NHS Scandal

[Brian Ellis]

Exactly and therfore I suggest you fix your local NHS first before uttering any criticism of the UK NHS.

I am not quite sure you get what I am on about but it'd help me personally if you'd reflect on this suggestion and its merits.

I have reflected and can't see why it would help you, where you are. I would point out that I am a UK citizen and not a Cypriot one, therefore I do have the right to add my 2 c worth to the BBC reportage.

Note I have not uttered a breath about the Netherlands Health Service.

OK, another anecdote: at the age of 92, my mother was having severe arrhythmia and a cardiologist decided she needed a pacemaker. This could not be inserted at Hawick hospital, where she lived, or even the Borders General; she had to go to Edinburgh Royal Infirmary. She was taken there (~100 km) in a vehicle with wooden slatted seats, taken straight in to cardiology, where it was inserted and adjusted, then sent back, in the same vehicle the same evening, to the Borders General. The travelling was repeated a week later for the final settings. So she did 400 km in an uncomfortable vehicle designed for the strictly local transport of the incontinent elderly, including one trip just a few hours after the operation. Why was she not bedded in the ERI for the week: can it cost that much more than at the BGH? OK, this is not a case of delays but simply patient comfort.

[GNEP]

Personally, I think that the single biggest problem with the NHS is one of scale: it's just too big. If it were broken up and power completely devolved down to a regional level, I think overall standards of care would improve significantly. Yes, there would be more of the oft-criticised "postcode lottery", but surely variations between good and OK are better than uniformly bad?

I say this because if the NHS, as one of the world's top 3 (in terms of size!) employers, simply would not exist in the private sector - organisationally something that large is waaaaaaaaay beyond an optimum economic scale.

And this is backed up by statistics. I don't know for sure (remember reading it, but can't think where and too lazy to search), but I think that if you plot national population size against satisfaction levels/standards of care per tax amount spent (or whatever are the appropriate measures...) for countries with nationalised health systems, then you find that too small is too expensive, and too large is just plain crap. There is a peak somewhere around the size of the health service required for a country about the dimensions of Denmark IIRC.

Just because the NHS uses an early model of social healthcare, and was a pioneer, does not mean it is in any way using the right model