Lying sick in bed this morning listening to a Radio 5 phone-in about the “state” of our Accident & Emergency (A&E) healthcare system here in the UK, I was struck by the failure of the radio show’s producers to engender the expected flurry of tales of woe and poor service.
Happy and Immaculate Professionalism
Far from the engineered curses that the show had hoped to produce – instead, a host of people took the time to phone in and praise the excellent service, waiting times, courtesy and professionalism that they had witnessed, sometimes under conditions of the utmost duress (e.g. during the accident black-spot due to falls on the winter ice).
We are now all primed for cutbacks in services in the UK to pay for the banks’ greed. However, all parties promise to protect the NHS’s frontline services.
The UK spends less on healthcare per capita than the USA. This is not in doubt. In fact, the USA spends more per person than any other country.
But now, consider this news article from Philadelphia in Pennsylvania. See how front-line healthcare staff are treated in the USA and consider the service you are likely to receive from such a system?
The nurses at the Temple Hospital in Philadelphia have been on strike since March 31st. This much is clear.
However, in contrast to the UK (and most of Europe), all the staff appear to be on fixed term contracts which had expired last September. In the UK, if you are good enough and pass all the tests, you get a job and keep your job (unless you need to move or progress in your career, say), to serve your local community. As new techniques arrive, you pass more tests etc. You build up your skills as part of a team.
In the USA, they appear to sack all staff from nurses downwards when their contracts are up, then replace all the staff with temporary staff! This means that,
Most healthcare USA Workers are temporary…
The trouble is that all the right-wing forces at work there seem to believe that this is a good system and actually mock our NHS with comments like, “have you seen their teeth?”. This is Obama’s problem with his efforts at healthcare reform. The real truth is shielded from those in work and with private healthcare insurance, and they are a vociferous lot!
The real truth is a warning: Do Not Fall Sick Near Temple Hospital…. After all, what sort of care could one expect from a hospital staffed like that? No matter how personally caring the staff are, there is no communication, no camraderie, no continuity, no honour.
In the dog eat dog world of America, it’s the last man standing who wins; but what’s the point of being in a club of one?
In fact, I have to question the sanity of anyone who would fight to defend a country (or it’s overseas interests) that treats it’s own citizens in pain with contempt and it’s caring profession with worthless indifference.
Last Friday, 20/3/2009, some archaeologists in Pennsylvannia, USA, dug up some bones of Irish labourers whose bodies had been unceremoniously dumped next to the railway line they were digging after they died, probably from cholera. There were 57 of them.
This is a big thing for Americans! Despite the almost ubiquitous death penalty in that country and the hugely expensive but ineffective health care system (certainly if you’ve no insurance), and despite the twin foundations of that place being built upon the ideas of “the self” and “hand-on-heart god bless America”, this team of people on the Duffy’s Cut Project are spendinghundreds of man-hours in a search for truth and to give the almost anonymous people some sort of decent burial, 175 years after the event.
Maybe there’s some sort of change happening after the excesses of the Bush era and the collapse and then public rescue of financial institutions and global businesses? It’s almost a Welfare State! Almost socialist! Maybe they’ll move on to properly interring some of the tens of thousands of Native Americans killed in the various massacres during the colonial push?
He’s described variously as the ‘father of epidemiology’ and ‘the greatest doctor that ever lived’. Probably rightly so.
Snow witnessed at first hand the arrival of Cholera into the UK in Sunderland in 1831 and it’s subsequent spread to Newcastle. While having an annual mortality rate of ~5%, in an epidemic most deaths occur within a week or so, which made it particularly appalling in Newburn near Newcastle and down the Sandhill in Newcastle-on-Tyne itself.
Thousands died within weeks in the crowded streets in an area not much bigger than a football pitch. Sandhill is just to the west of the famous Tyne Bridge. It’s a hill up to Dean Street which is actually a culverted stream/sewer. An original report on the 1832 epidemic is here (pdf file).
Because of this and subsequent events (e.g. the Broad Street epidemic now commemorated with a pump memorial) , Snow pushed for clean water for people to drink, actions that could either be provided by enlightened wealthy individuals or by the intervention and provision by the State. That is, public welfare by the State.
In Newcastle, the first proper water supply came from Whittle Dene, and the (since expanded) ‘Whittle Dene Filters’ can still be seen next to the Military Road. Since that time, hardly anyone has died from Cholera in Newcastle, a horrible way to go since you literally shit yourself to death.
Throckrington is a teeny-tiny place set in the ‘Wilds of Wanney’ in Northumberland. It has a cute little church and a farm that straddles both sides of the little cattle-gridded road. It’s truly one of the most wildly tranquil and beautiful places on the world.
Yet just to the west of the Church are a few bumps in the sheep-grazed grass. These are the remnants of the former village that was ravaged by a later Cholera epidemic, in 1847). (This is subsequent to the one witnessed by Snow in Newcastle). The Cholera was brought by a returning sailor who’d passed through Newcastle. The village was completely wiped out!
Remarkably, standing in the Churchyard, gazing out across this former village, if you cast your eyes down over the western tombstones in the churchyard, you’ll find one belonging to Lord Beveridge( and his wife), surveying the glorious western vista for eternity.
The Welfare State
William Beveridge as he was, was commisioned by the WW2 wartime UK government to produce a report which became known as ‘The Beveridge Report‘. This laid the foundations for something that became known in Britain as the Welfare State and the National Heath Service (NHS). And quoting from Wikipedia:
The Report to the Parliament on Social Insurance and Allied Services was published in 1942. It proposed that all people of working age should pay a weekly national insurance contribution. In return, benefits would be paid to people who were sick, unemployed, retired or widowed. Beveridge argued that this system would provide a minimum standard of living “below which no one should be allowed to fall”.
It recommended that the government should find ways of fighting the five ‘Giant Evils’ of Want, Disease, Ignorance, Squalor and Idleness. This led to the setting up of the modern Welfare State (the culmination of the Fabians’ project) with a National Health Service (NHS):
19.Plan for social security : XI.Medical treatment covering all requirements will be provided for all citizens by a National Health Service organised under the health departments and post-medical rehabilitation treatment will be provided for all persons capable of profiting by it.
It’s a long way coming, but it demonstrates the Buddhist principle of ‘the connectedness of all things’ and also the benefits of working altruistically for the common good, sometimes against huge peer pressure. This last is part of something called the Noble Eightfold Path by Gautama Buddha, that is;
right concentration. .
Dr Snow had many obstacles to his now accepted theory on disease transmission from his fellow medical professionals. Beveridge likewise had much opposition, only the arrival of WW2 made it happen. An earlier Clinton presidency failed at making Welfare reforms. There are some odious vested interests out there!
Yet despite it’s many curses, failures and problems, the UK still has it’s NHS, welfare provision, and public water supplies. The population of the country is extremely healthy and despite complaints, are considerably better off than that prior to 1845.
The USA under Obama has plans to considerably reform ‘medicare’ and the costly private healthcare insurance system that leaves vulnerable people worse off and yet costs much more per capita than the UK’s NHS. Let’s hope they do it right and fix all the other iniquities that have bedevilled that place.
………trumpets Work and Pensions Secretary James Purnell, neatly post-empting the angst-ridden rhetoric about Thatcher’s Britain and the cow-towing newspapers.
Profitability is a sign of the times
You’ve got to keep on working for the rest of your lives
If the tories get in it’ll be alright for the surgeons
But us on the dole we’ll be cutting grass verges.
The trouble is that:
Profitability is a sign of the times
You’ve got to keep on working for the rest of your lives
Now that Labour has been in for 11 years with a variety of spending initiatives designed to help those hard-working families less well off than most, in, it’ll be alright for the surgeons and other top healthcare professionals
But us on the dole we’ll be cutting grass verges or picking up litter, part-time at first but leading to full time after two years.
…is a bit of a mouthfull.
The other trouble is that all councils will now immediately lay off ALL their cleaning staff on minimum wage, safe in the knowledge that a load of dole-wallahs will be along, paid for from central government funds, to do the work for nowt!!!
The history of BUPA and the BUPA management is one of continuous cost-cutting, skimming of publicly trained staff (without recompense to the state), and a stream of mistakes that they neither accept responsibility nor pay for and that have to be picked up and made right by the NHS. The few good things they get right are paid for using far more money than necessary and are only attempted if there’s a decent chance of success.
BUPA really is capitalism sucking at the teats of the state.
They don’t train their staff – all the people are trained at public expense so their whole business model is flawed and based on sponging off somewhere else. If they included that into their costs AND took on every difficult case and procedure instead of just creaming off the simple mole removals etc, their real costs would be prohibitive even for executives on blue-chip schemes.
And now, Ben Bradshaw the latest incumbent to the Ministerial office, wants them to tell the NHS staff how to run their affairs.
I’d tell them to just fuck off if they came near me with their calculators and scalpels.
As I said in a previous post, the real problem for “The West”, especially as it directly affects us in Europe, is the fact that Russia and other nearby states are sitting on huge gas reserves that everyone else wants to use to sustain their society. I mean directly, as if the energy supply is interrupted as it was in the UK by the 2000 fuel blockades or the Hertfordshire explosion say, then we only have a few days to talk about getting things going before it’s too late. I work in a JIT (just in time) healthcare delivery environment. If deliveries are disrupted for more than two days then people die. Similarly, if supermarket deliveries are disrupted for more than a week, people will starve and start to riot. That’s what we are like.
***Without energy, life and society as we in the west know it, will die!***
And yet, we continue to distract ourselves with little problems like mad mullahs, Arab fundamentalists, Christian fundamentalists, terrorists of all descriptions, and currently, where the torch is on it’s pre-Olympics journey and how it affects relations between China and the west as described here in this BBC article from Mount Everest. Jillian made a good point on the “flag” issue in her article, chinese-factory-supports-tibet-cause-apparently, which was laughable but predictable once people embrace capitalism.
So basically, the real problem on our doorstep is being ignored, or maybe played down for fear of frightening people too much. “let’s keep them frightened about something not-very-dangerous…..” is probably being bandied around the corridors of power.
The escalation is following a standard pattern; say the most recent Balkan wars or the Nazi occupation of the SudatenLand (http://worldwar2database.com/html/czech.htm)……. An excuse is made to enter a country to help some poor disadvantaged souls, and then before you know it – all hell breaks loose.
This time, both Russia and Georgia have nuclear installations and weapons in the area, and any problem will very rapidly expand and cut-off Europe’s energy supplies. See my previous point *** above.
The West, at the very least should be ensuring that this war does not start or escalate further. Then we should ensure that all people in the area are properly respected and their lives improved. When this happens, the arguments will be seen as pointless dust, to be swept away into history.
If it doesn’t happen, then people will be seen as pointless dust to be swept away into history.
Nichiren Daishonin said it perfectly nearly 800 years ago in 1260 in a feudal Japan, paralysed and inwardly destructing itself from fear of an imminent Mongol invasion:
If the nation is destroyed and people’s homes are wiped out, then where can one flee for safety? If you care anything about your personal security, you should first of all pray for order and tranquillity throughout the four quarters of the land, should you not? – Nichiren Daishonin / On Establishing the Correct Teaching for the Peace of the Land – WND1, page 24
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