Sunday, 31 July 2016

If you build it, they will take the piss...

The eternal conundrum of the NHS is a riddle that may never be solved; where does all the money go? Variously described as a shining example to the world, a victim of its own success and a basket case, the National Health Service costs half of our entire annual budget. Okay, it’s not that much, but at £120 billion last year this is £4000 a year for each one of the nominal 30 million taxpayers. Of course, a huge number of those taxpayers are also in receipt of tax credits and other benefits so a conservative estimate probably makes it closer to £10k per head for those who receive no such rebate.

People in those income brackets and above of course are less likely to be sick, more likely to have access to private healthcare and even if they do succumb to illness are often too busy to seek treatment, certainly for minor issues. So it turns out that the NHS is really a wealth redistribution system, used disproportionately by those who play no part in funding it. I’m not arguing for dismantling it, nor for selling it off; bizarrely, for an evil, baby-eating Tory type, I think it is a wholly good thing that we have a health service accessible to all and free at the point of use. And yet...

It’s the same old thing, isn’t it? The left denigrate the rich and want to tear down capitalism and never seem to understand that if they get their wish and the costs of the welfare state had to fall more heavily on weaker shoulders the system would simply buckle under the strain. There is only so much money to go around and the NHS has been pleading poverty every single year of my sentient life.

Of course it can’t go on delivering an expanding menu of treatments to an ever greater population. Austerity isn’t mean; it’s living within our means. However you look at it, pouring more and more money into a system whose appetite is never satisfied is an appalling business model. Build it and they will come; give it away for free and they will gorge themselves. How, as a nation with our population, can we be so poorly that the NHS boasts of being one of the biggest employers on the planet?

Obviously, rationing healthcare is a dangerous road to go down; some need so much more than others. But shouldn’t we, as a society who pays for it all, start to take responsibility for this thing we can scarcely afford? If you knew you hadn’t the funds to replace it, would you deliberately crash your car? If you’re not going to eat it, why buy food with a short shelf life and then throw it away? So why eat, drink and drug yourself sick, relying on the health service to rescue you later?

The NHS is not free. I’ll say that again: the NHS is not free. Every penny it spends comes from the same source that funds defence, police, transport, education and your pension. Every bandage, pill, operation, therapy and consultation costs you, the taxpayer, and denies that funding to something else considered vital. You expect to draw on that pension for longer and longer these days, while also having your age-related illnesses eased? Which other fund do you sacrifice?

Take one every four hours... if you can afford it.

So, while nobody is suggesting you suffer in silence, if you really want to continue having access to non-judgemental care without up-front fees, how about taking some responsibility for your own health? And why not exercise a little personal triage before that automatic trip to the surgery? You keep demanding that the government saves our NHS. Why not save it yourself?


  1. "I’m not arguing for dismantling it, nor for selling it off; bizarrely, for an evil, baby-eating Tory type, I think it is a wholly good thing that we have a health service accessible to all and free at the point of use."

    Having done a bit of globe trotting I have experienced a number of different healthcare systems. None of which follow the NHS system and I can say but for the few exceptions they are better for not doing so. The French one considerably so and considering the French dislike of competition for them to include it in their healthcare says a lot about the efficacy of doing so.

    The ones that do the best have a considerable element of privatised provision and funding and no they do not disadvantage the poor. So your statement I have quoted above typical of the many I hear about the beloved sacred cow NHS envy of the world which it definitely is not is so totally wrong.

    1. I hear what you say. But as a principle, if unworkable, I still believe is a worthwhile aspiration.