Defaming the NHS

The British have succeeded in putting a price tag on human life, as we are about to. (from IBD editorials)

This ridiculous line suggests that there may even be some justice to the cliche that the Americans don’t understand irony. Because the writer obviously didn’t spot the irony in attributing the flaws of the US healthcare “system” to the NHS.

Let me spell it out. “A price tag on human life” is the price you have to pay when you don’t have good – or, indeed, any – health insurance. You know, like millions of people in the USA.

In the UK, we don’t have to worry about there being a price tag on our lives. The cost of UK healthcare comes out of our taxes, paid almost unnoticeably when we are well. So, we can just worry about being sick, rather than being sick as well as destitute because we are sick.

The NHS is great. It is generally free at the point of delivery. Almost everyone in the UK loves it, whatever their political views.

(However, if you really want to pay for private insurance and private healthcare, there is nothing to stop you. You’re not obliged to take the free version, which tends to be inferior to the private sector only in terms of the quality of the hotel services and in the speed with which you can get elective surgery.)

Hat tip to Respectful Insolence for drawing attention to this article as a sample of the dangerous lies being spread in the USA about the British National Health Service.

Respectful Insolence quoted a staggeringly stupid paragraph from the first version of the IBD editorials post. They claimed that Stephen Hawking (UK citizen) would have been left to die if he had had to rely on the NHS (for which I think he’s certainly got reason to be grateful). There’s a screenshot of this comedic claim on cheezburger.com

All the same, there are other assertions in the IBD editorials post that are just as absurd as the Stephen Hawking fantasy.

The controlling of medical costs in countries such as Britain through rationing, and the health consequences thereof are legendary. The stories of people dying on a waiting list or being denied altogether read like a horror movie script.

This is “legendary”, indeed. However, the word “mythical” might have been a better choice.

These stories may read like a horror movie script because they are exactly as true as the average horror movie script.

Health care isn’t “rationed” in the UK. Nor is it shared out according to a mad points system, contrary to the claims in this article that:

The more points you have, the more your life is considered worth saving, and the likelier you are to get care.

This article falsely suggests that the NHS operates some sort of non-voluntary euthanasia policy. This is so far from the truth that it is not even living in an adjacent galaxy.

In Sickness and in Health

“Doctors want right to talk faith” according to an item on the BBC health page about a BMA conference. The piece starts:

Doctors are demanding that NHS staff be given a right to discuss spiritual issues with patients as well as being allowed to offer to pray for them. (from the BBC website)

Doctors? Do NHS “doctors”, in general, feel that they have so much spare consultation time on their hands that they need to fill it with philosophical discussion? Well, no.

It’s those pesky members of organisations like Christian Voice, again. In this case it’s the “Christian Medical Fellowship”

The CMF web page title says :”a Christian perspective on Working Overseas, Ethics, Christian Apologetics, Abortion, Evangelism, Faith in Practice and Medical Training” This is too big to show in a browser title bar but you have to admire how comprehensively it gives the flavour of their interests.

They claim to represent 4,500 British doctors. (Scary, huh, if true?) The centrality of proselytizing to their goals can be seen in the literature offered by HealthServe, their overseas mission wing.

Isa Masih, meaning ‘Jesus the Messiah’, was published from July 1996 – April 1999. These back issues contain news from the Muslim world and resources for Christian students who are working towards bringing the good news of Jesus the Messiah to Muslims in universities and other tertiary institutions worldwide. …

What’s spurred their efforts to influence the BMA was the case of a Somerset nurse who offered to pray for a patient, was suspended then reinstated.

This is the sort of issue that the rabid wing of Christianity loves to make much of, and the media love to treat their complaints as news. (Auxiliary nurses told not to wear crosses and all that.) All following a goal of making religious fanaticism seem mainstream and “Christianity” under threat.

A mainstream CofE vicar (debating the issue with a man from the National Secular Society on BBC Breakfast) was aware that an unsolicited offer to pray for a patient would make her seem like the angel of death.

How much more terrifying to a sick person, if the volunteer pray-er is the doctor or nurse who is treating a patient?

If they really think prayer works, wtf can’t they just go off and do it without having to involve the prayee?

I will charitably pretend that they don’t just want to add numbers to a roll of converts (although this is the likeliest explanation for this evangelising) and that they really want to help people. In that case they must instinctively know that any efficacy of prayer comes from the power of suggestion. The prayers, crosses, and so on, are magical rituals and charms that rely on the expectations of the target.

The placebo effect, if it helps anyone get better. However, even the suggestion that your medical professional wants to pray for you would have a pretty definite nocebo effect on anyone, as it suggests that your doctor thinks you are beyond earthly hope.

of course, as the Chaplain pointed out the other day, if Christians really believed in heaven, why would the sick bother trying to stay alive? Or why would believing doctors be so cruel as to try to keep people away from their happy-ever-after afterlife?

Christian variant of classic scam?

Some “get rich quick” internet scams have the decency to target people who are gullible and greedy, as well as having more money than brain cells. (Oh, maybe I’m thinking of hedge funds, rather than email cons, here.)

Apathy Sketchpad has a few posts showing how to deal with some classic Nigerian scams.

There’s a more distasteful type of con that preys upon the mark’s charitable impulses and/or their religious beliefs, rather than their greed.

I found Sam Gipp’s “A Friend to Churches Ministries” site by following a link from fstdt. I was sniggering at posts like this, while thinking how glad I am there’s a whole ocean between me and the ground such people walk on:

Welcome to the U.S.S.A.
Since the “November Revolution” when the Communist Party took over our government and began its conversion to “GODvernment” the old United States of America is gone, replaced by a new entity: the United Socialist States of America. Here are some of the differences between these two countries.

Then I spotted this tale on the about page:

You all know that, in all the years I’ve written these letters I have never asked anyone to send us money…Don’t worry!…I’m not going to start now. But there is an Urgent Need that I am going to tell you about & ask you to help.

Well, I know you aren’t going to do anything so vulgar as to ask for money, Sam. It’s not as if I don’t trust you implicitly.

Carl & Leta Miller have been missionaries to Scotland for 23 years. They have been faithful through extremely difficult times. Their daughter, Libby, has had severe health problems. Carl has had surgery on the retinas in both eyes, needs to have his knees replaced, also his hips and has fought off cancer in his bladder. He cannot walk without leaning on his wife, Leta. Unfortunately, Leta is not much better. She has a severe back problem and uses two canes to walk. The great, government health care program won’t even look at her for surgery until they deem it, “Life threatening.” It takes 18 months just to get a pain shot. (Just wait until we have that here!)

Missionaries to Scotland? Hmm. It’s not as if Scotland isn’t already bursting with various Christian sects. This already stretches credulity.

But the next bit blows any residual credulity right out of the water.

It takes 18 months to get a pain shot.” Eighteen months! Are you insane? Well, OK, the Scots are stereotypically seen as tough, after all. Who knows what is normal in those strange Northern regions?… (Just, never try to take their Freedom.)

Based on an ultra-conservative perspective, he is insulting what he sarcastically calls our “great, government health care program” as if it provides a service that would compare unfavourably with what you’d expect to find in a Somalian war zone.

But, in fact, judging by the long list of health problems suffered by his doughty missionaries, they’ve already benefited from plenty of nationalised health care, including a series of surgeries that would have bankrupted the average American family. What are these people? Health tourists?

We talked to my doctor. He said he would look at her. Get this! The Millers have put every penny into their mission work and couldn’t even afford the plane ticket for Leta to come here for tests. Kathy & I bought her the ticket and paid for the tests. My doctor says he can help here. He said without the surgery she is headed for a wheelchair. Leta is now back in Scotland. The Millers are coming to Louisville in January. A brother has provided airline tickets, a lady at Shawnee Baptist Church is giving them a place to stay and another church is renting them a car. Here’s their problem; they have no health insurance at all. The hospital costs are going to be around $200,000-$250,000.

But, wait. Hooray! He can get these costs discounted! As long as they get the money REALLY REALLY fast.

But! My wonderful wife has talked to the folks at the hospital. They said they will reduce the cost by 60%! They also said, if the bill is paid within 30 days after surgery they will drop it another 20%.

Don’t you just love the idea that a hospital could so drastically reduce a bill of a quarter of a million dollars for a quick sale?

Word For The World Baptist Missions has started a “Leta Miller Medical Fund.” We have given and several churches have also helped. They need around $50,000. Around $15,000 has already come in. Will you help? If they can raise the $50,000 by surgery time, January 26, 2009, they can pay the surgery off and save thousands of dollars.

Wow, how economical is that. Praise the Lord!

But, stop right there, Sam Gyp Gipp. Let me save your donors a few more Yankee dollars. Guess what? We also have private medical care in the UK. Your $15k could buy the unlucky Leta as much UK health care as she can handle. Yes, even in heathen Scotland.

Abandoned babies

Finding a new-born baby in a bag on your doorstep seems to be becoming a minor hazard. Today, one was found in Birmingham. One was found in Liverpool on 25 September. South Lanarkshire on 7th August. A stillborn baby was found in Hackney in April.

It’s not just the UK. A Times article reported that Italian hospitals had introduced a higher tech version of the foundling wheel – a device that lets mothers deposit babies where they could be found – in response to rising numbers. Germany and Japan have “baby hatches”

Baby abandoning is very rare. So you can’t really identify a trend here. Granted, there are always going to be mentally disturbed or desperate or stupid women. There are always going to be individual lives that are tragic. All the same, it bears examination. Typically, mammals abandon their babies under extreme survival stress.. This explanation applies in many parts of the world where lack of access to contraception compound the effect of living on the edge of survival.

So, why is this happening in the richest countries in the world? In Western Europe, an unwillingly pregnant woman can get access to abortion. There are adoption agencies that can’t find enough babies for people who want them. There are a whole range of social and medical services that should enable a child to stay with its mother.

It seems to me that one thing that could contribute to ever higher numbers of abandoned babies is the Fortress Europe mentality. Access to health and social services is increasingly denied to the people who fall under the radar – failed asylum seekers and illegal immigrants.

Ever-tightening ID nets – where access to services depends on ID, as discussed last week – mean that more and more people live in an invisible underclass in the UK. The health impacts include increasing numbers of people without access to basic health care. Which includes contraception, abortion and maternity services.

The consequences could be much more wide-reaching than a potential rise in the numbers of dead and abandoned babies and greater maternal mortality (horrible as these are). What about communicable diseases? Do you really want people without the right ID documents to get treatment to be spreading TB around your neighbourhood?

Public health is public health. Circumscribing access to public health services might seem like a wise move in terms of short-term economic targets. It might make the Daily Mail readership feel that their tax money isn’t being spent on people they don’t want to support. So, there are political forces impelling this sort of exclusionary policy. But it is basically demented.

Medical staff aren’t deliberately not treating socially-invisible people. The system is doing the rationing for them. If you lack an entitlement card, you won’t see a doctor.

The cost of restricting entitlement is much greater than the cost of providing the treatments. Surely, a system could be devised that was flexible enough to stop exploitative health tourism without marginalising people.

Call me as selfish as you like, but I would rather take the chance that the odd illegal immigrant gets their bunions treated courtesy of my tax pounds than that I contract cholera or Ebola because the system offers no point of entry for a sick person.

Wifi Dangers

I dont have much time online, so I have pick and choose my ranting carefully now… The Will of Toutatis seems to have decreed that while I am mostly offline, the news is full of things which almost make my blood boil over. Bah. Humbug.

There is a long list of things which are stupid beyond belief in the media this week. I picked the post headline based on the furore from the BBC’s Panorama program which claims Wifi is three times more “dangerous” than mobile phone masts.  I didn’t watch the program myself, so my comments about it are based on the (mostly radio) news which picked it up.

For years there have been minor scare stories about mobile phone masts (cellphones for you colonials) causing all maner of problems to the people who live in their footprints. There has even been a considerable amount of rigourous scientific investigation into this. Sadly, for both the frightened and the media causing the scares, there is little to support the claims. Now, call me old fashioned but if you have 99 studies which show no ill effects and 1 which does, it probably means there are no ill effects.

Why in Odin’s Name do people focus on the outlier and demand that be considered as the “real evidence?” It is insane. It really is madness, and the BBC radio news about it was a cringeworthy example of it. There were “concerned citizens” calling on the Government to carry out an “inquiry” (as is the case today, if a dog craps on the pavement there needs to be a government inquiry into how and why it happened) and, predictably, there were “scientists” who wanted 15 mins of fame, demanding the same. All based on the same lack of evidence.

When I see things like this, I like to remember a pop-science programme I saw on television a few years ago (it was something like Brainiac but it wasnt brainiac), in which a group of “electrosensitives” were put in a house for two weeks. Outside was a broadcast tower. The subjects were told the tower would be on for the first week and off for the second week.

All subjects reported the “electrosensitivity” problems during the first week, which miraculously cleared up in the second. As they predicted. The kicker of it all was, the experiment was reversed. The tower was off when they thought it was on, and on when they thought it was off.

Now, I am not for one second saying that is the sort of thing which should be published in the Journal of EM Woo or whatever, but it goes a long way to showing how people convince themselves about something – and once they do it manifests itself in other effects.

This recent nonsense about WiFi is prime example, but pure comedy value can be gained from the “three times as dangerous” phrase. Radio towers are not dangerous, so what is three times zero.

I think I can agree with that.

Computers aren’t doctors

We all know Google has become the new hypochondriac diagnostic tool. All the same, it’s a bit disturbing how far the NHS has started to behave as if computers have some intrinisic sickness-curing value. And I’m not talking here about that inferior version of Google that you can find in the so-called NHS Direct high street shops. (Add a triage nurse, subtract the coffee and the wider web-surfing capability and these are NHS Internet cafes)

The general opinion on the new NHS computer system puts its cost at over £20 billion.

The National Audit Office claims that this cost will not all be borne by the taxpayer – only £12.4 billions, before factoring in the cost of the “savings” that will result from it. The companies involved – the major one of which was almost destroyed in the process – will somehow meet the shortfall. Hmm. I am definitely too sceptical. My limited understanding of the laws of the market make it hard for me to see why any company would bid for a contract that would cost them £8 billion pounds to complete. Their profit margins must be astronomical. In any case, I remember that about four years ago, this was going to be an unprecedented spend of £6 billion. So even on the most optimistic estimate, this project costs double what it was supposed to.

The Health Minister, Lord Warner, claims that the project will pay for itself. This in itself seems well nigh incredible, unless it means that huge numbers of clerical staff are to be made redundant, which begs the question of who is going to operate the new system then? My doctors and any hospitals I’ve ever visited have used computer systems for years. Were there some strange 19th century hospitals and surgeries lying forgotten in the world of the quill pen?

Correct me if Windows Calculator is wrong here but I believe that £20 billion (cost of shiny new national computer system) divided by 60 million (UK population) is £333.33. That seems to be the cost for every man woman and child in the UK

That’s approximately the cost of a cheap low-end PC isnt it? So this new system would buy everyone in the UK a low-end PC, WITHOUT any economies of scale.

How many doctors and nurses and hospital cleaners would it buy? Quite a fair number I would have thought, if we all club together a bit and put our £333.33 towards wages. A hundred of us could have paid for a junior doctor or a very senior nurse or paramedic or even two cleaners or cooks.

(Yes, I know that the blog has an excessively medical flavour this week. No particular reason, except maybe that getting a post picked up by the excellent NHS blog doctor site has skewed our thinking.)

Bad Medical Science

Heather wrote yesterday about some woo-like nonsense published in the opinion piece of the Nursing Times. Basically, the article said that obese patients were the cause of nurses back injuries. It was one of those wonderful articles that the print media so love. It had the air of self evident logic and attacked the current social demons (fat people). I am surprised it hasn’t been syndicated out to the Daily Mail (etc).

I had two main problems with the article (obviously lots of minor ones…). First, and most basic, the author of the article makes many, unsupported, assumptions. Statistical correlations supporting their claims are not shown (if they exist) so I have no idea where they drew the data for the claim made. It is shocking that being told “there is no evidence to suggest a link” was viewed as simply meaning more research is required. While continued research into every field of human endeavour would be fantastic, the line has to be drawn every now and then. Continue reading

Nurse gives fat patients a kicking

This week’s guest publication is Nursing Times.
It has a Comment article with the heading “It is fair to assume a link between back injury and nurses and patient obesity.” Well, after reading it, you would have to say “it isn’t fair to assume ..etc” There is no evidence in the article to support that conclusion.

It’s getting blogged here just because the argument typifies the increasingly common demonisation of fat people on spurious medical grounds, but from a new direction- obesity isn’t just dangerous to oneself- it threatens others.

The writer refers to HSE statistics on rates of back disorders suffered by nurses and nursing auxiliaries. If one actually examines the HSE data, the rates (31 per 100,000 for nurses and 44 per 100,000 for nursing auxiliaries, in the period from 2003/2005) come with such huge confidence intervals as to be little more than generally indicative of the comparative risks of different jobs. There is no evidence presented here to suggest that these rates are notably higher than those in previous years but this would surely be the first requirement, if the figures are to support an argument that patients are getting heavier and, therefore, healthcare workers are getting injured more. Continue reading