Brussels to the rescue
Fraser Nelson 8:59am
It is days like this that remind you why so many on the right were in the “yes” campaign during the Euro referendum of 1975. It was then to the right of Britain on many issues and still is on the issue of healthcare provision. The European Commission will today propose to give Brits the right to escape NHS waiting lists by going anywhere in Europe – and then have the NHS repay their bill and expenses. So lo, from Brussels, a massive threat to the ‘socialism in one country’ approach of the NHS. Its “business” model has always depended on there being no competition.
The Labour left is angry about the rich escaping the NHS system by private insurance so you’d think they’d welcome the chance for the poor to do so as well. But no, they say this European plan threatens the foundations of their beloved NHS. I’d like to hear someone explain that to a patient. “Sorry Mrs Dickson, you’ll have to wait in agony for another year but your sacrifice helps protect the ideological integrity of the NHS”. It is a cause they are prepared for others to die for.
Now, why would anyone want to go abroad? After all, Britain now spends more on health than the average European nation. But patients are turfed out of hospital beds here before anyone else in Europe (3.5 days). They’re three times as likely to get MRSA from filthy wards. And that’s not considering the health rationing system, which gives waiting times which simply don’t exist in much of Europe. I don’t know, but suspect, that Britain is the only European country where MRSA-resistant pyjamas are for sale on the high street.
On Today, Nigel Edwards from the NHS Confederation predicted without any sense of embarrassment that few would come from Europe to Britain and added – almost with a hint of pride - that “UK healthcare is relatively expensive”. Might that be because it it’s grotesquely inefficient?
And if anything does come of this, then Britain owed a big thank-you to a 72-year-old grandmother named Yvonne Watts who took the NHS to court and established this legal precedent.
PS John Humphrys said “Queues were much shorter than when Conservatives were in power, waiting lists have come down a great deal”. He’s right: the length of the queue is down 40% - but progress is far from uniform. In March 94 (the earliest date the Department of Health claims figures are available for) the median outpatient waiting time was 5.4 weeks. In March 2000 it peaked at 7.7 weeks falling back to 5.4 weeks in December 2006.
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Comments
Austin Barry
December 19th, 2007 9:17amThis could be just the shake-up the NHS needs. If the lefties are traumatised by the prospect of people doffing their MRSA-resistant jimjams and heading for a clean efficient hospital somewhere agreeable in Europe, so be it.
Praguetory
December 19th, 2007 9:27amObviously there are potential benefits to this, but it does raise some thorny questions. Will the NHS be obliged to provide a bill for EU health tourists? Maybe, I'm out-of-touch but that sounds like quite an undertaking. Also, what systems are in place to prevent fraud or excessive pricing (all at a cost to the British taxpayer)? For example, I wouldn't envisage that obtaining a bloated receipt from a Czech hospital would present many difficulties.
Donal Blaney
December 19th, 2007 10:48amI, for one, blogged on this on Monday - the ideological purity test is very much alive and well in the NHS - even if patients die to preserve it
http://donalblaney.blogspot.com/2007/12/proof-that-nhs-is-sick.html
GB
December 19th, 2007 10:58amSo, err, is there any area of public policy that the EU does not have the right to interfere with? Whatever happened to the idea that national policies ought to be thrashed out at national level according to the desires and needs of the electorate as a whole, however imperfect the means of doing that? Is there any point in voting in general elections if the EU will simply assume that it has the right to take control of *any* area of public policy, especially as it will not carry responsibility for the consequences - such as the one suggested by 'Praguetory'?
Tiberius
December 19th, 2007 11:13amThe question of queueing has to be viewed in the light of "waiting lists to go on waiting lists", a system routinely operated by a number of GP surgeries, and return on "investment". The former did not exist until the New Labour project took off, and the latter is paltrey by any reasonable measure. In general, anything which may knobble the Left's sacred cow is to be welcomed, but it is ironic that Britain is contemplating such relief from an institution that has otherwise wreaked havoc upon us in so many areas.
MatthewT
December 19th, 2007 2:14pmso you guys are against the EU interfering with UK policies except where you agree with their impact. I didnt realise euroscepticism was so nuanced - glad we've cleared that up and will look forward to a resurgance of Tory pro-Europeanism...
J H Holloway
December 19th, 2007 3:04pmWell, the excellent Lithuanians who worked on my house flew home for medical treatment. I don't think we need worry about reverse health tourism from the EU. But, as any Nurse from Paddington hospital will tell you, we do have huge health tourism from the wider world.
markinchiswick
December 19th, 2007 5:44pmfraser - what kind of bubble do you people live in? Most European health systems are grappling with the same problems as ours. Take one example, Ireland has the highest rate of MRSA infection in Europe - double the infection rate of second-placed Portugal.
Fraser Nelson
December 19th, 2007 8:41pmmarkinchiswick, in CoffeeHouse we're in the business of pricking bubbles not living in them. Plus you have Portugal and Ireland mixed up. Look at MRSA rates per 100,000 patients last year from the European Antimicrobial Resistance Surveillance System survey. Portugal was 27, Ireland 15 and the UK a shameful third at 12.5. Then we have France (8.6) Spain (6.3) Germany at a very clean (1.1). Poland 1, Lithuania 0.8, Sweden 0.3, Denmark 0.2. Does that ready to you like grapping at the same problems? As I said in the blog, the UK is more than three times the EU median (12.5 v 3.8). And do you know anywhere else in Europe that sells MRSA resistant pyjamas?
Verity
December 19th, 2007 9:32pmWell, I've hawked my workable idea for the improvement of healthcare on a couple of other blogs this week, so I'll air it here, too. It's simple. Keep the compulsory NI contributions, but let the salary-earner nominate which healthcare provider (including the NHS as one of a number of choices)he wishes to deal with. Private healthcare companies would spring up, competition would be introduced to the marketplace and standards would rise. People on welfare who have NI contributions deducted from their welfare money should equally be able to direct their contribution to the healthcare provider of their choice. The result would be improved healthcare and much, much improved customer service, cleanliness, timeliness, care and food. Because children cannot make their own provision, needy children would be treated free until age 18. Otherwise, people who were not making NI contributions would be deemed to have chosen not to have health insurance and could live (or die) with their decision. Foreigners would be required to purchase emergency health care insurance when entering Britain - possibly from those machines you can buy flight insurance from at airports. No proof of insurance, no entry. In other words, not so much as a free aspirin to people who hadn't contributed (save other EU countries, obviously, as long as they could show the equivalent of an NI number.) The NHS would shrink drastically and might become more efficient and competition would drive service, but the point would be freedom of choice and making healthcare customer, not bureaucrat, driven.
Nigel Edwwards
December 20th, 2007 3:10pmI dont know what sort of journalist feels capable of imputing motives to someone without any evidence - not a very professional one I think. I did not say that UK healthcare is relatively expensive with a hint of pride. How dare you impute this sort of motive to me on the basis of nothing more than your prejudices?
I was in fact referring to the UK private sector which is much more expensive. Comparisons between the NHS and Europe are harder to make but even where there is a difference it is not possible to draw conclusions about efficiency, becuase cost and efficiency are not the same thing. In fact there is some evidence that elements of UK healthcare are at least as efficient as the best in Europe. Another fact that you miss is that healthcare acquired infection is a feature of emergency care - and is realtively uncommon in elective surgery.
Your comments also suggest that you don't understand the directive - the poor can't escape because you have to pay up front and claim it back.
Stan, UK
December 20th, 2007 3:53pmWould you be able to travel to europe and get drugs the nhs wont pay for ie alzeihmers, cancer etc?
Michael McGowan
December 20th, 2007 6:01pmNigel, without going into the other details of your post, the point about the poor not being able to escape is easily dealt with by imposing a means test threshold on those who do have to pay upfront. That is common, I think, under all the European social insurance systems where access to healthcare is universal. The poor will also benefit from the consumer pressure to improve national healthcare systems that the Directive will bring. That consumer pressure of course is what the more diehard defenders of the NHS fear most: they regard it as a positive virtue of the NHS that the evil selfish middle classes are coerced into paying for it rather than coopted.
Nigel Edwards
December 21st, 2007 7:58pmMichael
You are right about the impact of consumer pressure.
There is a problem with your neat solution in that there are a number of Beveridge systems that do not have a machinery for means testing for healthcare use. There is also the issue of paying for travel and styaing locally.
The admin burden of the system is potentially huge and I think it is likely that before long the Commission would be proposing a EU wide health standards regulator.
Mike Stallard
December 22nd, 2007 9:17amWhat is scary about the NHS today is that the doctors have turned into civil servants. They are even told when to work now.
Yesterday the Doctor's Representative sounded just like the TU man on the airports strike who came on just before he did. The Government sounded just like the employing airports authority.
Doctors are professional people with professional care and judgement. They are not civil servants.
Until doctors are treated with respect as professionals, no matter how much the government tinkers or even the EU tinkers, things will not be right.
Myself, I do not see how this will change, even with the help of Europe.