Tuesday, 16 July 2013

Big is Butt Ugly

The theme of last night’s Newsnight seemed to be that whatever government is in power the NHS operates primarily for the benefit of its staff and not that of its patients. We’ve seen this before; the rail and coal and steel industries all suffered the fate of state monopolies with self-interest coming before efficiency and ever higher subsidy required to cover up the reality that economies of scale are simply lost when there is no real accountability.

As more and more scandal is reported and more and more evidence comes to light about a profession blighted by targets and box-ticking and the relentless imposition of qualifications in place of simple human compassion, the current government is lambasted for attempting the necessary reforms while the Labour Party seems to be more concerned than anything else with covering it all up and saving their own skins.

NHS; the emphasis should be on the H and not on the N – focusing on the so-called big picture and the sanctity of the state behemoth (one of the largest employers in the world) the detail has been neglected. And the detail is all about the patient care; the small print is written in human misery. Ah but, we are all stakeholders in nationalised industries surely and that must be a good thing, right? Except that is a just another meaningless sound bite, the product of governments unable to tackle reform on political grounds and trying to justify throwing ever more money – our money – into the pit. We must ‘save’ the NHS; the envy of the world, the jewel in the crown of the welfare state. Anything to put off the day when sleeves have to be rolled up and the rot eradicated.

It’s a mere aphoristic kindness to say that the NHS is a ‘victim of its own success’. That’s like saying Piers Morgan is a victim of his own likeability. The bigger any system gets, the more complex its operations, the more removed from individual responsibility becomes every single person in that system. Remove individual responsibility and soon it’s just another trough to shove your snout in. And you can’t blame people for taking advantage, because humans are just another opportunistic species and the snout mentality is never far away.

Corruption doesn’t just have to mean drug companies colluding with the medical profession and skimming off billions. It doesn’t just have to mean management reforms inevitably generating yet more management. It can simply mean taking ‘sick’ days because you can, or going on pointless courses because you can… not caring because you still get paid whether you care or not. This is the British disease, the sick man of Europe resurrected from the shallow grave that Maggie was prevented from digging deep enough.

This is the inevitable conclusion of Statism. It doesn’t matter what works or what doesn’t, it doesn’t matter who dies and who lives, it doesn’t matter who pays for it, or how we pay for it because when we own everything we can control the flow of information too. And we’ve proved it again and again – Hitler, Stalin, Mao; all cut from the same cloth – repeat the lie often enough and people will believe that Big Brother loves them and they will come to love and rely on him. If only we had a state broadcaster in our pocket, too. Oh…

Harsh medicine time for the NHS

So, now we know the NHS is fucked and has been for a long time, how long before realisation dawns that bigger is not necessarily better? Collectivism always erodes individualism, which is fine when everybody is working away in the salt mines, but you can’t have both or rather you can’t have an unlimited amount of both. You might want to consider this when you are deciding what you think about the European Union.

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