days easier for the patient it appears "the plan" is a way to make medical care cheaper and meet budgetary restraints by denying treatment to old people.

Meanwhile another scandal is brewing in regards to NHS staff members who become sick. It appears that the National Health Service doesn't trust its own care when it comes to their staff members. Recent documents reveal that over the last three years the NHS spent £1.5m (about $2.4 million) so that their staff could receive private treatment outside the NHS system. Some 3,000 NHS employees received private care paid for by the NHS, care denied to patients of the NHS. Norman Lamb, Shadow Health Secretary for the Liberal Democrats said: "If the NHS thinks it necessary to pay for private treatement for its staff to jump waiting lists then it raises serious questions about whether the current system is working as it should."

One local newspaper looked at how the NHS paid to have ambulance staff receive private care and was told by a spokeswoman for the amubulace service that "we want to get [our staff] back o work as quickly as possible so they can continue to provide services to the people of the east of England..." Apparently to give quick service they have to scuttle the NHS and go private.

The BBC recently reported that a report on NHS procedures show that: "More than 5,700 patients in England died or suffered serious harm due to errors lastest figures for a six-month period show." And another NHS report shows that one in 50 patients are receiving treatment to undo the harm done by the NHS with previous care. This includes those with reactions to medication, those suffering from "misadventures" during surgery and "adverse incidents" related to medical equipment.

Another example of how nationalized systems lower costs comes with the drug tocilizumab. This drug appears to work very well for patients with rheumatoid arthritis who have not responded well to other medications. But nationalized systems are known for being cheap and being cheap means not offering medical care deemed too expensive. The NHS has an agency called the National Institute for Health and Clinical Excellence (which they abbreviate as NICE). NICE is not nice when it comes to recommending drugs. NICE said that the medication is too expensive and has advised against its use, not because it is ineffective or dangerous, but because it costs too much. The National Rheumatoid Arthritis Society says the decision is "extremely bad news."

However, while they can't afford to pay for medication that would ease the pain of patients, the NHS can afford to continue to pay executives who no longer work for the NHS. A publication in Wales reports: "The Western Mail understands that chief executives and finance directors displaced by new arrangements that came in last week have a guarantee that their existing salaries will be protected for 10 years." So, a job is ended, but the staff member stays on salary for 10 years at full pay.

Photos: Upper left, Lester Millington with a photo of his deceased son, Matthew. Mid right: Christine Ball with her still quite alive mother, Hazel Fenton.k

UK's health system: more bureaucrats than doctors.

I was reading the British news, as I often do, and came across a story regarding the National Health Service in the UK—an institution that the Obamatrons and sundry statists in America want to emulate. The UK, as might be suspected, has had problems keeping medical costs down. As new technologies develop more medical options are available. And the more that is available the more that gets spent. One easy way to cut medical costs in any country is to simply ban all new technologies and drugs. If you want 1950s health care costs then use only 1950s health care technology.

But the UK doesn't want to be quite that drastic, even if they do restrict medical choices significantly. So the upward pressure on their health budget has a tendency to get completely out of control. Apparently the Labour government commissioned a study on how to cut NHS expenses. The report came back suggesting cutting 137,000 staff members.

I find that highly unlikely. Remember these are 137,000 government employees. Many of them have families and friends. They will be angry if they get sacked and they vote. So a political decision is likely to be made to keep the staff and cut costs somewhere else, where they hope it won't harm election night totals as much. One thing to remember under a politically-controlled health system is that what's good for the ruling party comes before what may be good for the patient. So the report looked for ways to cutting staff, without actually cutting staff, not filling vacant positions, for instance.

Cutting staff may not be a bad idea for the NHS, however. Buried at the bottom of the news story were some figure regarding staffing at the NHS. The NHS employes 1,368,694 people. Of those 49%, or 666,863 are classified as "non-medical staff." So for every medical staff member they basically have one staff member who is not medical. What I found interesting is that the total number doctors (both general physicians and hopsital doctors) is 121,808. The entire staff of doctors of the NHS are outnumbered by administrators alone, 178,151. If you add in the "senior managers" then the bureaucrats, 219,o64 of them, who control the system outnumber the 121,808 physicians who work in the system. For every 100 physicians in the NHS there are 180 administrators.

Video: Just some appropriate amusement from the classic British series, Yes Minister.

How England Saves Money on Health Care

I have argued that the main method by which nationalized health care systems, such as the National Health Service in the UK, saves money is simple: deny health care. Care is bureaucratically rationed out. Some people get it, some people don't and it often depends on the whim of untrained bureaucrats or by which "health district" you reside in. This story illustrates NHS health savings in action.

Expectant mother Carmen Blake had sudden and unexpected contractions indicating that her fourth child was about to be born whether she liked it or not. The contractions were strong enough that Carmen realized that she had virtually no time left and called the hospital for an ambulance. The hospital refused her an ambulance and told her to walk. Under normal circumstances that is not too unreasonable as she did live close by. But she was already in labor when she called. Blake recounts: "They said they were not sending an ambulance and told me I had nine months to sort out a lift."

Blake, with some friends also on foot, tried to walk to the hospital as instructed. But she didn't make it. The woman couldn't move any further. A passing woman, Helen Ivers, who is a physio-therapist ended up delivering the child on the sidewalk. Worse yet the umbilical cord was wrapped around the baby's neck so she wasn't breathing. Ivers said when she got there she shouted: "Where are the paramedics." Ivers said "When the baby's head came out I realized the cord was around its neck. Its all a bit of a blur but I think instinct kicked in and I just pulled it over the baby's head."

The friends had called the hospital which, now realizing that Blake was giving birth on the public sidewalk, thanks to their cost-cutting, finally sent the ambulance she had previously requested. The communications manager for the ambulance company said: "This was clearly a traumatic eperience for all concerned." I suspect it was more traumatic for Blake because she was refused an ambulance and then traumatic for Ivers who had to do the hospital's job on the sidewalk because the NHS was saving money.

A spokesman for the state-run hospital said: "We are disappointed that Ms Blake was not happy with the advice and care she received and will of course investigate any complaint." Wow! How compassionate! Note that they didn't apologize for telling a pregnant woman to walk to hospital. Instead they said they are disappointed that she isn't happy. And they again pretend they offered care, which they did not. Blake wasn't disappointed by care she received but by the absence of care requiring her to give birth in front of traffic.

At roughly the same time another expectant mother, Rebecca Molloy, turned up at an NHS hospital. She was 38 weeks pregnant and having contractions. The hospital told her that she wasn't ready and to go home, they were unwilling to admit her. (Too costly you know.) Three hours later Rebecca found herself on the floor doubled up in pain from contractions.

Husband Tony called the hospital for help but "could not get any response." (Perhaps the NHS staff were busy writing letters in defense of state-managed care in England because the criticism they received from opponents of Obamacare.) Left hanging by the hospital, Tony ran out and got the car to rush Rebecca to hospital.

When he returned she told him it was far too late and the baby was being born. Tony Molloy began delivering his daughter. The infant was ashen gray in color and not breathing. It too was born with the cord around its neck. Remembering birthing videos he had watched Tony removed the cord from the child's neck and slapped her on the back to start her breathing. Tony said: "She was grey and not breathing. I was talking to her, saying 'come on little one, breathe for daddy."

When the NHS hospital was asked by the media about their sending a very, very pregnant woman home, without being helped, the hospital spokesman said: "We would encourage the family to contact our patient advice service if they have any concerns over the care received." Actually wouldn't that be "over the care NOT received?"

There is no magic in cutting health care costs—just cut health care. That is how it is done in England and that is how it can be done in the US. You do get what you pay for. Pay for less, get less. It's not that hard to understand. So why does the Left believe that Obama is some messiah who can magically take "a loaf of health care," bless it, and pass it around so that everyone has as much as they want at no additional cost? When government controls health care it saves money by denying treatments and services to people.

Consider poor Ms. Blake. Had she lived in the US, she would have called the ambulance saying she was in labor. It would have showed up and the cost of that would be added to America's health care costs. She would have gone to hospital where she would have had the child, again racking up costs toward the US health care total. All that care, in the current debate, would be counted AGAINST America's health care costs and would be considered a bad thing.

In contrast, in the UK, she was told to walk to hospital, to save on ambulance costs. She delivered on the sidewalk with care given by someone not being paid by the NHS to deliver that service. All that added up to health care savings for the NHS. And, based on the tenor of the debate over Obamacare the costs show that NHS service is superior to health services in the US precisely because the NHS doesn't cost as much. Imagine how efficient the NHS would look if it had patients perform their own heart bypass at home! (Sort of the way NHS patients were forced to pull their own teeth because the government rationed dental care.)

The NHS, life expectancy and America's health care debate.

Bureaucrats who work for the British government’s health care system are unhappy that their system of centrally planned care is being used as an example of what Americans should fear with Obamacare.

One such individual, from the Faculty of Public Health, Alan Maryon-Davis, claimed “The NHS (National Health Service does a damn fine job.” And his proof:

“We spend less on health in terms of GDP than America but if you look at health indices, especially for life expectancy, we have better figures than they do in America.”

What is interesting is how Maryon-Davis was able to include so much misinformation into one sentence. It is almost breathtaking. So let’s unpack his claim one phrase at a time.

“We spend less on health in terms of GDP than America...” This is true. But does it mean anything?

Americans spend more on cars, in terms of GDP, than do Brits. Does this mean Brits have better automobile transportation than Americans? Not at all, they have significantly less. The British government puts a lid on health care in some very simple ways: they deny it. So you can’t get the treatments in the UK that you can get in the United States.

Americans can choose to spend on these treatments, British subjects can not. If we cut the amount of health care we give out, we could cut our costs significantly. Take one example that was in the news recently, because this British woman, agreed to be interviewed by opponents to Obama’s take-over of health care.

Katie Brickell asked for a pap smear when she was 19. The NHS told her she could not have it. When she turned 20, she was told, she could ask again. She asked again, one year later. Now they told her they had changed the rules and she could only have a pap smear when she turned 25. So, once again she delayed the test. When she was 23 they told her she had cervical cancer, the very thing the test is designed to detect. She said: I gave an interview and everything I saw was truthful...” She said: “I would say to anybody in my situation now that if they had the money, they should go private.”

Luckily she was working a company that also provided private insurance. So she was immediately put on drugs that, so far, have saved her life, and appear to have put the cancer in remission. She has to take two different drugs and she acknowledges, that under NHS care “I would have had to get a lot of clearance to get that level of care. On private, that just was not an issue. If I needed a scan, it was immediate. On the NHS, it was often a two or three-week wait.”

The NHS was doing what it was designed to do: cut the costs of health care by rationing health care according to edits set by bureaucrats as their best guess as to what, is a good idea, on average. The rules are set to cut costs. In most cases a 19-year-old doesn’t need a pap smear, Katie wasn’t “most cases.” The system can’t individualize needs the way that private care can.

Thelma Nixon was told that her case of wet macular degeneration would mean she would go blind. She need injections into the eyes to prevent this. Injections, or blindness, there was no other option. The NHS told her she didn’t fit their guidelines because the cost was too great. So they decided she needed to go blind, after all NHS provides health care at a lower cost than the US and that’s a good thing.

Thelma remortgaged her home while the Royal National Institute for the Blind went to bat for her. The press caught on to the story and started campaigning for her. Since British health care is politically controlled this was causing bad publicity for the ruling party and the NHS relented—for Thelma. Those who don’t manage to create a media frenzy around themselves are not so fortunate.

But Thelma’s initial treatments were paid for by herself, from the house mortgage. And when that ran out a local businessman gave her the funds for two more treatments. Other readers of her local paper rallied to her case and provided funding. ONLY after this media frenzy was created did the NHS relent. They sent up new guidelines for assessment and will not disqualify people from care according to the new policies.

Jane Tomlinson knew that the squeeky-wheel gets the grease in the NHS system. But she didn’t want to go that route. She was an avid supporter of the NHS. She worked for the NHS as radiographer. She spent much of her time raising additional funds for the NHS. It is estimated that she raised close to $2.9 million for the NHS.

She was diagnosed with cancer. Her medical team told her that the best option for situation was treatments with Lapatinib. But that costs $11,000 for a year’s worth of care, but that’s just a fraction of the funds she raised for the NHS. Were the bureaucrats thankful? No. They told her she could not have the treatment in her region. Had she lived in other regions of the country, the bureaucrats had decided differently and she would have had the treatment. She died. The NHS Trust said: “We were deeply disappointed not to be able to offer Jane the treatment she and her consultant wanted. We support Jane and Mike’s (her husband) views that we need to debate about access to drugs that have not yet been licensed or nationally approved.” They were disappointed! Tell that to her her small son.

Remember, it is easy to cut the percentage of GDP spent on health care. Just ration it. Cut the amount of care that people are allowed to receive and you will cut the costs.

What matters, is not the percentage of GDP you spend on care, but what you get for it. We could give Americans 1950s costs on health care if we limit the care to 1950s technology. Cut out CAT scans and you can save a lot of money, and lose a lot of lives. Cut out bypass surgeries and you can lower the total amount spent on care. There is no magic in cutting health care costs. It’s easy and it is done in country after country, merely by limiting the supply of care.

We could cut the costs of education in America the same way. Just fire half the teachers and ration education. We could set up schools with waiting rooms where kids line up in the morning and the first 200 in get to go to class and the rest go home. Of course, they can try again tomorrow!

The proponent of government-run health care only whine about the costs of health care. If education is being discussed they attack America for “not spending enough.” When it comes to public transit they whine about “not spending enough.” When it comes to government programs then more. When it comes to private services then more is evil. It isn’t the cost that offends them. In the UK the same proponents of socialized care want government to spend more. Spending more is only considered evil when it is done privately.

Let’s look at the second phrase in the defense of the NHS: “if you look at health indices, especially for life expectancy, we have better figures than they do in America.”

The problem here is that life expectancy is not a measure of health. It is and it isn’t. It is a measure of life expectancy which is determined by countless other factors, of which health care, is just a small factor.

Imagine two towns, with the identical number of people, fitting precisely the same profiles. They get the exact same health care. But in one town the villages like to drive wildly, while the other town is inhabited by people afraid to drive fast then 20 mph. Which town will have a lower life expectancy?

People who smoke have a lower life expectancy than people who don’t, even if they get the identical care. A town with a higher murder rate will have a lower life expectancy than a town with few, or no murders. People who exercise and eat their vegetables will have a higher life expectancy than people who don’t. There are literally hundreds of factors which impact life expectancy which are entirely outside of the health care system.

This is widely known, but that doesn’t stop the proponents of socialized health care from using this statistic. The numbers they use are correct, but the spin they put on them isn't.

What is an objective criteria that can be used? How about survival rates for patients, suffering similar conditions, under various systems. Since the examples I used earlier, of Katie Brickell and Jane Tomlinson, involved cancer let’s explore the survival rate differences between the US and Great Britain.

The British medical journal, Lancet Oncology did just that. When it came to measuring the survival rates of cancer victims guess who came in first place: the United States, where 62.9 per cent of female patients survived. In England the rate was 52.7 per cent. For male cancer patients the news was better Americans but worse for the Brits. Sixty-six per cent of American male patients with cancer survive. In England only 44.7 per cent do.

Survival rates for cancer victims does measure health care, especially health care around the issue of cancer. Yet, the NHS apologists avoid mentioning this statistic and instead trot out life expectancy, which has little to actually do with health care. But then, what choice did Maryon-Davis have in order to make his case?

Photos: Photo #1 is of the queue outside one of the few NHS dentists in Wales taking new patients. To limit costs the NHS strictly limits the number of dentists. The results are long lines of people hoping to be allowed to see a dentist. Some pensioners have suffered so badly from tooth aches, and facing NHS restrictions on care denying them dental care, that they have resorted to pulling their own teeth. But, when they pull their teeth, instead of the NHS doing it, it lowers the percentage of health care as a part of GDP, and that's a good thing according to NHS proponents. Photo #2, Jane Tomilson and the family she left behind.

England's NHS starved man to death.

Earlier this month the nationalized health service of England took another blow in the media as it was revealed that they had let a man starve to death while under their care.

Martin Ryan was a 43-year-old man with Downs Syndrome who had difficulty communicating. When he had a stroke he was unable to swallow food. No one bothered to fit him with a feeding tube while in hospital. After 26 days without eating the hospital discovered that this error had been made but it was too late to save Ryan who literally starved to death. The NHS trust that operates the hospital has apologized to the family

But the medical care was free....

Stewart Fleming was lucky, according to some. He lived in England which has nationalized health care. I won't say his treatment was free, after all he was very heavily taxed to pay for the care so that it would be there when he needed it.

And he needed it. Mr. Fleming, 37, was attacked by a virus that was devestating his body. His physician was horrified by what he found and called the local hospital to tell them of Mr. Fleming's condition. The doctor gave Fleming's wife, Sarah, a note explaining to the hospital exactly how urgent Mr. Fleming's condition was. The virus was attacking his heart and other major organs. The matter was very serious indeed.

When the Fleming family arrived at Medway Maritime Hospital, Sarah gave the staff the note from the physician urging the immediate admission of the father of two. Sarah was told to get to the end of the line and wait. The English National Health Service has rules about quickly a patient must be seen after admission to the hospital. As I've reported before the way the NHS gets around the rule is to simple force sick patients to wait and wait and wait before they admit them. By shifting the waiting time to "pre-admission" they can claim prompt service after admissions. A patient, who can't be seen for eight hours is thus left sitting for five hours before admission and then the NHS claims the patient only had to wait three after since the "official" waiting time only begins at admission.

And that is what happened to Mr. Fleming. The hospital refused to admit him immediately. Instead they left him waiting for hours. First, he waited for hours before he was admitted and then he waited hours before seen by a physician. And this was an urgent case. Sarah Fleming said they arrived at in Emergency care "before 5:30 pm. He was finally called through to be examined at 11 pm."

As Mr. Fleming was waiting the virus continued to attack his heart and his liver and his kidneys. He was put into a medically induced coma but that didn't help. The doctors amputated a leg that was infected hoping that would help. Unfortunately it was too late. The virus had spread too far and a few days later Fleming died. But the care was free (if you don't count the taxes)!

When the Medway NHS Foundation Trust was asked to comment about their treatment Mr. Fleming the spokeswoman for the government hosptial said: "Due to patient confidentiality we are unable to discuss any details." See, even now they are just thinking of Mr. Fleming's well-being. Fleming leaves behind his wife of 15 years, Sarah, his daughter Lauren, 14, and a son, Matthew, 12.

The photo shows Mr. Fleming in the emergency ward, in severe pain, as he's waiting to be treated.

Nation Health Service logic.

Sometimes all you can do is shake your head in wonderment.

A recent report on the state of dental care under the United Kingdom’s socialized health care system indicates that reforms, meant to improve the lackluster service, have actually made things worse.

First, they saw a massive reduction in the number of patients who were seen by dentists. Patient levels fell by 900,000 in the 18 months after the service as implemented. And complex procedures like bridges, crowns and root canals dropped by 45%. So what happened? Apparently the level of extractions rose. So instead of fixing the problems teeth, which previously would have been repaired, were pulled out.

The committee of members of parliament concluded that patient care did not improve at all. The British Dental Association called it “damning” and said it “highlights the failure of a farcical contract that has alienated the profession and caused uncertainty to patients.”

But in its defense a Department of Health spokesman said: “We have invested over £200m in NHS dentistry this year, over and above increases in the last three years. This takes our total investment to over £2bn.”

Are you following this? The NHS “improves” its dental services and the result is 900,000 fewer patients being seen and teeth being pulled instead of repaired. But the NHS brags that they managed to spend a lot more money in the process!

Can you imagine any business, anywhere, claiming that a large reduction in their customer base is somehow offset by an increase in their costs?

Only in government.

NHS reveals real motive for nationalized care.

There is an article in the New York Times which gives away the entire philosophy behind nationalized health care. And it isn’t pretty.

Let me recap the story that they tell before getting to the key part.

Debbie Hirst has breast cancer and it has metastasized. Her oncologist wants to treat her with Avastin, a drug which is used widely in the United States. But the National Health Service has said that they won’t provide it. Please remember that. That proves that one of the selling points of socialized health care is a lie: that everyone should have the health care they need and they will get it with socialized service.

That isn’t how it goes with socialist health care at all. Never has been that way and never will be that way. The reality is that people are routinely denied treatment under socialized health systems.

Hirst talked with her physician and said that she and her husband will do what they can to private raise the funds to pay for the drugs that she needs. It’s a lot of money and family taxes to pay for “free” health care are already taking a big chunk of their income. But when your life is on the line you will do what it takes. So problem solved? Not really.

The National Health Service told Hirst and her physician that she will not be allowed to purchase the drugs privately unless she also pays for all her health care privately -- something that is not possible. Remember Hirst has already been paying the NHS for her entire life for “free” care. Yet the care she needs they refuse to supply and they forbid her to buy it privately unless she dumps all the care she is getting, and which she paid for already in taxes.

Imagine a car insurer doing the same thing. You have an accident and the car is dented badly and the window cracked. You bought a policy that covers the dent but doesn’t cover the window repair. They tell you that window repairs are not covered. You accept that and say you will have the window repaired elsewhere. Now they threaten to withdraw the insurance which you have paid for in response. They say that if you have the window fixed privately they will no long cover the dent either. That would be consider fraud.

Of course government “insurance” is never held to the same standards of honesty that apply to the private sector. The reality is that if private insurers acted the way governments routinely act they would be arrested and imprisoned for fraud. But with political services the rule of “do as I say and not as I do” dominates.

The New York Times explained the British government’s reasoning for condemning Hirst to die by refusing her the drugs she needs and forbidding her from purchasing them herself without given up all her health care in the process.

Officials said that allowing Mrs. Hirst and others like her to pay for extra drugs to supplement government care would violate the philosophy of the health service by giving richer patients an unfair advantage over poorer ones.
Patients “cannot, in one episode of treatment, be treated on the N.H.S. and then allowed, as part of the same episode and the same treatment, to pay money for more drugs,” the health secretary, Alan Johnson, told Parliament.
“That way lies the end of the founding principles of the N.H.S.,” Mr. Johnson said.

Consider the reality of what is being said here. The purpose of nationalized health care is not to give everyone the treatment they need at all. It is to make sure that no one has better treatment than anyone else!

The motivation for socialized care is not compassion for the sick at all. It is envy directed against those who can afford their own care.

In Hirst’s case she can’t afford the care but what choice does she have. She was putting her home up for sale to pay for the drugs which “free health care” won’t provide her.

One of the most powerful motivations for socialism has been equality. But what sort of equality. It is not the upliftment of the needy, which is a very hard thing to do. It is the destruction of the well-off. They don’t level up but level down. They aren’t promising prosperity for all just equal misery.

There was lots of publicity over Hirst’s case and the government found a loophole -- sort of. Further examinations found that the delays in receiving the treatment means that the cancer has spread throughout her body. Now they say they will provide the Avastin even though it is now too late to be of much use. As Hirst said: “It may be too bloody late.”

She was denied the drug when it could have done the most use. And only given it when it wasn’t likely to be effective. What Hirst doesn’t understand is why she was denied the drug due to costs. ““I’m a person who left school at 15 and I’ve worked all my life and I’ve paid into the system, and I’m not going to live long enough to get my old-age pension from this government,” she said.

Reasonable if you look at this as a form of insurance. But then it isn’t really insurance. As we’ve already noted: the main purpose of nationalized health care in England wasn’t to provide health care to all but to make limit the ability of some to get better care than others. The goal wasn’t provision but equalization. And that is a very different thing.

Nationalized medicine and the incentives they face.

The role of incentives are too easily ignored by individuals who have the idea that the State is somehow, magically, the solution to whatever problem we face. And government-run health care is supposed to be the solution to the scarcity problem in health care.

Economists argue that incentives matter and that political-provision of services creates distorted and perverse incentives. And here is a perfect example.

The British National Health Service is notoriously slow in treating patients. Some people deny this is the case and point to various numbers released by the NHS itself to show how efficient it is. And one number the NHS takes seriously is that they require patients admitted to the emergency ward to be seen within 4 hours of admission. Doesn’t that sound peachy?

Don’t get too excited. Let me point out how well-intentioned interventions can create unintended incentives. A town in a poor country is faced with too many rats. They offer a bounty for each rat that is killed. Proof of a kill required the bounty hunters to hand in a rat’s tail. Alas, a bevy of tailess rats were soon seen running about town. To solve that problem the city required the entire carcass of the rat be handed in. And they were inundated with dead rats. But it seemed to have no impact on the number of rats running about. Apparently individuals took to breeding rats.

There was a time when the South African government decided that they would offer an award for every AK-47 that was turned into the police. These weapons were frequently used in major crimes and it was a bit embarrassing to the ANC government that they had been the importers of the weapons in question when they were trying to overthrow the previous government. So they offered a nice hefty bounty on each AK-47 that was turned in. The only problem was that AK-47s could be purchased in neighboring countries for a lower price. One could buy it in Zimbabwe and legally sell it to the South African government at a premium. AK-47s were duly imported in record numbers in order to collect the awards the government was handing out. To say the least they merely increased the number of such weapons in the country.

Governments are very good at establishing perverse incentives without realizing it. And so it was with the NHS. The 4-hour rule is simple. A patient must be seen within 4 fours of admission. If too many patients are not seen in that time the health service could lose funding. Of course the ability to see patients that quickly is not increased by the rule. Instead the local hospitals have incentives to act in very strange ways.

If you know you can’t see a patient in emergency care for at least six hours, but you are required to see them within four hours of admission, then the easiest way to solve the problem is to delay admission for an additional two hours. And that is what is happening according to the Left-of-center Guardian. The paper reports, “thousands of seriously ill patients in ambulance ‘holding patters’” were being kept outside in the ambulances “to meet a government pledge that all patients are treated within four hours of admission.”

The story was originally broken by The Observer. The Guardian notes:

Those affected by 'patient stacking' include people with broken limbs or those suffering fits or breathing problems. An Observer investigation has also found that some wait for up to five hours in ambulances because A&E units have refused to admit them until they can guarantee to treat them within the time limit. Apart from the danger posed to patients, the detaining of ambulances means vehicles and trained crew are not available to answer new 999 calls because they are being kept on hospital sites.

Notice the knock-on effect of this incentive. The hospital can’t see the patients within the required 4 hour period. So it refuses to admit the patient until it can see them and meet government edicts. That means the patients is left in the ambulance. That means the ambulance can’t treat other patients.

Under normal conditions the government says that it ought to take 15 minutes from the time an ambulance arrives with a patient until they prepared to depart. Ambulance crews say it is usually 5 to 10 minutes. But reports now show that on 14,700 occasions at 35 hospitals in London alone, in the last year, an ambulance mysteriously took over one hour before they could turn around. And on 332 occasions they took more than two hours. The total for the entire country is probably three times that.

For a moment I want you to think about a fast food restaurant -- say McDonalds. Let us say that the manager notices that they aren’t serving customers as quickly as they should. So he sets a 4 minutes rule. From the time a customer enters the line, he should not wait more than four minutes to be served his meal. Do you really think that the way they would meet this target is to lock the doors so customers can’t get in?

Why is it that clerks at the local grocery store can process your purchase within a few minutes while government departments around the world can keep you waiting for hours at a time? Are clerks at the local Safeway just that much more efficient than those at the DMV? Or do they face entirely different incentives?

Does the DMV fear losing customers? Does Safeway? Does the salary of the checkout clerk at Safeway depend on keeping customers happy? How about the DMV clerks? I don’t think the people differ that much. The problem isn’t the personnel -- as some Republicans tends to think -- the problem is systemic. Government just hasn’t found a way to create the right set of incentives. And people who work for government are responding to the incentives they do face.

The illusion of universal, national health care continues.

Health care for all: a nice dream that built the Britan's National Health Service. But here is a story from the BBC that once again indicates that this goal still remains firmly a dream.

Don Wilson, from Kent, says that he’d call NHS dentists to see them about a toothache and they’d tell him that it would be weeks before have an appointment.

Wilson tried other NHS options but none were helpful. There are openings at private dentists but not with the NHS. He says: “I went for a rummage around in my tool box and found these fishing disgorgers -- the tool you use to get a hook out of the back of the fish’s mouth. they look a bit like scissors or pliers.”

He just grabbed hold of the tooth and started pulling until he heard a cracking sound. He said it was painful but so was doing nothing. He has pulled five bad teeth this way so far with one still half in.

He said if he could get an appointment with a NHS dentist he would do it. But since he hasn’t been able to he didn’t have much choice. “If you’re in agony with toothache, you haven’t got much choice.”

The NHS did, however, save some money by never having an open for Mr. Wilson. And that gives ammunition to those who want a similar system in the U.S. It's cheaper. Imagine how cheap it would be if they rationed dentists even further.

Around ten weeks ago the Aberdeen Evening Express told of the woes of NHS dental patients in their area. They said that the number of people waiting to get on the list of an NHS dentist has grown from 16,714 one year ago to 25,058 this year. The local member of the the Scottish Parliament noted: “People are not going to dentists because they can’t get to dentists.”

While the NHS tried to open more dental clinics, more and more dentists simply stop taking NHS patients. One cost saving measure for the national service is to try to shift the actual costs for dental care from the NHS to the individual dentist. One dentist complains: “The government sets what dentists can charge, and they are same whether you are in Central London or Skye, irrespective of training or other costs.” Another said: “There are lots of costs for dentists. Some of the equipment is funded, but a lot of it has to be bought by the individual practices, and the maintenance is costly as well.”

So varying costs are neglected. A private patient comes in and pays around £25 for a basic check-up and that helps cover the costs for all the items not covered by the NHS. But for the NHS patient the government pays £7 each. The patient sees the care as free since the taxes he paid have already been taken from him and visits to the dentists don’t immediately result in more costs to himself (long term they do).

This illusionary “free” cost encourages people to make appointments while the very low amount actually paid to dentists discourages actual care. The demand goes up but the supply goes down resulting in long queues of people unable to obtain dental care. One dentist noted that many of the people in on the NHS waiting lists “are quite willing to pay £40 a month on their Sky [cable television] subscription, but not pay £10 a month for dental treatment.”

This would mean that a lot of the equipment used by NHS patients is actually paid for by private patients and that not only are people subsidizing the NHS care through taxes but private patients are paying for it as well through higher dental bills. NHS patients are paying through taxes for care that many of them simply can't get from the NHS. Private patients still are taxed for the NHS care they aren't using and then they pay for their private care on top of that plus some of that is still helping subsidize the NHS patients who are getting care. No wonder nationalized health care is cheaper. It is no mean feat to have a cheaper service if you don't give out the care required and charge people for care they aren't receiving.

Another snapshot of the state of nationalized health care.

It has been awhile since I’ve presented a snapshot of health care under socialized medicine. What this column presents is relatively simple. I pull up recent news stories on the National Health Service and see what has been reported in the last week or two, sometimes only the last couple of days depending on the number stories.

String enough of these stories together and you have a good idea of what happens with socialized medicine on a fairly regular basis. One story by itself is not adequate to gage anything. The key to understanding is to look at the trends long-term.

The first story was posted just two hours ago (from when I write this). It’s open line is “Significant failings in the management of several Kent hospitals resulted in the death of 90 NHS patients in Britain’s worst outbreak of a hospital superbug, the government’s health watchdog said on Thursday.”

What they found was that “lax management at all levels... fueled the outbreak of the bacterial infection, Clostridium difficile.” This is considered so serious that that the report has been handed to the police who “have the option of bringing charges of murder, manslaughter or breach of health and safety regulations.”

“The study claims dirty wards, inadequate staffing and pressure to reach government targets were contributing factors in two outbreaks of C. difficile in 2005 and 2006.”

It gets worse! They found “evidence of ingrained blood stains on floors, bedpans that had supposedly been cleaned but still contained faeces and open skips containing bags of old dressing and bodily fluids.” Lovely. (This one is particularly disturbing as these are all hospitals in the area where I am currently staying. I think if a car hits me crossing the main road I might be better off recuperating the street than being taken to in for treatment.)

As a result of these lax standards they concluded that “90 deaths ‘definitely or probably’ occurred as a result of of infection. Sixty of these deaths were found to be a result of the failure to introduce adequate counter-measures.”

The BBC reports that as a result of the report “Kent Air Ambulance has suspended all flights to Maidstone Hospital” and will be taking patients elsewhere. But the NHS Trust that runs Maidstone slammed that decision saying that their “infection rates” “are better than average nationally.” If true that is frightening.

Another report has more precise numbers. It says that over 1,000 patients were infected in the NHS hospitals and that “345 patients died while being infected with C diff, the infection being a definite contributing factor to their deaths in 124 cases, probably a factor in 55 and possibly a contributing factor in 62.”

Obviously this story is dominating the media especially in the United Kingdom. There are more accounts than worth reporting. Most emphasize the breaches of acceptable medical care -- such as nurses not washing their hands and patients left to lie in their own diarrhea.

The Telegraph has a report on a relatively obscure NHS agency called the NHS Litigation Authority. They are the agency that pays out the claims for harm caused by negligence by NHS staff toward patients. Obviously they will be very busy in light of the previous story. The report notes that last year they paid out compensation of around $1.22 billion to patients who were harmed by the care they received. The report focused on the almost total secrecy under which the agency operates. They don’t have their name on their door, don’t give copies of their annual report to the press, or even send out press releases about it. They try to avoid press interviews. They do say that they have one open meeting a year but the press never attends, however they admit that they don’t actually inform the press as to when those meetings are held.

This is London reports that the NHS “rationing body” has made a decision to deny medication to “hundreds of thousands of women”. They are restricting drugs for osteoporosis and ordering doctors to “prescribe only the cheapest drug, even though it does not work in many cases.”

Women in Wales and England with osteoporosis are being told by the National Institute for Health and Clinical Excellence that they will only be allowed to use alendronate, which costs about $2 per week. The alternative, more effective medicines cost about $8 per week. Those will only be available if special permission is granted. It is reported that there “is also evidence that some taking other drugs are being swapped to the cheapest without their doctor’s knowledge.”

The Daily Mail reports on the NHS budget which is scheduled to rise to $220 billion by 2010. Even with the extra $40 billion the budget is “less than advisers told the Treasury were needed to maintain standards in the NHS.” Since the problems with the “superbug” are in the media the government announced that they will spend $280 million just to try to end the infections patients contract while in hospital. In just the first quarter of 2007 there “were 15,592 cases of C. Diff in patients over 65” which is an increase of 2 percent from last year. Funding increases greater than what were given were supposedly needed and it is not feared that “more wards [will] have to close and more drugs [will] have to be rationed.” The Financial Times reports that the NHS now consumes one fifth of the entire national budget for the British government.

The Waterbury Republican-American editorialized on health care and mentioned the case of Jane Tomlinson, a victim of breast cancer, who worked tirelessly to raise fund for the NHS. They say she “raised $3.5 million for the NHS” and was an “unflagging supporter.” They also reported:

Mrs. Tomlinson, 43, died last month because the NHS refused to pay $13,700 for anti-cancer drugs that would have extended her life. The reason? Her address made her ineligible for the benefit. This quirk in the socialistic system is described in the British press as "the gap between the rhetoric of a comprehensive and universal 'national' (healthcare) service" and reality. She valiantly fought the NHS for months, but by the time the bureaucrats relented, her condition had deteriorated past the point where the drugs could hold her tumors at bay. Her widower, Mike Tomlinson, told the British news media his wife was "fundamentally let down by an unjust system." For her troubles, she got a posthumous apology.

Another story in the Telegraph told more of the story. Tomlinson knew that the system was geared so that patients who got lots of publicity, and made the politicians look bad, could get priority treatment. And she knew she was considered a celebrity. But she thought that was wrong and didn’t want to use her status to force a political decision in her favor. She had requested the use of the anti-cancer Lapatinib. But the NHS refused the treatment to her.

She could, however, get treatment at another NHS hospital is she was willing to travel 150 miles round-trip each time. But that was a grueling experience for her and that was only after waiting too many months. She asked her husband to only release the details of her case after her death, which took place last month. Mr. Tomlinson “detailed how she battled to get access to Lapatinib, which costs £6,700 per patient, per year. Mr Tomlinson said her medical team in Leeds decided that the drug was her best option. However, Leeds Teaching Hospitals NHS Trust had taken the decision not to participate in a GlaxoSmithKline-sponsored access study of the treatment.” Remember that under socialized medicine the last decision maker is not you or your physician but a bureaucrat.

Mrs. Tomlinson had to make further applications with different NHS Trust’s before she found one that would accept her. But that took time. “The delay,” said her husband, “ in not having treatment from January to April severely affected Jane’s health. It is unproven, but felt by the family, that this shortened her life. All individuals should have a right to access to the same drugs. Jane has been fundamentally let down by an unjust system.” In response the local NHS Trust said they were “disappoint not to offer Jane the treatment she and her consultants wanted.”

Tomlinson, who was actually a radiographer for the NHS, was to received a Commander of the British Empire award from Queen Elizabeth for her service to the NHS in November. Instead her 10-year-old son will receive the award on her behalf.

This report says that the Healthcare Commission audit of the NHS complaint system “found NHS trusts are failing patients who make complaints and not learning from their mistakes.” In total 32 NHS Trusts were being inspected “due to concerns that they were not meeting standards.” The Commission says the Trusts seem more interested in process complains rather than finding a resolution for the patient concerned.

And the British Dental Association is very unhappy that the NHS continues to short-change patients on dental care. They note that since 1990 the NHS budget has gone up by 75% while the budget for dentistry has gone up 9%. Peter Ward, chief executive of the BDA says: “Investment in NHS dentistry remains inadequate as the government itself acknowledges that around two million people who want to access NHS dental care are unable to do so.”

This next report strikes me as a bit odd. The NHS says that in Worcestershire alone there is $8 million wasted due to “unwanted repeat prescriptions”. For the West Midlands region the total is $70 million. The report says the patients no longer need the medications and many have stopped using them.

The NHS has launched a campaign for the patients to remind them to order only what they need and to review their needs for prescriptions. The will put up posters and billboards and distribute leaflets all aimed at patients. The entire campaign seems to be geared toward the idea that the patient is at fault.

But these are prescription medicines that patients can’t get without the NHS first authorizing it. It seems to be that the NHS is giving lots of patients medications they no longer need while other reports are showing the NHS denying patients the medications that do need. Since the patient can only get the medication if the NHS prescribes them shouldn’t the emphasis be on the prescription process not on the patients?

And even if patients were the ones responsible for this misallocation of funds why run a general advertising campaign that will cost millions? Wouldn’t the NHS actually know to whom prescriptions were given? And wouldn’t it be cheaper to just contact those people directly rather than running ad campaigns that are mainly seen my people not using prescriptions?

Those are just a few of the media reports on the NHS over the last few days, most over a three day period. Starting to see a pattern yet? Isn't the political allocation of medical care precisely what America needs? The ideal is apparently a health service run by the same people who give you the Department of Motor Vehicles -- no lines, speedy and friendly service. Yep! Just what America needs.

Photo: I'm cheating with the first photo. These are some people who were killed by the care they received from the NHS. I cheat because it is from a story from last year. That article reports that 2,159 people died as a result of "serious lapses in care" which were avoidable mistakes. You can read that story here. Click on the photo to enlarge it and read what happened to these people. The second photo is Jane Tomlinson with her son.

Another bad hair day for national health care.

One task this blog has undertaken is to challenge the illusions and myths of nationalized health care. Which is not to argue that the US system is the ideal alternative. That is a different issue.

The main myth we try to address is the idea that there is universal health coverage under socialized medicine. Much like we know that socialism doesn’t feed everyone—witness the politically induced famines in the Ukraine in the Thirties and in China in the 50s — we know it doesn’t give medical care to all either.

Socialism has always relied upon the political allocation of scarce goods, meaning that some groups or classes of people are intentionally denied access. And since socialism has proven itself very poor at the creation of those goods and services, its allocations are, by necessity, made from a smaller pool. There is no “universal” coverage under “universal health insurance”.

It may be that everyone can get an aspirin if they want it, or a doctor’s appointment if they can wait long enough. But the serious medical requirements, the ones most people worry about, are not available to everyone by any stretch of the imagination. They are often denied in a calculated manner to bolster the second main claim of socialized health care -- that it is cheaper. Obviously if you refuse to give people care that is costly, you can have cheaper care. Deny all care and the cost is zero. “Cheaper” can be obtained in any system if you limit consumption intentionally. That is not necessarily a good thing.

To illustrate this point we take a snapshot look at the much praised (by the nationalizers) National Health Service in the United Kingdom. This service is often held up as a model for the world to emulate. The argument given by some is that it provides more service, better service and cheaper service. Nationalized care gives more of one kind of service, over small things, and lots less of other services for serious illnesses. Add it all together and there is a lot less health care. The service is better if you are worried about small issues but worse if you are concerned about serious ones. So “better” is determined by whether there is a minor problem with your health or something major. Cheaper it is, but the lower cost is induced by the denial of care on a routine basis for more costly problems.

What is wrong with a snapshot, using British news reports on the NHS over a few days, is that perhaps the NHS was having “a bad hair day”. There are just some days when even the super models look pretty awful. So regular snapshots are needed. In fact, a portfolio of photos is usually required to make a decent judgment.

Here are a few other snapshots taken from British news sources for the last few days. We are not accumulating random incidents over a long period of time, but numerous incidents over a very short period of time. These are in no particular order to this issues.

The National Health Service says that they will have a £983 million surplus (almost £2 billion dollars) this year. That is after a £547 million deficit last year. Twenty-two of the local trusts, which provide the actual care, are in debt and for 13 of them the debt is growing rapidly. This is not as bad as last year but still serious. Sounds good. Of course one way to get rid of a deficit, or lower it, is to spend less which in this case means to cut health care.

The general secretary of the Royal College of Nursing, Dr. Peter Carter, raised that issue. “We have to ask at what cost this has been achieved.” Carter says one way this was done was to increase workloads of doctors and nurses even more. The Telegraph for August 30 reports:

... Hamish Meldrum, chairman of the BMA GPs' committee, said the cuts were "thinly disguised forms of rationing" patient care.

"At the end of last year we saw services to patients being cut, with operations delayed, outpatient clinics cancelled, and referral management schemes," he said. "There are still hospitals that are threatening to lay off hundreds of staff in order to break even."

Only last week, plans to downgrade A & E services and maternity services in Greater Manchester sparked protests from the Tories. Maternity services will shut at four hospitals, the A & E at one hospital will be downgraded and intensive care for premature babies will move from another.

Liberal Democrat health spokesman, Norman Lamb, said “this year’s surplus” was created by “dreadful cuts in key services” last year. One such cost savings has been in the way junior doctors have been treated. Many are simply left unemployed as the NHS trusts try to cut costs by reducing the number of physicians they have to pay.

For instance, Dr. Kapil Lad was working at one hospital which blocks access to personal email during work hours. When he got home that evening he found an email which said he had a few hours to respond as to whether he wanted to take a one month job. Non-response during that time was considered a rejection. Yet the time limit had passed because he was actually in the hospital caring for patients. Now he finds himself unemployed as a physician. He is now considering employment options outside the UK and says that he feels that if takes a foreign job it is unlikely he’ll return to the UK.

Trainee doctors are easy for the NHS to dismiss or ignore so they have. The country has 33,000 of them but is offering only 22,000 training posts. The rest are left out in the cold. With about a third of all junior doctors getting screwed over it is no surprise that many of them took to the streets to protest as the accompanying photo shows.

Hip replacements under the NHS are notoriously slow. But 79-year-old Thembi Nobadula finally received the replacement she needed and then was sent home without the follow up care required. She ends up sleeping sitting up in a chair and has been unable to take a bath for months. All she needed was one piece of equipment that would allow her to get in and out of the tub but NHS wasn’t listening. Her condition was considered bad enough that the NHS sent her to hospital appointments by ambulance but no one would listen to her needs. Only after the local Islington newspaper got involved did they suddenly listen and promise she would get the equipment she needed in about a week’s time.

Thelma Nixon has a serious eye condition that will lead to blindness unless treated -- wet macular degeneration. Injections of Lucentis into the eye are needed. But the NHS told her she can’t have them. They were more expensive than guidelines allowed. Thelma remortgaged her home to cover the cost of injections herself through private care. The York Press campaigned on her behalf and so did the Royal National Institute for the Blind -- without the publicity it is unlikely she would have received the NHS treatment.

A local businessman funded some of her injections and two other readers of the original newspaper article also were donating funds toward further injections. But with the bad publicity in this case the local NHS trust relented. But Thelma was warned that if she sought any further private treatment it would jeopardize the funding she would received.

William Foreman, 66, of Suffolk, needed a hip replacement. The NHS told him he would have to wait. And when it comes to hip replacements the elderly wait, and wait, and wait. Foreman didn’t wait. He took £6,400 of his savings and flew to Poland. That covered his flight, the hip replacement, and three weeks or rehabilitation. From the time he was told he needed the hip replacement to the surgery itself was a total of two weeks. For this price he got a private room and twice daily sessions with a physiotherapist.

Foreman is just one of thousands of people from the UK who become “medical tourists”. Medical tourism is a booming business that helps individuals who can’t get timely treatment, or treatment at all, from the NHS obtain the same treatment overseas. One study indicates that 50,000 people leave the UK every year for medical treatment elsewhere. If they didn't the waiting lists would be even longer. And the money these people spend to get the care they aren't receiving from the NHS is not counted toward health care costs for the NHS.

Russ Jones needs the drug Sutent because he has a gastrointestinal stromal tumor. The NHS has refused to supply it because it is too costly and they question whether it is effective. Jones is now depleting his savings to pay for the drugs himself. The problem Jones has is very rare which is why there is little research on the drug which would prove whether it is effective or not. But in some parts of the UK Sutent is available while in others it is routinely denied. This has lead to what some are calling a “postcode lottery”. People who live in certain favored areas receive treatment that is routinely denied to everyone else.

Cancer patients in Northern Ireland, part of the UK and under the NHS, are unhappy. Those suffering from asbestos cancer have been told they will have to wait until 2009 at the earliest before they can receive the drug Alimta. This form of lung cancer is incurable and Belfast is one of the UK hotspots for the disease. While Alimta does not cure the disease it relieves symptoms and increases life expectancy. Waiting two years for treatment is a death sentence since most patients with the disease die within one year. The drug is available in other parts of the UK by the NHS just not to people in the “hotspot” of Northern Ireland.

Brigitte Stankovic has worked her entire life as a hair dresser. Now 42 she runs a busy hair salon. She has kidney problems and high blood pressure and needs regular medical attention. But to seek that treatment means taking hours off of work at a loss of personal income -- and lost income is not counted in health care costs. Brigitte explained her problem:

With the NHS I just couldn’t get an appointment to suit me or the phone was constantly engaged and when I did get an appointment you would be sitting for ages in cramped conditions and then rarely see the same doctor. I have worked all my life, since I was 15-years-old and running a hairdressing salon is a job where time is money and I couldn’t afford to go on like that.

She said that with the NHS it was impossible to get treatment without losing work time and income. Brigitte now uses the first private GP practice to open in Wales. Dr. Jo Longstaffe sent up Independent General Practice three years ago and now has three offices with a fourth opening shortly. She has six doctors working for her and three more on the way.

Our final snapshot of the NHS for the last few days covers the phenomenon of “hidden” waiting lists. It is widely known that socialized health care often results in very long waiting lists. These lists prove a constant embarrassment to the advocates of the system. One way of addressing the problem is to cut the lists. This doesn’t mean that people receive treatment. It just means they are removed from the official waiting list and put on a waiting list for the waiting list. This means they no longer have “guaranteed” treatment within a specific period of time.

The Scotsman reports that “5000 Lothian patients have been switched from main waiting lists on to the ‘availability status code’ list” instead. And while these secondary waiting lists had seen some reductions in recent years they are growing once again. The reason for the growth is that fewer surgeries than needed are provided.

Separately, NHS Lothian was also unable to secure all the surgery time it wanted for patients with coronary heart disease - one of the biggest killers in the region. Local health chiefs asked the Golden Jubilee for four weekly sessions, but were only granted two, later increased to three.

Another issue in tackling the level of ASC codes in the Lothians is the need to provide more orthopaedic surgery, such as hip and knee operations.

More than 300 plastic surgery and orthopaedic patients have now been sent to the private Murrayfield Hospital instead.

In Scotland alone the “hidden” waiting list has 25,000 people on it who are merely waiting to be moved to the official waiting list. Public Health Minister Shona Robison promises that no one will wait “more than 16 weeks for treatment” and that they will get “rid of hidden waiting lists” -- next year.

Apparently it’s another bad hair day for the NHS.

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