Daily Archives: Sun, 28 October, 2007

No mad quack

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Minette Marrin ranted absurdly against Michael Moore’s new film Sicko, in the Times Online.

Apparently, Michael Moore made the unarguable point that the NHS is free. (Well, almost free, except for prescription and dentistry charges) Free at the point of delivery. Provided according to need, not according to the ability to pay. That’s the principle.

For the benefit of Americans, that means, for example, that you don’t face bankruptcy at the same time as major illness.

Being sick is bad enough in itself, surely. Free access to competent medical treatment isn’t just one of the best candidates for recognition as a universal human right. It even makes perfect common sense socially, given that the healthy aren’t normally mad-keen to catch TB from the untreated poor.

The infinite superiority of free medical care was made eloquently clear by Richard Titmuss decades ago in The Gift Relationship: From Human Blood to Social Policy , original updated 1997, LSE Books.* Titmuss showed that the properties of altruism and social responsibility, on which UK blood banks depended, actually produced a product – blood for transfusion – that was of better quality than that available from US blood banks. (People who sold their blood tended to be hungry, diseased, alcoholic and/or drugged. People who willingly gave blood tended to be healthy. Well, d’uh.)

Moore seems to be making a similar, but updated, point that free healthcare is better for the vast majority of consumers, is cheaper and more effective. (We are English. We aren’t supposed to need telling that.)

It’s hard to see how free health care could seem like a bad thing to anyone except the executives of medical insurance companies. (Not even to doctors, given that they do pretty well out of the NHS and can also run unfeasibly profitable private practices.)

In England, we complacently take the National Health Service for granted. We whine constantly about specific local problems. Plenty of people (including us) rant about crazy high-level decisions to spend billions on computerising bits of it. But, we genuinely cannot imagine what it would be like to live without it.

Well not so Minette Marrin. Her piece has the title “Quack Michael Moore has mad view of the NHS“

Quack? So Michael Moore’s film is peddling crystal aromatherapy for cancer then? I assumed from the reviews that it was about the horrors of US healthcare and the merits of alternative ways to provide it. Silly me.

She claims that Moore showed a rosy view of the NHS, apparently by showing a clean and efficient hospital.

You would never guess from Sicko that the NHS is in deep trouble, mired in scandal and incompetence, despite the injection of billions of pounds of taxpayers’ money.

Well, I can only assume that her definition of “deep trouble” is subtly different from mine. Even without referring to years of targets- and cost- and privatisation-driven policies that have been imposed on the NHS (spot the misdirection, yes, I did mention them) I would say that the NHS may face a few problems

These tend to be problems talked up out of all proportion by a biased media, but, wait, that’s what she’s accusing Michael Moore of doing.

Nothing undermines the principle that our NHS is so superior to the US health care system that it can look mockingly over its shoulder at US healthcare and say “Call that a health care system?” Then give a sarcastic laugh.

Even Minette has to acknowledge this, after she’s brought up a selection of NHS failings: prevalence of hospital infections; loss-making NHS trusts and GPs who don’t provide out of hours healthcare.

None of these problems mean we should abandon the idea of a universal shared system of healthcare. It’s clear we would not want the American model, even if it isn’t quite as bad as portrayed by Moore.

I think that is too grudging and it’s way too late to unsay what she’s already said.

The issues she mentioned are all issues of policy. They do not in any way relate to the wider principle of free universal health care. It’s as if Micahel Moore said he liked your house. You say “I hate it”, listing things you hate – like the creaking doors – without considering that this might imply that you believe you would be better off homeless.

* See, I can reference, though granted it’s not Harvard system. The British Medical Journal has a full reference. There’s a Wikipedia article on Richard Titmuss, if you are interested in post-WWII social policies

How much is liberty worth?

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More than just a philosophical question in this day and age – we seem to have an answer. Reading the BBC online news today, it seems that the recompense for spending two days under wrongful detention is a measly £7,500. In a great example of how the “freedoms” we cherish in western democracies are being thrown away as the government panders to the fear generated by a largely right-wing media we get this news item:

A man accused of being an illegal immigrant while on holiday in Northern Ireland has been paid £7,500 after he was wrongly put in prison.
The Immigration Service wrongly detained the man in Maghaberry jail.
Frank Kakopa who is originally from Zimbabwe, was on a short break with his wife and young children in 2005, when he was stopped at Belfast City Airport.
Despite showing documentation that he lived and worked in England, he was taken to prison.
He was strip-searched and held for two days.
This had happened despite his manager in England confirming both his legal residency and employment position.

So, let me see if I understand this. Mr Kakopa was carrying the proper documentation for his residency status, his employer confirmed his residency and employment status yet the Immigration Service still strip searched him and detained him for two days.

What on Earth is going on here? Are we now so firmly entrenched into the habit of dismantling human rights that this news item is buried in a relative backwater are of the BBC (I only found it by chance – it hasn’t made any of the major news bulletins). Now, I have actually used Belfast City Airport (comically named “George Best Airport”…) and the staff there are, generally, officious, obnoxious and obstinate – however the thought of them deciding to detain me for two days despite being a British Citizen is mind boggling.

The lack of an outcry over this is equally shocking – I am sure if it had been a white businessman people like Lord Rees-Mogg would be the first to complain how we need to reinvigorate our human rights approaches.  As this person seems to meet all the criteria for an outrage – a professional worker (structural engineer) travelling with his family – I can only assume that his detention, and the total lack of news about it, is entirely related to his skin colour. (Not an original assessment, I agree – even the BBC article implies it…)

The article continues:

Mr Kakopa, a structural engineer, said the experience still haunted him. His family were left at the airport and Mr Kakopa said he had no idea what had happened to them.
“They wouldn’t allow me to make phone calls – I was actually detached from the world,” he said.
“I did not know where my kids were taken to.”
“It is still difficult to believe that what was supposed to be a relaxing break for my family turned out to be our worst nightmare.”
“I was locked up with convicted criminals, having committed no crime, while my wife and young children were left abandoned at the airport of a strange country worrying about where I was and how I was being treated.”

In some respects Mr Kakopa is very, very lucky in that he was carrying a lot of proof and documentation – if for whatever reason he had left one of the critical documents at home in England, he may have found himself detained indefinitely until the Immigration Service deported him. Wouldn’t that have been good? I wonder, how much the out of court settlement would have been then…

All my life, I have read about this sort of behaviour in “foreign” countries, and it normally accompanies some diatribe about how this is proof [insert dictatorship] is a bad regime etc. It is the sort of you expect to hear the evil Commies doing, or Mugabe or Korea. But good old Blighty? Shocking. No wonder the home office declined to comment – what could they ever say which would justify detaining someone who was carrying the correct documentation.

In this day an age, a mistake (or malicious act) by the immigration and security personnel is not a trivial thing. These unelected, barely accountable people have the power to detain without trial or deport people without reason. Despite this already shocking state of affairs we seem to be sleepwalking into granting them more and more powers – all while removing what little safeguards remain.

A very sad state of affairs. I wonder who really won the cold war…