THE CATASTROPHE THAT IS THE NHS

Chapter 3 (Meaningless Crap) of my book records Dave (The Vague) Cameron’s answer to the permanent crisis in the National Health and Education industries which supposedly are, as Gordon Brown never tires of saying, “free at  the point of use”.

“Yes you should meet higher standards, yes you should give your patients and your pupils more.  But we’re not going to tell you how to do it.  You are professionals.  We trust in your vocation.  So in a Conservative Britain, professional responsibility will provide the answer to rising expectations in the NHS and schools.”

(David Cameron, Conservative Party Conference 2006)       

No doubt Dr Michael Ingram, a GP who writes occasionally for The Telegraph, agrees wholeheartedly, declaring on 5th February that:

"Waiting in the wings are the privatisation of general practice and its metamorphosis from a personal, long term relationship of care that is valued in  this country and admired abroad into a private production line system where the concept of “your” family doctor is just a distant memory”.

What planet is he on?  Surely this has to be Cheeky Crap.  “Your” family doctor, the embodiment of which pre-dates the NHS (remember Dr Finlay?) has been a distant memory for at least 30 years.  The state-run NHS, the world’s third largest employer, has been reduced to setting utterly meaningless, weasel-word targets and other bureaucratic nonsenses, for want of price signals.  Take, for example, the current mixed-wards scandal.  No doubt a stab at the likely costs of a full makeover has been made, but there is only one way to find if mixed-wards are worth it, and in what circumstances.  That is not to commission a study, it is to test it on paying customers.

The more fundamental point demonstrates why professionals alone, whatever their intentions, cannot run any large organization, let alone one which is in the “public” sector and “free at the point of use”. It is that, as Nikita Krushchev is reported to have said, “When all the world is communist, Switzerland will have to remain capitalist, so that it can tell us the price of everything”.1

Prices are the invisible hand which guides decisions about the use of all scarce factors of production (capital, labour, land and a myriad of sub divisions); that is why socialism is impossible, and why “national planning” must always be grossly inefficient. (It is not surprising that government censors free market prices wherever it can, that way we, as well as them, must grope about in the dark.)  It is also why the NHS cannot even grope without them.

What, then, has enabled the NHS to stumble along this far?

Firstly, I suggest, is that it started life by compulsory nationalisation of a system that already worked.  As that system became obsolete (via changes in technology etc.) the NHS began to crumble.  Secondly, á la Krushchev, it relies on “Switzerland” i.e. external markets.  Do not Messrs Cameron and Ingram realise how vital in hospital budgeting and funding are its tariffs, (e.g. for operations) copied from the private sector?  Thirdly, it is bolstered by the taxes of the increasing number of taxpayers who don’t use it, preferring to go elsewhere at home and (increasingly) abroad.  (Were this iniquity to be removed by tax rebates, the exodus would become a flood.)

The anti-choice nature of the NHS has been deliberately muffled since its birth by the socialist slogan “from each according to his means, to each according to his needs” – misleading crap and ultimately meaningless crap.  Why?  Because any group of citizens and families with the same means demonstrates a huge diversity of choice amongst different goods and services – health, education, holidays, hobbies, shopping, eating out, and so on.  Only a Stalin would remove such choices by nationalisation and taxation in the name of “free at point of use”.  Only a Stalin would gladly trade several thousand hospital deaths a year in the name of socialism2.

And a Bevan, of course. Aneurin Bevan, the founder of such injustices, is one of the Cameroons’ “Key Britons” whom we must be taught to remember for all time (yes, as a beacon not a blight).  Yet within a couple of generations or so, either the NHS or civilization in the UK will be doomed.

1. The underlying point was first proved by Ludwig von Mises in the 1920s and has never been refuted.

2.   By, for example, outlawing the sale of organs for transplants and by wilful neglect of MRSA,  virtually unheard of in private hospitals.