THE RANDLE REPORT

NHS Crisis: Patients is a Virtue

Every investigation into Britain’s embattled National Health Service asks us individually how much we have ‘cost’ the service from the cradle to the grave situation it now finds itself in.

Nobody seems to find this odd.

I don’t see any shock horror probes into how much tourists are costing the travel industry. When a tour operator collapses it blames everything from the value of the zloty to acts of God, but I never yet heard one blame its customers.

Customers are as much the life-blood of the NHS as they are in any other enterprise. The responsibility of the health service is to deliver what it promised. Any failure to do that is not, by any stretch of the imagination,  the fault of those customers.

No enterprise could have been more successful in amassing a customer base. Who else started out offering magic chemical cures for everything? Who else was legally allowed to?

Stuffed surgeries the length and breadth of the country and mammoth hospitals buzzing with high-tech machinery are testaments to the popularity of the product.

The system should never have been a drain on anyone’s resources. It was never ‘free’ as is often suggested. It was financed by contributions taken from every employed person. In other words, it depended as much on ‘health insurance’ as any private scheme

.

It wasn’t smokers or people who eat junk food who placed an excessive burden upon the service. As a service it was constituted to treat all alike. If it didn’t do that, it became something else, some kind of branch of eugenics, in which the smokers who had worked and paid their dues all their lives were left to die on a gurney somewhere while their contributions were used to improve the quality of life of out of work actresses.

At the same time, the medico-pharmaceutical fraternity for whom the system was the real cash cow relentlessly promoted products and procedures that would attract more customers than the NHS could reasonably be expected to service - people with wants rather than needs.

The situation was further exacerbated by taking on legions of ‘managers’ who cost more money and delivered none of the services the punters needed or wanted.

Unlike the visionaries who imagined the whole thing into existence, successions of mediocrities, in parliament and within the edifice itself, tinkered and bodged and finally broke the golden thread between the vision and the reality.

The only people who really ‘got’ what a bonanza there was for the taking were the medical equipment suppliers and big Pharma.

Here was the single largest and ever-growing market for their regularly questionable, frequently useless, and all too commonly dangerous products. A single negotiating authority could provide the whole network to them and that authority had no commercial basis or interest in protecting the funds it was lavishing. As a result, it seems, its negotiators never pulled the drug barons aside and said, ‘I’m delivering you the means to supranational wealth beyond imagining; the biggest and fastest gravy train you could possibly conceive of; not just all these hospitals, but a direct line to brainwash all our doctors and students into the belief that what you cook up in your cauldrons is doing anybody any good - any chance of a bit of a discount?’

If there is a real challenge to the future of the NHS, it comes from a combination of lack of will, lack of vision, the lack of a contracted working population to pay the health insurance and the underlying corruption that has seen it transformed from a health service, serving its intended customers to a marketing wing of the ‘keep them sick and keep them coming’ pharmaceutical and medical equipment industries.

The visionaries who founded it didn’t see that one coming. It would never have occurred to them that the very patients it was designed for would, in some dystopic future, be held up as a justification for selling it out to the parasites who have sucked it dry.