Going private? My reply to a job offer from a private health company

What the heck is this? I’ve been trying and failing to stop the government from privatising the National Health Service for years, and now a private healthcare company has contacted me about a job!

The email from Care UK says they are “seeking a Media Relations Executive for our Head Office based in Colchester and your skills and experience appear to be a good match.” Huh? They are offering a “competitive salary, 25 days holiday and corporate discounts.”

Here’s what I have replied:

Dear Laura,

Thank you for your unexpected email about the Media Relations Executive job with Care UK. I am very interested. Since Care UK is possibly the leading private healthcare company making inroads into the NHS, I would relish the opportunity to publicise what it does – indeed, this is precisely what I was trying to do in my previous job as information officer for Keep Our NHS Public (on a much smaller budget, I’m sure). That must be what you were referring to when you said my skills and experience are “a good match”.

As you can imagine, I am brimming with ideas. If you don’t mind, I would like to set them out here. First of all, I think much more needs to be done to let the public know what Care UK is. Hardly anyone realises just how big a chunk of the NHS you now run, from GP surgeries and walk-in centres to treatment units doing things like bunions. If I were your Media Relations Executor I would promote this aggressively to build the brand. I think the public has a vague idea about NHS privatisation, but they aren’t yet able to put a face to the name, so to speak. Care UK’s name could be that face. As a profit-making healthcare company owned by a private equity firm you are perfectly positioned.

I believe a key talent for any disrespecting Media Relations Executive is the ability to turn a negative in to something offensive. For example, it must have been a stressful time in the Media Revelations office when that tax avoidance story broke a few months ago – the one saying that Care UK had reduced its tax bill by taking out loans through the Channel Islands stock exchange. All this talk of tax havens and tax avoidance isn’t good in the current climate. But as your Media Relationship Executive I would have used a little reverse psychology, instead of denying it as your spokesman did. After all, this could put you right up there with the big boys like Goldman Sachs, Vodafone and Jimmy Carr.

Similarly, you got some bad press when it was revealed that the wife of your former chairman John Nash gave £21,000 to Andrew Lansley’s office before the last election, when Lansley was shadow health secretary. But let’s view it from another angle – doesn’t this serve to highlight Care UK’s excellent political connections? And look how it turned out: Lansley is in power and he has passed the Health Act. He has opened the door wide to privatisation, and Care UK is already inside redecorating the place.  We thought Lansley wasn’t going to manage it for a while, when all those thousands of patients and doctors started protesting and June Hautot shouted “codswallop” at him in the street. But he pulled through, sacrificed his future public career for private gain, and God bless him for that. Care UK now stands to make a fortune. This is something to boast about, for Bevan’s sake! And all for £21,000, less than it would cost to employ a Media Relations Executive for a year. (Please confirm.)

You should play to your strengths. Care UK is a true pioneer in this privatisation drive. You were the first private company to run a GP surgery in Dagenham back in 2006. And the first to face enforcement action from the Healthcare Commission because of slack hygiene procedures at the Sussex Orthopaedic Treatment Centre in 2008. And who’s to say you weren’t the first to forget to process 6,000 x-rays at your ‘urgent’ care centre in North-West London in 2012? As a Mediocre Relations Executive, I would advise not mentioning those last two.

If there’s just one thing that Care UK knows how to do – and there is – it’s take money from the state. I would make a bigger deal of the fact that 96 percent of Care UK’s revenue comes from the NHS. That’s the kind of solid base that any company would envy – taxpayers’ money, minimal risk, easy profits. So shout about it! It shouldn’t just be left-wing NHS obsessives who hear about this stuff.

Take the Barlborough Treatment Centre. It’s a complicated story, but in the hands of a good Media Relations Excretion it can be turned into a wonderful example of the company’s strengths. First, Care UK was paid £21.9 million over five years to do orthopaedic surgery – hip and knee replacements, that kind of thing – but you only did £15.1 million worth of work. (The local NHS Medical Director saw the trick, complaining: “The problem we have got is that they cherry-pick; they don’t take any patients with complicated conditions”. I guess the joke’s on him.) The NHS eventually realised it was getting a bad deal, and things weren’t looking good for Care UK. But then the NHS bought the treatment centre from you for £8.2 million, a lovely gesture. And finally the NHS signed a new 30 year contract to run the centre with… Care UK! (As an aside, it is important from a media management perspective not to spoil this tale of triumph-from-the-jaws-of-lucrative-defeat with any reference to the several lawsuits brought by local patients claiming that their surgery went wrong.)

As an example of what I could bring to the company I would like to propose a new corporate motto: ‘Care UK – Providing less, for more’. These words came to me when I was thinking about Manchester, where last year the NHS paid you £2.7 million for work that was never done at your Clinical Assessment and Treatment Centre. According to a parliamentary report, the services you provide up there are between 7 percent and 12 percent more expensive than equivalent services in local hospitals. Providing less for more – it’s a record that really ought to be publicised.

And Care UK should be proud of its talent for cost-cutting, like the plan to use more nurses and healthcare assistants in your GP surgeries because doctors are too expensive. Your managing director, Mark Hunt, describes this as “workforce efficiency on skill mix”. As a Meddling Relations Executive I would advise him to ditch the jargon and tell it as it is. Patients might get a worse service, but at least the company is making more money and that’s good for the economy. We’re all in this together, as someone once said, in jest. I’m convinced that if Care UK followed my strategy it would solve the serious problem of patients accidentally opposing the private take-over of GP surgeries through confusion and surfeit knowledge, like when those blasted Keep Our NHS Public campaigners scuppered the Care UK health centre in Euston by threatening court action.

Be bold. Be proud. Be shameless. That’s the approach I would bring to the job, and I hope you like my initial ideas. Please be sure to let me know when and where the interview will take place (the formalities must be gone through, I understand). I trust that I will hear from you soon.

Yours sincerely,

Alex Nunns

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334 thoughts on “Going private? My reply to a job offer from a private health company

  1. Magnificent..do let us know if you hear anything back!

  2. Patricia Farrington says:

    Such a good letter! Well done! These people should be hounded out by embarrassing them but their skins will be as elephant hide. Please let us know if you hear back.

  3. jayarava says:

    brilliant! Thanks

  4. Neil says:

    This is a brilliant brilliant letter. Alas I fear it will go over the head of the person who receives it, and will just be ignored :(

  5. Anthony says:

    Bravo!

  6. JOAN BELL-FAYE says:

    HAHAHAHA! You’ve made my day :D

  7. Combination of sound knowledge and excellent wit makes for a thoroughly grand piece of writing – it’s made my day!

  8. diversecymru says:

    Ha! That’s brilliant! You’re a marketing genius. Though I would hold out for a larger salary if I were you…

  9. Stu says:

    I cant believe you are still using Hotmail and havn’t had your account hacked yet.

  10. Vince says:

    You wrote a long-winded reply to a Recruitment Agency. Well done you.

    • MissBlack01 says:

      Weak and snide from response from you. Great Post.

    • Steve B says:

      And since it just hit Caitlin Moran’s twitter, and 4 of my friends with 100s of friends each just shared it on Facebook, it’s effective at spreading the word to the public about all the issues he listed. Who cares if the 1 person at Care or an agency doesn’t respond? This post just did a hell of a lot of good.

    • Anonymous says:

      Interesting take on it.

  11. Rhiarti says:

    Glorious! In more ways than one, I hope they hire you!

  12. theauracl3 says:

    Incredible. There needs to be more people like you to get the facts out there.

  13. B.O. Locks says:

    Ha Ha! They don’t like it up ‘em (the truth, that is)

  14. [...] http://wheretheresmuck.wordpress.com/2012/07/10/going-private-my-reply-to-a-job-offer-from-a-private… Rate this:Like this:LikeBe the first to like this. This entry was posted in Uncategorized and tagged Get Lost, NHS Privatisation, Private Health Company. Bookmark the permalink. ← Marcus Agius Tracked Down. [...]

  15. abetternhs says:

    Reblogged this on Abetternhs's Blog and commented:
    Fabulous post from Alex Nunns, Press Officer for Keep Our NHS Public

  16. colibooColette says:

    Absolutely fabulous response. You must have felt great pressing ‘send’ – I know I would have ! Well said!

  17. Alisdair Cameron says:

    *Clap,clap* Have reposted and distributed. They’ve just taken over a GP practice in our neck of the woods, and that is unspeakably unsettling.

  18. Mike Squires says:

    Fantastic.Not only a great read but more ammunition against Care UK

  19. Barefoot Saboteur says:

    Well that was awesome.

  20. Paul says:

    A brilliant reply but an otherwise depressing indicator of what will happen to the NHS

  21. Julie@fuchsiablue says:

    Powerful stuff. I suspect it will go viral & I hope the message starts to get out.

  22. kevin says:

    sorry to intrude a fact among all the jollity, but all GP surgeries are already private and always have been

    • B.O. Locks says:

      But were contracted to work for the NHS for 98% of their time and 2% to the private sector. Under Lansley’s proposals these proportions will change to 51% NHS and 49% private. See how it works?

    • Anna says:

      Actually some are salaried practices owned wholly by the local community trusts

  23. Jackart says:

    Ooh Goody. They’re privatising the NHS? Maybe I won’t die unnecessarily of Cancer, or wait four hours because no-one can be bothered to see me with a dislocated shoulder, until the target time runs out.

    Excellent. It will still be free at the point of delivery, so why, apart from vested producer interest and left-wing prejudice, would you oppose private, but state funded provision?

    I note with interest you got the usual left-wing digs at “corporations” like Vodafone. I’m glad you admit you’re against efficiency and don’t want skilled nurses to offer simple services, but would rather ensure that someone wait to see a doctor. I had a bike accident outside my GPs surgery. The Doctor refused to apply a steristrip, and demanded I go to A&E 10 miles away. (and wait 4 hours). This is an organisation run for bureaucratic convenience, not that of patients, infused top to bottom with the “more than my job’s worth” attitude of the public-sector

    The NHS is NOT the “envy of the world”. It’s a mediocre service 17th best despite the UK being 11th richest per capita. The NHS underperforms and is in desperate need of shaking up, if not breaking up.

    With any luck the NHS will be privatised. And I will enjoy watching the wailing and gnashing of teeth from people who have been wrong on absolutely everything else, and are wrong on this too.

    • B.O. Locks says:

      And do you think will survive under private health care? It is a form of social Darwinism where the fittest are allowed to survive. Those without insurance or money will be left to die.

      • Jackart says:

        No. They won’t. They aren’t anywhere else in the developed world, even America.

        When people say ‘NHS’ they mean Free at Point of Delivery. They couldn’t give a shit whether the state runs it. THey just don’t want to be left on a gurney for hours. They’d like to be seen within 4 hours.

        • Elizabeth Berg says:

          Want to bet? I’m American, and I’ve had two friends die of cancer because they lacked health insurance.

      • Yes, this will. I’m an American, and I beg the UK to not adopt our system. We have the best health care in the world here–if you’re rich. The leading cause of bankruptcy in my country is medical treatment. People sell their homes, their cars, everything they own, even if they HAVE INSURANCE (because the insurance companies will often find ways to not pay it). And the people most in need of care cannot afford it, and are left to die.

        I have been lucky. My employer provides decent health care coverage (75%–I pay the other 25, plus co-pays, which are usually $24-$40). But many others are not.

        Private health care is an evil business

        • EbSal says:

          According to your own logic, you get health care so you’re rich? No, you just struck an employment deal in which you traded some of your earnings for health insurance coverage through your employer. You could just as easily have pocketed the full salary in cash, put the amounts you and he would have been spending on health insurance into a private health savings account (HSA) along with catastrophic health insurance. Then if you need care, you spend the money. If you don’t need care, you continue to accumulate the amount as savings toward future care or some other need. You’d have an incentive to shop for price in your health care, helping to introduce market competition which is greatly lacking due to consumer non-awareness of price signals. But not only that, you’d also be shopping for higher quality, just like you do at the grocery store for vegetables… price and quality are the standard criteria we all use in our grocery purchasing decisions. Health care can be exactly the same. Unfortunately, it’s not under either NHS-style schemes or 3rd party payer schemes such as we have in the US.

          Let me give you an example. I have the HSA + catastrophic care insurance scheme I’ve mentioned. My friend has conventional employer-provided insurance with a small deductible. Both our children needed their wisdom teeth removed. His was done here in our town. There were no in-surgery complications. My friend did no comparison of fees with any other provider. I happened to have asked the price of the same surgeon, and was quoted $3200. I shopped around and got another quote of $1400 from a surgeon in another town. We went with the $1400 offer and were very pleased with the surgery and aftercare. My friend’s son was escorted from his surgery while still mostly out from the anesthesia and went home vomiting and bleeding. $3200 for that sh!t? Sorry, but when you don’t have an incentive to price shop, you also have little incentive to quality shop either. Why should you? It’s all somebody else’s problem and expense, not your own.

          Just like what happens in the British NHS. People are stuck with crappy service and are paying sky-high prices for it through taxation and various rationing subterfuges. Free care ain’t free, bub… it’s more expensive than paying the market rate that individuals negotiate. Try to wrap your mind around this simple immutable fact.

          • alexnunns says:

            Try to wrap your mind around the very simple and immutable fact that the NHS is far cheaper than a market system – you don’t have to believe me, just look at the figures. Incidentally I had my wisdom teeth out on the NHS a couple of years ago. Perfect service, all done in a couple of hours, no problems, no complications. And it cost me £0. That works out at $0 by the way.

        • @eb sal

          A flaw in your argument is that shopping for health care is not he same as shopping for groceries or vegetables. These commodities can be inspected before purchase. How do you propose a surgical procedure, for example, is inspected before an operation? How can you assess the quality when you have no expertise?

          Same with education. How does one know one is receiving a good education? One needs a good education in the first pace to evaluate the quality.of what is being delivered !

          I would suggest that both health care and education are post-experience goods. That is, it is not possible to assess their quality until after receipt of the service. That’s a bit late if you have dies in surgery through clinical incompetence.

          In a free market, which I understand to mean an unregulated market, how many patients will need to have died during surgery first before customers vote with their feet and choose another surgeon?

          • alexnunns says:

            Exactly. The consumer is not sovereign, as they say in the jargon. So a market in health cannot function properly, even if it was desirable to ration healthcare by wealth (which it’s not). It takes a doctor in the UK seven years to train. When a patient comes to her or him there is such an information in-balance between what the doctor knows and what the patient knows that the patient is forced to trust the doctor. Market signals don’t work in this situation, because the patient is not a proper consumer.

        • Chris says:

          in reply to those saying private is cheaper and free market means savings- Uh, no. Being private does not lead to savings. I used to work for a major pharmaceutical company, and one of our big products had two price points: one for the UK, and one for the US, which was ten times higher. Why? Two reasons:
          1) The nhs is massive. If you want to sell in the UK, you gotta pay by their rules, or you make no money at all. Any profit is better than none, and if the access to the UK market means being subject to the nhs’s bargaining process then so be it. Sure, the odd drug doesn’t make it, which is why sometimes we don’t get herceptin easily- but it keeps our other dugs cheap.

          2) Americans WILL pay. It’s a vicious cycle, increased prices for drugs means that treatment costs more, which the insurance companies try to haggle down. So the doctors set unrealistic price points, so they claw back their money. The drug companies see the markup on these drugs and realise they could make more profit. And so the cycle continues.

          Ironically, it is however this process that pays for the nhsThe nhs bargain so hard that if Pharma JUST sold to the nhs then it would be uneconomic. But the massive profit made from the states mean that the NHS can piggyback off it. Congratulations America, your free market model means your insurance is indirectly subsidising the treatment of the British. Thanks guys, you’re so helpful!

    • Rob says:

      you obviously have never had to visit a hospital in asia/africa otherwise you wouldnt write such crap,the NHS is the envy of the world,it has its problems,mostly caused by management but you can still go there and get first class medical treatment whoever you are,and not be left dying on the sidewalk because you have no insurance!

      • Jackart says:

        Envy of the world? Why has no-one (except cuba) copied it?

      • Jackart says:

        Oh, and yes, I have seen hospitals in Africa. I don’t see it as comparible. Get hurt in France. Now THAT’s how it’s done.

        • tomlinson.helen@gmail.com says:

          French health care is AMAZING! I would rather be sick here than anywhere else I’ve been in the world. However we have some of the highest social taxes in the world and French people are currently leaving in droves. One of the main differences that strikes me between the UK and France is that in France if you haven’t paid in, you don’t get to take out. I pay my tax in France and therefore I receive healthcare here. If I’m in the UK and I need assistance I would expect to pay for it despite being English – I haven’t paid any tax there for years. That’s what travel insurance is for. There really should be some sort of healthcare card that everyone has to apply for to prove residency and healthcare providers should be set up and ready to take a fee from anyone without one. Imagine how much revenue this would provide, without having to change entitlements for all British people?!

      • He’s also never been to a hospital in America, where yes, we die with alarming frequency for lack of health care. We spend more than twice as much per capita than the country next, and are 49th worldwide in life expectancy. I’ll take the NHS over the US system every day.

    • I don’t think anyone would deny that there are problems with the NHS as it stands but can’t you see any problems with a profit-driven system? Don’t the examples above where CARE UK have clearly undelivered in order to take maximum profits worry you in the least?
      I’m very curious about your vitriolic tone. There are no winners here, least of all anyone with an ‘expensive’ illness who will be curiously dropping off waiting lists and falling through loop holes more and more. I’m sure you’ll be alright though, which is all that matters.

      • Becky says:

        Good point. Some excellent brainwashing techniques going on to only consider two alternatives the NHS v USA private system. It doesn’t take a genius to guess a private health care with a venture capitalist owner is a recipe for disaster. Its old rope to say we need to replace the NHS with this potential nightmare situation because the NHS has flaws. A case of throwing the baby out with the bathwater? (an then adopting a little psychopath)

      • js207 says:

        The really expensive treatments get blocked by NICE anyway: as we should all know, they have a set price ceiling for treatment approval. When the NHS explicitly states “you can’t be treated for that condition, it’s too expensive”, how can you use the ‘threat’ of an imaginary alternative possibly doing the same thing in future?

        People need to look beyond the false dichotomy between an imaginary NHS which gives any treatment needed regardless of cost and a caricature of the US (when the real thing does actually guarantee emergency treatment regardless of insurance and financial circumstances!) – there are far, far better examples right on our own doorstep, as well as countries like Australia and Canada we could learn from. No, the NHS isn’t the worst system in the world, but it’s far from being the best either: there ARE better systems, there are improvements we can and must make.

        • G Solent says:

          NICE does not decide whether to recommend treatments based on expense. It decides based on value – the amount of benefit for the cost. A drug could be the most expensive in the world and still be approved, if it was also the most effective in the world. They rightly withhold their approval for drugs that are extremely costly with little benefit. This dissuades pharma from fleecing us even more than they do anyway.

        • js207 says:

          You have an acute case of hair-splitting there, between “expense” and “cost”, as well as an over-simplified view of NICE’s criteria which actually look at the cost per year of quality life delivered – rather than approving the “best” or “most effective” treatment in every case as you seem to imply. As you should be aware if paying attention, there have indeed been cases where they have denied treatment on cost grounds, recently including certain vision problems: the loss of an eye, for example, is something NICE regard as having a low value, so expensive treatments for it have been denied in the recent past. They were effective, but not *cost* effective: treating it was too expensive for NICE to approve. (That particular decision did get reversed later, as I recall, but the overall approach remains.)

    • B.O. Locks says:

      I’m afraid that people in the USA are left to die if they fall ill. There are innumerable homeless people in the USA who have no health cover and who are left to die if they become afflicted with a serious illness.

      Be careful what you wish for – your wish may be granted.

    • B.O. Locks says:

      I have no problems comparing NHS treatment against other European health systems which I understand are very good. Despite faults of the NHS it does not leave the poor to die of ill health as they do in the USA.

      • Jackart says:

        That does NOT happen, at least not any more than in the NHS which of course also stops treating a number of conditions at specified ages.

        • G Solent says:

          No it doesn’t. Doctors will decide on the risk and benefit of a treatment based on a patients fitness, comorbidities etc, not age.

          You’re just making stuff up it seems.

        • NHSdoc says:

          You are a moron who obviously have no idea what you are talking about with regards to the NHS or the US health care system…….daily mail reader??

        • McCatllar says:

          Jackart?…Jackass more like.

      • Michelle Shalbrock says:

        It’s not a good idea to compare the NHS with a system that’s almost as bad. The USA has the HMO act signed into law by Nixon in the 70’s. It protects the HMOs at the expense of patients. That’s almost as bad as the NHS, where the state is more important than the patient and decisions about interventions are based on budget targets and trying to get away with spending as little as possible to keep money available to finance the sheltered employment of the expensive socialist NHS fat cat managers. What we need is free enterprise, where service providers compete to provide as much care for as little cost, and the patient is put first.

    • Winty says:

      So jackart you advocate breaking up the NHS despite the
      fact that I as someone who ,like many 1000s in the country , is in remission from cancer (3 out of 4 of my family have had cancer now) and private health insurance wouldn’t touch us with the proverbial 100 foot barge pole? Should
      I kill myself now to save any future worries should the cancer return ? let’s face if you had your way I wouldn’t be able to afford the chemo necessary to prolong my life if it does return !!!

      • W says:

        Check Jackart’s profile and his associated blog. He is a professional troll and a stockbroker. Either of which would be curse enough for a real human being, but he has to suffer both, the poor thing. He’s used to being a social pariah. He’s probably like one of the Barclay’s drones ‘reduced to tears by the end of a day, but only when they had departed from the building.’

        Pity him and his kind. They are socially defective. That’s why he has to ‘man up’ on the internet, he craves the attention, because there’s no love in the Square Mile.

      • Jackart says:

        Did I not say I support “free at the point of delivery”?

    • W says:

      Ah a professional troll and a City of London parasite. Well done you!

    • Dennis Lynch says:

      Waiting room time in the US is often 10 hours or more, only waiting 4 hours would be a dream come true in the land of Private medicine.

      • Jackart says:

        Have I mentioned the US system? I did not. The US system is about the only one worse in many respects than the NHS, which is why the lefties are so keen to use it as a comparison. It saves them having to admit the N bit of the NHS is what causes it to be mediocre. Break it up. Privatise some of it. Then the NHS will work as well as mixed systems in Europe.

        • vistarj says:

          You just don’t understand the Governments plans – have you read anything in the last few years?

          The Govt is no longer responsible for delivering health care, only for ensuring that someone provides it in some form. They passed the horrendous Health & Social Care Act to pave the way for a completely USA type service, based almost entirely on health insurance which, surprise surprise, means it’s a far worse service – as you rightly say – because it is profit-driven, not health. Free at the point of use? … read on about the better outcomes in the USA for the poor – and those on medium income.

          USA has the highest rate of suicides directly related to also having the highest rate of debt anywhere in the world for their health care. Bankruptcies run at enormously high levels, due to health care costs – whether people are insured or not, because no insurance covers 100% of the costs involved, it’s usually way less than 70% of what is an artificially hyped cost due to profits, rather than health, being at the heart of almost every aspect of the system.

          I think you really need to broaden your narrow view of the world, or maybe you don’t care about future generations ‘Jack’.

    • Tom says:

      “It’s a mediocre service 17th best despite the UK being 11th richest per capita”… but we only spend the 19th most on healthcare per capita (http://www.who.int/whosis/whostat/2011/en/index.html). Merely being rich doesn’t improve our healthcare if we’re spending it on other things. Based on what we actually spend on the NHS, it’s quite efficient, and we’re punching above our weight.

      Plus we get a much more equitable service than most other nations – see, for example, this Commonwealth Fund report (http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2010/Jun/1400_Davis_Mirror_Mirror_on_the_wall_2010.pdf) which ranks the UK 2nd overall, out of 7 developed countries’ healthcare systems, with it leading the way for effectiveness and efficiency, and for access for all regardless of wealth, and 2nd (behind the Netherlands) for equity.

      • Jackart says:

        You’re measuring inputs. Equtiable is not a virtue if it’s equally rubbish. And there’s quite a lot of “postcode” lottery.

        Look, I know in the absense of anything else for the left to hang onto from the post war settlement, you cling to the NHS like a baby to a blankey.

        All I’m doing is pointing out the emperor’s if not naked, then at least with his trousers down. It’s rubbish at Cancer, strokes, A&E, and palliative care. These things are what’s really important.

        Other countries do state-financed healthcare by eschewing the bureaucracy, by decentralising and privatising. We should too.

        STILL FREE at POINT OF DELIVERY, TAX-FUNDED, but also PRIVATE-SECTOR.

        Headfuck, I know lefties. But there you are, that’s what works on the continent.

        • G Solent says:

          You want it broken up, and then complain about a postcode lottery. can you spot the problem here? The postcode lottery we already have is due to localisation of control.

      • jamie says:

        Bravo. Sadly facts don’t come into it for idealogues like “jackart”

        • js207 says:

          G Solent: I don’t think Jackart was complaining about the ‘postcode lottery’, but pointing out it is hardly compatible with claims of the NHS delivering ‘equitable’ service. He has a point there: how is the service equitable when it’s so different between regions?

          Personally, if treatment X is important enough for the government to fund in Cornwall it should be funded in Aberdeen too, and vice versa; a car MOT or a maths A level is subject to the same standards whether done in Dover or Devon, why not the medical treatment too?

          Jamie: facts are, in this case at least, exactly what Jackart seemed to be trying to introduce – pointing out flaws in inconsistent claims about the NHS. How can regional variations be a fatal flaw in an alternative, when it’s present in the NHS itself already?

    • flictoria says:

      You really haven’t got a clue and in some ways I am happy for you as it means you have never experienced the serious lack of care in other countries. My mother died of cancer two months ago. Firstly, despite visiting her doctor practically on a weekly basis complaining of neck and back pain and begging to be referred to a specialist the incompetent Doctor refused. The cancer was discovered when my mother’s bones disintegrated one evening and she spent the night on a trolley in her local A&E. The very day that the Doctor had told her yet again that he wasn’t going to refer her as she was being a nuisance and there was nothing wrong with her. My mother lived in Southern Ireland and had private Health Care!!! Whilst my mum was alive I witnessed first hand how abysmal the health system was in Ireland. Barely any home nursing care, she was lucky if she saw someone once a week. She couldn’t get in or out of bed without help & my 78 year old Dad with a heart condition was left to care for her pretty much on his own with me coming home once a month to try to help. Her legs became badly infected over Christmas and needed to be dressed daily. If it wasn’t for me kicking up an unholy stink she would have been seen once in 7 days. The nurse told me that we couldn’t dress them as there was a danger of infection and this needed to be monitored but in the next breath told me that it would be over a week before someone saw her.
      I sincerely hope that we save the NHS from privatisation as let me assure you privatisation is not the answer

      • Jackart says:

        Privatisation and decentralisation, within a public funded system IS the answer. Still free at the point of delivery.

        • vistarj says:

          Why on earth should the public purse cover exorbitant costs of private corporations? Especially as they have never had any experience of running a Health System – and repeatedly prove they haven’t a clue – when there is 66 years of experience, and investment of talents and innovation, in the NHS?

          Yes the NHS needs adjustment, particularly due to decades of Govts being more interested in nuclear weapons, war-mongering, vanity projects, and the economy (especially their own) than in the welfare of the people who elected them, e.g. by foisting PFI contracts on hospitals at enormous cost for decades to come. But it will not be improved by abandoning the belief in one life being as important as the next, giving preference instead to making money out of health, to subsidise the money they make out of money.

          Real security can only exist in reasonably egalitarian societies – never in one ‘protected’ by continual economic ‘growth’ and failing to address the fact that we share a single planet. Ask the 1% of the world’s population who have more wealth than the poorest – and shortest-living – 40%. They make money out of money, rather than anything that will truly last.

      • Jackart says:

        Some people get acceptable care. This does NOT mean it wouldn’t have been better elsewhere, or that others don’t regularly recieve substandard care in the NHS.

        The plural of anecdote is not data.

    • In my opinion Jackart is a blinkered, cynical, selfish queue-jumper who believes that when it comes to health, you just need deep pockets and private health insurance. The fact is the NHS is the only complete health system in the UK. Private health offers no teaching hospitals nor the cost saving buying power of the NHS. Instead, private health companies cynically and immorally cherry pick experienced medical staff already highly trained by the NHS at public expense. Thus the private sector is a subversive, damaging parasite on the NHS and should ideally be outlawed.

      Those who are worried about the quality of treatment in the NHS should get up off their backsides and join the fight to improve and care for it; not succumb to moral cowardice by signing up to the private health sector in the hope of queue-jumping.

      Those signing up to the private sector have to disclose every medical problem they ever had. This is because there is often no insurance cover or restrictions for “problems related to pre-existing conditions”. This one fact makes a nonsense of all attempts to compare NHS care with the private ‘equivalent’.

      The NHS provides uniform, cradle to grave care. If you want similar cover from a private company, you’d better be a banker with a lifetime of fat bonuses to sit on, because once you’re past 60-65, the annual premiums become astronomically expensive at an exponential rate. Most of the moral cowards eventually come crawling back to the NHS anyway when their money runs out sooner than they anticipated.

      • Uncle_Lumpy says:

        >”In my opinion Jackart is a blinkered, cynical, selfish queue-jumper ”
        Fair comment but I disagree and might say the same about you. Anyway, moving on…

        >”who believes that when it comes to health, you just need deep pockets and private health insurance. ”
        Wrong! Do not pass Go, do not collect £200. Jackart believes that you shouldn’t let big bureaucracies run things like a Health Service.
        He has consistently said all through the argument that he believes in “Free at the point of delivery”

        >”The fact is the NHS is the only complete health system in the UK. ”
        So what. Wouldn’t it be nice to have another one? Or two, or thirty….

        >”Private health offers no teaching hospitals nor the cost saving buying power of the NHS. ”
        Two separate issues. I believe that Doctors and Nurses are trained at the Public’s expense? Why not make it a condition that they continue to train at NHS run hospitals for say, 10 years, as some sort of pay-back for all the money we’ve thrown at them for their training? How about they are obliged to train new Docs and Nurses coming through for a few years?
        Anyway, I reckon private health care companies might strike a better deal than the notoriously bad deals than the NHS (see PFI ad-nauseam, NICE, etc)

        >”Instead, private health companies cynically and immorally cherry pick experienced medical staff already highly trained by the NHS at public expense. Thus the private sector is a subversive, damaging parasite on the NHS and should ideally be outlawed.”
        I’m glad they pick the good ones. Be a bit silly to pick the bad or in-experienced ones. Immoral, parasitic? I expect that they’re paying better wages than the NHS. Might be an incentive to be a bit better at NHS run establishments. Oh, silly me, nothing to distinguish good from bad at NHS.

        >”Those who are worried about the quality of treatment in the NHS should get up off their backsides and join the fight to improve and care for it; not succumb to moral cowardice by signing up to the private health sector in the hope of queue-jumping.”
        Aaarrrrggghhh. The whole point of Jackart’s response is to say that the best way to improve the NHS is to reward the good bits. If the NHS were free to buy in the best performing, or cheapest, or quickest, or those with the highest customer satisfaction ratings, or any other combination, then I might have this choice that everyone keeps going on about. At the moment, I have to take whatever my local NHS gives me. It might be fantastic BUT I DO NOT HAVE A CHOICE.

        >”Those signing up to the private sector have to disclose every medical problem they ever had.
        This is because there is often no insurance cover or restrictions for “problems related to pre-existing conditions”.
        This one fact makes a nonsense of all attempts to compare NHS care with the private ‘equivalent’.”
        You have deliberatley misunderstood. It is the only explanation. He is not saying dismantle the NHS. He is not saying “get insurance or die”. He is saying that the NHS is a big, ugly machine that tries to do everything and does it badly and wastes money. You are not the customer. The customer is the State who pays it. That is why there are so many performance indicators, reviews, managers, commissioning agencies, consultants. These people are not there to help you get better. They are there to make sure the correct forms are filled out, the key metrics met etc. If the NHS were free to buy in services from the Private Sector, a marketplace, it will almost certainly be better, cheaper, quicker, more efficient that what they do at the moment. That is what the argument is. We get to choose what value we give to each of those things: better, cheaper, quicker, more efficient. If we like better, then choose that. If you like better and cheaper, then we choose that. At the moment, we do not have a choice. You get what they choose and that is what the NHS can give you.

        >”The NHS provides uniform, cradle to grave care.
        If you want similar cover from a private company, you’d better be a banker with a lifetime of fat bonuses to sit on, because once you’re past 60-65, the annual premiums become astronomically expensive at an exponential rate. Most of the moral cowards eventually come crawling back to the NHS anyway when their money runs out sooner than they anticipated.”
        Fine. Let the bankers get their private health care. It’s their choice. We don’t have a choice. I want one. I want to be able to choose whether
        to go to my local NHS hospital with all its services in-house, or, and this is the important bit, the hospital down the road that has subcontracted heart surgery to a Swedish company that can compete equally with the in-house services, and has a higher satisfaction rate with “customers” and and much higher success rate. I do not want to have to take private health care for it. I want the local NHS trusts to be able to decide that the Swedish company can do it better than their in-house unit and be able to contract for it. That is what privatising the NHS can mean.

        Please also note that I believe that the people working for the NHS are fantastic. They work hard, in shoddy conditions for not enough money doing a job I never could. Privatising the NHS *may* be the best thing to happen to them. It gives them a choice to work for a company that will pay them what they are worth. Shouting that it’s a race to the bottom is not the answer. We’re already heading downhill with the NHS. Throwing more and more money at it is not the way to fix it because that money does not end up in the right places.

        Enough. Before I have a coronary.
        Uncle Lumpy

        • FireflyRae says:

          Just for your information – doctors are required to work for the NHS after qualifying if we wish to work in the UK. Junior doctors in specialist training to be GPs or consultants are all working for the NHS, for an average of 7 years, with no other employer options unless they join the military, or leave the country, or leave training.

        • Peter Handy says:

          I am lucky that I haven’t had to call on NHS hospital services very often, but whenever I needed hospital treatment, I ask my GP which hospital he would use, and when I get the referral letter there are usually 2 or 3 choices. My wife and daughter have needed to use the system more often. My wife suffered a serious stroke around 30 years ago and has ongoing complications. Yes the quality of service does vary from one regional hospital to another, and between different departments of the same hospital, and between one GP and another in the same practice. Why would private firms, running all these facilities, each with there own individual ethos, provide a more uniformly high quality service?

    • You’ve replied to the article by ignoring every single well-sourced and backed-up point it makes, instead choosing to cite a rather pathetic personal anecdote. Well done.

    • A.C. Grabham says:

      Businesses really do such a good job in the world, look at the RBS, Lloyds, railtrack, the libor scandal, the list is endless. The pursuit of profit in a service industry will always be at the expense of the customer who the service is meant to serve. How can the introduction of a profit margin help to deliver a better service unless it is done pro bono? You have obviously never given anything for nothing or because it is the right thing to do. What do you believe in besides profit?

    • Lina says:

      As someone who sadly has to spend way too much time using the NHS I would like to say that I think the NHS is brilliant and should get a lot more credit. The fact that they manage as well as they do with the money they get is amazing and should be applauded. I think it’s an extremely bad idea to let something as important to the overall populations as health care go private.
      Small example – Sweden who used to have excellent health care (hopefully still does) privatised the ambulance service and since there has been cases of people dying at home as their injuries weren’t deemed serious enough for an ambulance to be sent. An ambulance not arriving on time is one thing, one not being sent at all is another completely. Before it was private an ambulance had to be sent every time someone called even if it didn’t seem serious.

    • Michelle Shalbrock says:

      Good response. What the NHS needs is complete free enterprise. Patients should choose their service provider based on their track record. No more mid-Staff cockups. Failing, incompetent, socialist units would simply go out of business and patients would be seen by professionals pleased to have them as clients – something we haven’t seen in England for decades.

      • Alex says:

        Yes Michelle, because the first thing most people think when they fall ill is “Me? I’m a healthcare client and I can’t wait to choose some healthcare services”. The NHS can’t go out of business because until recently it WASN’T a business. Do you see how it works?
        What you’ll notice about business by contrast is that poor customers aren’t of much interest. Annoying, unhealthy, moaning people, with a long list of problems and not much money – but screw them, eh? Anything else would be a little too much socialist medicine…

    • Lynne Gill says:

      Certainly isn’t the envy of the world since the private sector got its greedy little hands on it. Millions wasted on slick consultancy firms missing the whole point of what they were assessing; BILLIONS wasted on unworkable IT projects; millions wasted on Fundholding – and all this money wasted by the Private Sector.

    • Alex says:

      You haven’t actually read ANY of the details in the letter above have you? The details of which give very little succour to the imbeciles on the right who blithely assume that the market capitalism that makes fizzy drinks possible is going to be very interested in doing a good job on your difficult medical condition, unless that is, you’re paying bottomless amounts of money in cash…

      Also you’re confusing the US global healthcare outcome ranking with ours. We’re not perfect, but we’re the best possible at the moment:

      http://www.independent.co.uk/news/uk/uks-healthcare-ranked-the-best-out-of-11-western-countries-with-us-coming-last-9542833.html

      Most doctors and nurses I’ve ever dealt with, since childhood at the Great Ormond St., have been unfailingly polite, patient and professional. The fact that you couldn’t get seen with a bike injury doesn’t really refute 60+ years of successful national provision in my estimation…

  24. Absolutely fantastic… I do hope you get a reply..

    • June Hautot says:

      Absolutely Fantastic lets hope all applicants follow you Alex ! I hope for the day
      to come very soon when we will be in the courts, with proof of corruption, greed
      and theft of our NHS there must be a loop hole in the Law somewhere. Please anyone reading
      these comments stop and think before you sell your soul to any of these Vultures
      Thanks once again Alex.

  25. Omar says:

    Amazing!

  26. karen says:

    Omg Charlotte….you would have made a fantastic politician….except of course you wouldn’t actually stand a chance….You have a heart! Love it xx

  27. Bob Bailey says:

    LOL, you are a dick.

  28. sidthemanager says:

    Thank you. Thank you. Thank you. You have the job. When can you start?

  29. JD says:

    Rooting for ya

  30. oobidoobidoo says:

    A message for Jackass – sorry – Jackart. Yes, you are right: the NHS is no longer the envy of the world, as it has been savaged and neglected so much in recent years. It is also true that most western European health systems are better these days in all respects… but I would point out that those that are in ‘ruder health’ are those that are run on socialist (with a very small ‘s’) principles, while those that are getting worse have all been lead along the path to privatisation.
    The simple answer to the question of what we do with an ailing NHS is to MAKE IT BETTER. Which I hope is what it’ll do for you when you need it – because Care UK won’t give a toss.

    • James Brinton says:

      Thanks for that jewel of insight. Of course it needs to be made better, that’s the whole reason for the reforms in the first place. Perhaps you have some other pearls of wisdom for us concerning other sectors? For example “It’s obvious what to do with our public transport system, MAKE IT BETTER.”

  31. That is so well written, you should work in PR, except I would suggest you overly well endowed in one area that will limit your future employability, conscience!

  32. Stuart Nolan says:

    Beautifully done! Bravo!

  33. Ethelred Unready says:

    When do you start? Al

  34. Clare says:

    JAckart the health system in Norway is absolutely fantastic, you are correct. It is however, FREE. not private

    • Jackart says:

      Actually in norway it is Mixed, state and private, private provision (with state funding, which I support for the UK) is expanding, as it is in the UK. It is also a decentralised system with regional health boards.

      So 1) straw man
      2) wrong
      3) A healthcare system can be both free at the point of delivery AND significantly private.

  35. Dr Cas Shuttleworth says:

    Well done! I very much doubt you’ll hear back from these spineless bastards. This is the sort of thing that makes me feel sick with worry. I qualify as a GP in a year’s time.

  36. David Woods says:

    Reblogged this on ThinnerBlueLine and commented:
    Privatisation might be better for the public but somehow I can’t see how you can charge less, make profits for your shareholder and still provide a better or even equivalent. You either reduce your workers pay to make profit or reduce service. But then I only have an ‘A’ level in economics, and don’t hold the purse strings.

  37. Good for you! The last thing the NHS needs is a load of cynical profit-mongers. It needs many more of those wonderful, compassionate caring, overworked, underpaid angels whose life’s fulfilment is the care of the rest of us. The work of the NHS is priceless. Only a cynical fool could think of putting a price on it.

    • Jackart says:

      For every paragon you describe, There’s one lazy slattern, leaving arses unwiped and the elderly unfed.

      As there is in any profession.

      The N bit of the NHS ensures the lazy, time-serving and incompetent are not retrained or fired. Break it up and decentralise, then the Paragons multiply.

      • Alex says:

        Which is of course a completely fantastical, naive notion on a par with most other freemarket gibberish. If you’d read the letter above you’d see that the first thing that happens when you have free market players in healthcare is the quality of service gets squeezed, less senior people typify the headcount as profits must be made. Face it – big national systems are difficult and riven by complexity and administrative problems – but simply assuming the ‘hidden hand’ of the market will fix it is just as naive. Under your system, different people benefit – middle managers interested in cherry picking the most profitable illnesses perhaps. Lovely stuff.

  38. Dave says:

    ^check out this guy’s twitter. What a charmer.

    • Jackart says:

      Check out the ad-hominem and straw men on this thread. You lot are charming too.

      • W says:

        City of London Tapeworms should expect ad-hominem attacks on a daily basis. You choose your profession mate. Man up, or change job. I thought you, hot blooded, eyeball ripping city guys could take it!

      • UnbiasedPhilosopherChippingIn says:

        Nietzche (a man I don’t doubt you’d respect) once claimed that we should look past arguments – as the exchange of words rarely results in action – instead examining the motives and personality of the men themselves. Please also remember that the negative character we bring to light is one is not done so purely to damage your reputation, but because it suggests a competing interest (stockbrokers and private ownership seem to go well together). That is highly relevant.

        In this case, ad hominem as a fallacy can no longer be claimed, but if you have any better arguments than appealing to seemingly-superior European systems or ignorance to the suffering of the American poor, we’d be glad to see them!

        • Sean says:

          ..or in other words play the man not the ball. It pretty well sums up the shyster Nietzche was. Personally I go for Popper, politically he was left of centre but he gave us a solid scientific base for our arguments unlike that other great German Shyster Marx, who he falsified.

      • DaveP says:

        Jackart’s blog has a similar slogan to Fox News, and a similar far right agenda. Makes the Daily Mail sound like a peace march. Nobody, not even you, can really believe all that. You’re attempting to sell Far right politics to the hard of thinking and call it the middle ground.

        We’re not buying it and you shouldn’t be selling it.

        To believe that private healthcare and wild west banking is good for the country is to believe that David Cameron really does like pasties. A peddler of BS for personal gain or a sucker who can’t see the corruption all around him, it doesn’t make for informed comment. Middle of the class perhaps, but middle of the road – not so much.

        Suspect you’ll have a few extra hits on your dark blog today. None will witness a voice of reason or compassion or someone with an accurate self image. They will see the rants for what they are.

        • Alex says:

          Is the art of sarcasm lost on you? This is quite obviously a wind-up.

        • Trundle says:

          DaveP, I read Jackarts blog quite a bit and there is no way can it be considered ‘far right’.

        • Sean says:

          pure smeers. jackart is classical liberal / whiggish the idea its some sort of nationalist racist in tone and agenda tells more about you than he.

        • Tomsmith says:

          DaveP, It is bizarre that you cannot tell the difference between free market liberalism and big government conservatism like Fox News or the Daily Mail. These are entirely different ideologies

  39. matt says:

    with scruples like that Alex you will never make millions with them. good for you! also I think aced the section ‘knowledge of the private healthcare market’. what a legend.

  40. DaveP says:

    21 grand for what return? In the US, political “contributions” had an AVERAGE of 22,000% return last year. Are they supporting the party who benefits them most or are they buying bad policy for personal gain? You can’t tell, it looks identical. Corporations deciding elections is what created the mess of healthcare in the US, is that what the UK wants? 21 grand for “dinner with Cameron” may sound expensive, but not when you consider what your country can do for you at the expense of everybody else. Something so easily corruptable will always be corrupt, especially when the money stays within the old school network. Some inefficiency is always preferable to unfairness by corrupt design. The NHS should never be up for sale or it ceases to be an NHS and starts down the path of the US system: no cover below middle class, no decent cover below the top 10% and control of everything in the hands of tax-dodging corporations.

  41. Ethelred Unready says:

    The distance from the straight and narrow to the warm embrace of Mammon is but a short step. Ask Felix Dennis or all the lapsed trotskyists beavering away in the Labour Party from Lord Mandelson down. Good call, Care.

  42. Nathan says:

    My experience of the NHS is this: Fantastic hospital departmental care, and middling, often uninterested GPs.

    My daughter suffered Pyloric Stenosis manifesting from 3 weeks old, as I did 30 years ago. Frequent visits to the local GP surgery- and several GPs at that practice simply brushed us off insisting she was colicy and we should persevere with feeding. We were also told that the condition isn’t at all heredetory and is very rare in girls.

    This went on for a week, daily visits to the GP to be told the same. She was dehydrated and her weight started to fall. They still said the same.

    One night we decided to go to A & E as she was particularly distressed, we were seen immediately. A training paeditrician looked at my girl for about 30 seconds, felt around her abdomen, asked the history and said staright away that it was Pyloric Stenosis and that they would operate that night.

    They did, and all involved at the hospital were wonderful throughout.(This is New Cross hospital in Wolverhampton, which has received it’s own bad press, but also where I was very well treated when I was run over aged 12, where I continue to be looked after at the Eye Infirmary and where my brother was treated for his major stroke and plenty of other visits).

    On asking the doctor about her diagnosis she told us that there is indeed a high chance of inheriting the condition and that there is a fairly even split of cases between the sexes, also stating that ‘the GP should’ve seen it, it’s obvious’.

    This and other instances of misdiagnosis leads me to think that GPs are largely incompetent, or worse-indifferent.

    I’ve no problem with someone being ‘in it for the money’, that’s fine, it’s the only reason I go to work after all- but be the best you can be at it. If targets would improve GP performance then why not try it? Make them earn their money by being good at the job.

    As I state above, I’ve received and been a party to great hospital treatment by my local NHS Trust, a trust that has been under fire. The ‘bad’ treatment has always been through GPs- that’s where the biggest ‘kick up the backside’ is required

    Excellent letter by the way!

    • js207 says:

      Sadly, far from alone there: GPs do seem to be very much the NHS’s Achilles heel now. Never actually delivering treatment – practice nurses doing that, with anything more demanding involving a referral instead – just acting as gatekeepers and obstacles to actual treatment by real doctors.

      My brother has a chronic pain condition. He sees a very senior pain specialist in the nearby teaching hospital, who adjust his medication and sends the details to the GP – who second-guesses it and refuses to write the prescription until overruled. Does anyone benefit from that, besides the GP’s ego?

      This, not hyperbolic waffle about “privatisation”, is what troubles me about the current reform plans. Far from putting more money and power in the hands of GPs, we should seek to eliminate them entirely: a hospital secretary/receptionist could deliver the referrals, nurses could continue to deliver the routine vaccinations, blood pressure checks etc as they do now but without a GP in the way.

  43. [...] genius post : Going private? My reply to a job offer from a private health company Share this:TwitterFacebookDiggStumbleUponPrintRedditLinkedInEmailLike this:LikeBe the first to [...]

  44. Maybe Laura is an ally, and thinks you’d be perfect for the job!

  45. Paul Cotton says:

    Alex, yerra Don Lar…….!

  46. Hilary Wardle says:

    YOU, Sir, are fantastic. I like to imagine you have a handlebar moustache. If you don’t, you should grow one straight away so you can stroke it while writing witty, explosive emails that tear private healthcare firms a new one.

  47. In my job I’m approached almost daily by people asking me to pay them for what I get paid to do… I nearly always mail them back stating their stupidity and lack of basic research, but this really, really is inexcusable. Such a great response.

  48. Notanidiot says:

    Why do people hate stock brokers and bankers? Jealousy. The only people who oppose privatisation of the NHS are people who just don’t have a clue. Provisions are made for those who genuinely can’t afford it or can’t work. Those who are too stupid or lazy to get a job which pays a decent salary could do with a kick up the arse anyway. Maybe the idea of no free healthcare or handouts might get them in gear.

    • jussi10 says:

      I’m not jealous of stock brokers or bankers. I am a nurse. I see incredible suffering on a daily basis and yet I love my job. I don’t make that much money considering the hours I work or the studying that I have done to get to where I am. But you know what at the end of the day I can sit back and think to myself I am a good person, I do what I do for the benefit of other people and I am very privileged to be able to do it. I love our NHS because it means that those people in society who are less privileged than the rest of us are equal at least when it comes to the provision of health.

  49. Jon Harris says:

    I’m going to find a hat immediately, so that I may doff it in salute. Brilliant.

  50. Nicki says:

    Dear Jackart,
    i before e except after c! It is an easy enough rule to learn. Receive! not recieve!

    Happy to say I am one of those “slatterns” that works for the NHS. Start work at 7.30am (1/2 hour early) and usually finish at about 5ish (1/2 to an 1 hour late) having taken a 20 min break when I can fit it in. I have a family to look after and do voluntary work – I must be very lazy indeed!

  51. KI says:

    Interesting that Jackart has nothing to say about the author’s long list of Care UK’s overt fleecing of government funds. Of course acknowledging that private health services readily sacrifice quantity and quality of service in order to maximize their profits would make it significantly harder for him to condescend to the rest of us about how we just don’t understand corporate efficiency.

    Private health services exist to turn a profit, not to care for people. If that means short changing the tax payer millions of pounds on their contracts, hey, that’s just efficient use of resources. It’s not Care UK’s fault that the NHS hasn’t figured out how to save some quid by punting complicated surgeries, replacing doctors with nurses, and skimping on sanitation. If only the NHS operated on profit, we could all receive efficient services like patients of Care UK. Oh to dream!

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  53. Trundle says:

    I’m all in favour of getting rid of the NHS as it is currently constituted. It has totally failed to provide adequate and acceptable health coverage for the taxpayer. It might be brilliant in some specialist areas such as neonatal care, but in general it’s a rubbish system. The average customer of the health ‘service’ has to put up with GP’s who seem to serve themselves and the NHS structure rather than the patient, long waits at A and E, scandalous geriatric care (admission to an NHS geriatric ward is to be quite frank almost a guaranteed death sentence) and dirty, disease ridden hospitals. Oh, and Mental Health services that are the scandal of the western world. It would be cheaper and more efficient to issue every citizen (note I said citizen not some foreigner who’s just got off the boat) with a personal heath budget of £1 million in the form of a special debit card and let them spend it with whatever health provider and on whatever treatment they choose.

    I’ve no problem with health care being free at the point of use but I have a major problem with the NHS being in effect a monopoly supplier. Either give us the freedom to spend our health budget ourselves or stop thieving so much tax to pay for an inefficient and frankly deadly National Death Service.

    I used to be a lefty until I had to make use of the NHS healthcare system and saw the whole rotten edifice in action. The NHS is riddled with failure and is a prime example of producer capture in action.

    • Gordon Powrie says:

      Irony? If it wasn’t for the NHS, I wouldn’t be here!. There’s no way that my mum and dad could have paid for the operation that saved my life when I was 6 weeks old.

    • Yet, the NHS largely produces healthy people and positive outcomes. I’m not sure which country you’ve been living in. Perhaps it was the USA and you got mixed up?

      Is there a country with a perfect healthcare system? If so, I’d like to hear which one, and particularly your experiences in using the system.

      Isn’t it a huge assumption to guess it will become more efficient through farming out most of it’s core work to private companies, with essentially zero experience?

      Companies are efficient at making profits. Sometimes. After all, there are good companies and bad companies are there not?

      Why the constant assumption that these particular companies will be any good? After all, if they knew anything about healtchcare, are were all about patient needs instead of profit, they’d be in there improving the NHS instead of whinging about it and looking for the best place to get their next paycheck.

      I am all for competion in private markets. I want choice in where I buy a tin of beans. But the idea that choosing a healthcare provider is that simple, and the same doctors who are apparently deadly inefficient and incompetent now, will do just fine, once they have lots of competing companies with no track record to choose from is absurd.

      Soon we’ll be known as the ‘schoolboy error’ healthcare system. Because people with zero experience and only motivation to make money just simple can’t produce good healthcare.

      Have you looked at the price of a decent private dentist lately?

    • Charles Johns says:

      In total agreement with Trundle. I’ve had to make use of the NHS, Hospitals and
      doctors in the last few years. Sorry! the nursing staff are nowhere near efficient or as clean or capable as they were in the past. With no sense of pride in the job, and
      lazy to boot.

      • sum_won_els says:

        The results of any of the studies into various measures of health system performance show clearly that up until very recently, the NHS was the best in the world. This is a fact widely accepted internationally by those who take it upon themselves to study such things.

        The same studies show a startling correlation – a higher proportion of health systems under private control is conclusively shown to mean lower standards in most measures of health system performance. One need only look at statistics on access, efficiency and health outcomes of the US system for a picture of the perils of leaving healthcare in private hands.

        Trundle’s main issue was with efficiency and ‘bang for buck’ – here’s news: the NHS is the most financially sustainable system in the world.

        Charles Johns’ main issue seemed to be with the attitude of employees of the health system. I would suggest that this is largely to do with a combination of the training institutions (which – surprise, surprise – since New Labour’s rape of the education system are being increasingly run on profit models) and the preference of successive governments to spend money on military hardware than training enough staff and paying them properly.

      • zeb says:

        “With no sense of pride in the job, and lazy to boot.” – when I’ve used the NHS over the last few years I’ve seen more a case of overworked, undervalued and demoralised, a bit of a change since before the cleaning got contracted out and the matron did the inspection

      • Alex says:

        I think it depends on where you are; I was in hospital just the other week and the nurses couldn’t have been nicer. One time an old guy dropped his bed adjuster and a nurse ran over almost cheetah like to pick it up for him.

      • Pablo says:

        Maybe this is due to MASSIVE under-investment by consecutive so-called ‘govern’ments through the 80’s and early 90’s? Effects still being felt now…?

    • Tom says:

      If you don’t like it Trundle, may I suggest you go to the U.S.A. Trouble is, if you don’t have much money you won’t be getting any care.
      But as this is the system you appear to be advocating it looks like you might be well off financially, maybe this just a case of I am alright jack?
      Or just a lobbyist on a night in?
      You have never been a ‘lefty’…. That much is obvious.

    • Steve Wilson says:

      I have had six surgeries on the NHS, by my count if I had been living in America I would now be 300,000 dollars in debt, my credit score ruined unable to get a house. If you are able to wait they ask you to wait, I had to wait six weeks for my back surgery. When my gallbladder died and was gangrenous inside of me I had it out the morning after I went into AE. Nothing is perfect but the very idea that a company who’s main goal is making money instead of making people better, being in charge of healthcare makes me sick

    • loobyloo says:

      It’s a myth to think that competition with the NHS will improve the NHS. It won’t. It will only result in more resources going into competing facilities with resulting impacts on NHS staffing, fragmentation of service provision, and disgruntled patients. The NHS is the country’s largest employer, and by and large provides a very high quality service for a fraction of the price of systems in, say, the US, which spends a the highest per capita on health in the world but fails those most in need.

    • James Dowse says:

      Oh how easy it is to generalise, takes little effort at all. All geriatric care is a death sentence? all dirty, disease ridden hospitals? All black people have rhythm and there isnt a woman in his country that can park…. cheap shots.
      Pay the NHS the same rates as the publicly funded private initiatives and we’ll see about cutting your waiting times.
      Every organisation has it’s flaws. Happy with your last mot garage bill, the last meal out you had? If i was to reply in the thoughtless manner in which you berate the health service i would simply say: everything thing you say is rubbish, worthless and full of lies.

    • Hello.Kitty says:

      I’ve just come back from a country where there’s no state heath cover. Want an ambulance? That’ll be £50 before you get in. Want to see a GP? That’ll be £50. Want to give birth? That’ll be £3500 paid upfront before you’re admitted to the labour ward with the rest being payable before your child is allowed their birth notification.

      The “great” thing with private hospitals is that they can refuse entry to potentially stat-damaging cases. The NHS takes everyone, regardless.

      The NHS isn’t perfect, but it’s still a fabulous resource which is all too easily taken for granted. If it weren’t there, many wouldn’t be able to afford basic medical treatment, and that’s a horrid situation to be in. I’ve been there.

    • Terry McCusker says:

      So just because you had a bad experience of the NHS its a rotten edifice? From an entitiy that is the third largest employer in the world and provides a services to almost everyone in the country (except the rich people with private health care) – don’t you think it just might be a bit of a mixed bag? If we are talking about indvidual experience my wife was diagnosed with cancer and was treated (succesfully) in a clean state of the art hospital by some of the best consultants in the world. She’s still walking around today because of the NHS. If you are in agreement to a health service that is free at the point of use, what about someone with cancer? Their treatment could take months or years, what happens then? Don’t you agree there are certain shades of grey when it comes to healthcare? When (not if) the NHS is privatised and you have make use of your free, consumer choice I hope your credit card has some room on it. Good luck.

    • Sam says:

      So penalise the critically and chronically ill is what you’re saying?

    • Alex Feather says:

      Erm. The NHS is widely regarded as the second best health system in the world with some of the most ground breaking treatments anywhere in the world. And if you think GPs are self serving then applauding the handover to GP groups isnt going to cut it either. In fact the GPs by and large dont want these changes either because on clinical grounds its not defensible and it carries terrible risks and its a huge waste of money and time. The american health system is a disastrous system which this government are trying to emulate. I cant hardly begin to describe how idiotic these changes are.

    • George says:

      I find it really irritating to hear personal experiences generalised to condemn all services. Challenge those who give you poor service and provide an analysis, as has been done in the article, to make a useful contribution.

    • actuallybothered says:

      There is NO WAY you used to be a lefty. No lefty in the universe would ever come up with the sort of tripe you’ve been writing. Fine, the NHS has its faults and weaknesses, but it’s not the concept that’s failing – it’s corporate GREED. And as for the ‘foreigner who’s just got off a boat’, I wish people like you would just go get on a boat and get the f off this island. We’d do much better to be inhabited on this island by real lefties, wherever they happened to come from, because lefties generally have more care and concern for others, and are usually not just out for what they can get.

    • jill says:

      I couldn’t agree more. The NHS is widely lauded and nobody is willing to publciy admit that its staff are not all angels. My elderly father was admitted for a standard procedure and after 3 months in hospital includin a hospital aquired infection, has been redcued to a shadow of his former self. If you have a heart condition or are having a baby they’ll pull all the stops out, but if you are elderly or are suffering from depression they really can’t be bothered. The NHS seems like an amazing thing until you actually have to use it.

      • Hannahbean says:

        I think that the times that the NHS provides poor service is down to lack of funding and overworked staff. My sister has had numerous operations for an illness and will probably continue to do so and there is absolutely no way she would be able to afford that care if she had to pay for it. Her care has ranged from brilliant to awful but I maintain that when it has been bad it was down to understaffing. And you mention that people with depression dont get effective care? From personal experience I was referred immediately and was seeing someone within 2 weeks of speaking to my GP. No our system is far from perfect but show me a health care system that is. I take pride in the fact that we have the NHS. Can you imagine having to pay for any treatment? No matter what it was? If you can and you can afford it good for you but I would get you to meet with people already struggling to make ends meet and sit and do a budget with them as to where they could scrape the cash from.

    • Anne says:

      You really are quite the ‘geriatric’. The term has not been used in the NHS for at least 10 yrs. It’s ‘Elderly care. http://www.nice.org.uk/newsroom/news/CallsToFollowNICEQualityStandardToImproveElderlyCare.jsp

      Foreigner’s getting off a boat ? I’m assuming you are including asylum seekers too? So I’m thinking that all people, in your ‘mindset’ are not equal when it come to emergency/ urgent clinical care or plain old popping into a walk in clinic or G.P surgery. As a nurse I am bound by a code whose principles guide us in safeguarding the health and well being of the public. Public to me is whom ever I happen to care for in my professional work regardless of whether they can pay for it.

      I doubt Whether you have ever been guided by either principles, morals or ethics.

      May i remind you that the NHS was set up to banish inequalities in a health care system that saw my mother watch her niece die in her mothers arms due to a childhood illness that has now been eradicated due to an up to date vaccination programme. She died because her mother could not afford the ‘tuppence’ to get the doctor out. Maybe one day you might see the care and responsibility towards human kind in this service beyond the money and management.

      • Anne says:

        The above is in reply to ‘Trundle’ by the way. I think most people on here would attribute those awful comments to above said.

    • Alex says:

      ” It has totally failed to provide adequate and acceptable health coverage for the taxpayer.”

      Wrong. Not even close. Please look at the statistics:

      http://www.independent.co.uk/news/uk/uks-healthcare-ranked-the-best-out-of-11-western-countries-with-us-coming-last-9542833.html

      “It would be cheaper and more efficient to issue every citizen (note I said citizen not some foreigner who’s just got off the boat) with a personal heath budget of £1 million”
      Really? You’ve costed that have you? Because that sounds essentially MENTAL.
      But maybe in whatever godforsaken UKIP corner of this country you live in, everyone’s immortal so it’s all fine…

  54. Ace says:

    Hahahaha… Brilliant!!! I would be curious if the art of sarcasm was lost on them… What a blast it would be if your reply was taken as out-of-the-box thinking and you were actually to receive a date for your interview. In that case a follow-up blog of how the interview went would be much appreciated! ;)

  55. [...] Where there's brass there's muck…. A reply to a job offer from Care UK [...]

  56. [...] A letter to Care UK (funny but tragic in its implications). [...]

  57. Jason Jayes says:

    I worked for Care UK for 3 years. I’ve attended head office meetings were 5 or 6 people on 70k or more each discuss little more than how to reduce the cost of orange juice in their care homes. One of the directors of residential dementia services was very keen to remove nurses from their homes and just have a ‘super nurse’ on call for 3 or 4 local homes. No concerns shown as to the needs of the residents or the underpaid and overworked care staff. Some of this stuff beggars belief. Despite getting up to 1k per week or more for providing residential dementia services, Care UK generously provide a paltry 3p per person per day for their stimulation once they move in. Here’s a testimony in the words of one of their care home residents re the quality of his care; http://trebusprojects.org/read/stories-from-the-archive/john … read it and weep.

    • RoRo says:

      I was extremely worried before, now I have no doubt this country’s healthcare system will descend into a complete shambles :(

    • actuallybothered says:

      God this is so so worrying. Not that I’m surprised or anything. More that everyone is openly reading and sharing such information, yet still the country is being sold off to the private sector before our eye-boggled eyes… Utterly depressing…

    • Anne says:

      That says it all Jason , straight form the ‘Horses Mouth’ so to speak . Money, money and more money. This is why Private companies have to stay out of the NHS

  58. hks says:

    Pathetically posting the draft of an email that no doubt never got sent.

    • Carpe Diem says:

      Oh dear hks what a pointless reply. But if it made you feel better to say that then that will be £1200 thanks!

    • matthew says:

      Politically motivated smears without a shred of evidence to back them up merely serve to display your petulance. What on earth brings you to think that somebody who has followed this line for years would write such a long, eloquent piece as this and not send it? Not everyone in this world is as narrow minded, self-serving and cowardly as yourself.

    • SJB says:

      Hks – Pathetically posting a completely lame response to a brilliant letter and not even having the balls to apologise to Alex when he confirms he did actually send it.

  59. Clarissa Bone -Idle says:

    A job. A JOB? How dare they. Don’t they realise that could seriously interfere with the production of your forthcoming hit single? Don’t worry, Jackart is working hard to keep your housing benefit topped up. You show them. Let’s have more PROFANITY on twitter. Caitlin Moran knows some REALLY rude words you could use to help with street cred.

  60. Mln says:

    Surely it can’t all be positive?

  61. Tomsmith says:

    Why is it better for NHS bureaucrats to ration how much everyone is allowed of their own money as opposed to just jetting them spend their own money as they see fit? It isn’t “fair” if you use the government to forcibly take my money for your purposes, is it? To me, that is the epitome of unfairness. Why should I pay to treat your cancer if I do not want to do so? We all die after all

    • Carpe Diem says:

      Oh Tom, and the same would apply to you to. Lets face it compassion seems to be missing in your life. It seems you have bought the greed t shirt and will wear it proudly. Nevermind eh we won’t hold it against you afterall if your that selfish you won’t care what we think. But I hope that when your costs for private health care go up and up and you can’t afford to do the things you used to enjoy you’ll think even for a split second and remember that once there was a cheaper alternative that may not have been perfect but at least it was there.

      • Tomsmith says:

        It can only be called compassion if it is freely chosen. If the government takes my money and spends it on your health condition then that isn’t an act of compassion from me. If you vote to have the government take my money and spend it on you then that isn’t an act of compassion from you. Selfish is not wishing to take care of friends and family above total strangers; it is believing oneself entitled to what is not yours.

        • B.O. Locks says:

          @Tomsmith

          It’s not your money. Tax levied on citizens belongs to the State. In a democratic society you are free to campaign against the State’s spending priorities and to vote against them. That is one of the purposes of democracy. In the meantime, a democratic State has a legitimate right to levy tax on you and other citizens and to spend the money in accordance with the programmes for which it was elected.

        • Tomsmith says:

          @B.O. Locks

          It is my money until the state takes it. Taken to its extreme the logical corollary of your argument is that nothing belongs to the individual and everything belongs to the state, which is of course ridiculous.

          Democracy is merely the majority deciding how the minority gets to live and using force to make it so. This is nothing to be proud of.

        • B.O. Locks says:

          @TomSmith

          I don’t recall anyone from HMRC applying force to me or anyone else by way of obtaining tax revenue. Using the word “force” to describe the way tax is collected is emotive and misleading. Your arguments would be stronger if they exaggerated less and were less emotive.

          You are right in one respect though. Everything does ultimately belong to the Crown. We merely have a lease granted by the Crown on our property. Obviously things have developed in modern times to modify this stark arrangement but I suspect a study of our Society’s development might confirm the ultimate truth of what I say.

          You frame your description of democracy in such negative terms. In modern democracies, minorities are protected against majority oppression.

          Democracies allow a majority to legally remove an unpopular government, without force, every 4 or 5 years. This makes for political stability which facilitates investment and economic development from which both you and I benefit. I wouldn’t knock it – the alternatives to democracy are much worse.

        • Tomsmith says:

          @B.O. Locks

          There is no exaggeration here; the state will send men in uniforms around to your house and remove your property and/or liberty if you do not pay its taxes. This is the use of force.

          If I own myself (which I do, since to argue against is logically self defeating), then I own the product of my labour and the state does not. You conflate state seizure of what I own with state ownership of the same. I do not voluntarily give any of what I own to the state. I do not contract with the state for provision of goods and services. The state merely takes what it wants and throws me whatever scraps it sees fit.

          Democracy is a facade hiding the legalised plunder of the productive by the unproductive and the parasitical. I don’t suggest any alternative to democracy since all political systems are based upon the same principles of force, coercion and plunder.

        • HMRC may do what any creditor may do in satisfaction of an unpaid debt – send in the bailiffs. Private sector organisations make frequent use of this remedy to enforce County Court judgements against reluctant debtors. So HMRC (the State) is no different from any other player in this respect.

          It makes little sense to castigate HMRC for use of this remedy but not other (often private sector) organisations, Do you oppose this remedy in all cases? In each case, lawful confiscation of a reluctant debtor’s s property will be authorised by the State via a Court judgement and subsequent enforcement proceedings.

        • B.O. Locks says:

          Every UK resident, has a right to recover debts owed to them through the civil courts. HMRC is no exception. Further, if a court judgement is obtained (ie the debt is proved) then the plaintiff may subsequently take enforcement proceedings which may include distraint (the bailliffs). So when the HMRC sends in the bailliffs to recover unpaid tax it is not exercising special powers given to it alone. HMRC is subject to the same laws as everyone else. Anyone owed money can take the matter through the civil courts.

          I believe you are naive to say that you “own yourself”. No you don’t, that’s a delusion. The fact is that ultimately, you are owned by the Crown, whether you like it or not. In times of war you can be conscripted and to kill and be killed on behalf of the Crown. it’s not voluntary. In the UK the starting point is State (or Crown) ownership. The liberties we possess have been conceded to us either through struggle or because of the State’s genuine liberal disposition. The best you can hope for is to live in a liberal democracy that recognises its human rights obligations to its citizens and this is what you’ve got here in the UK.

          You omit the free rider issue, which is where some people will seek to benefit from the assets and toil of others without paying If I build a road, how do I stop others from using it for free even though it is my money that built it? The solution to this problem is probably not desirable or efficient.

          The State permits you to keep the post-tax fruits of your labour . You may believe the tax rate to be too high but this is something about which you can campaign. By choosing to live and to earn money in the UK you have effectively volunteered to abide by the UK’s tax code. Just as employees have agreed to surrender a large proportion of the fruits of their labour to their employer via the employment contract

        • Tomsmith says:

          @ Garnet College

          Debts in the private sector are not comparable to taxation in any way. In the private sector you voluntarily contract with another individual and agree upon a mutually beneficial exchange. In dealing with the government there is no contract, no voluntary agreement, and no provision of what you actually want. The government merely provides you with what it decides you want, and then charges whatever it sees fit to charge. Do you see the difference?

        • @TomSmith

          Nope, I don’t see the difference. it matters not whether a debt is created through a contract or through legislation. In both cases the debt is legally enforceable.

        • Tomsmith says:

          @ Garnett College

          “Nope, I don’t see the difference. it matters not whether a debt is created through a contract or through legislation. In both cases the debt is legally enforceable.”

          I will make sure to arrange for a group of thugs to come round your house. You can vote among yourselves whether they should collect the debt they believe you owe them. Hope that sounds fair.

      • Tomsmith says:

        @ B.O. LOCKS

        Debts aren’t owed to HMRC because HMRC did not contract with anyone to provide them with what they wanted. If I send you a parcel containing a dog crap and then show up at your house demanding 1 million pounds in return am I acting in a logically defensible way? It is nonsensical to argue that the government is subject to the same laws as everyone else.

        Self ownership is a presupposition of argumentation; a person contradicts themselves when they argue against it. It matters not that governments claim ownership over people. What matters is a logically consistent position. Government ownership of people as chattels is an idea that contains a fatal logical contradiction.

        If you build a road you prevent others from using it for free by building toll booths with barriers. You know, the way most toll roads in the UK and abroad work? Roads are not ‘public goods’ because non-paying users can be excluded easily and so are uncontroversially best provided by markets.

        Arguing that I “choose” to live in the UK is meaningless unless I am presented with the option of declaring myself independent or moving between various political systems with my possessions until I find the one I like. I am not, and so this common social contract argument is void..

        • B.O. Locks says:

          @TomSmith

          HMRC assesses and collects tax on behalf of the government. If you decline to pay your tax bill when you receive it then you should be aware of the consequences. There is little point in me advising you. Sometimes people need to learn by experience. Perhaps you are one of these people.

          The right to recover debts is not limited to our government- every UK resident can recover debts owed to them through the Courts and by subsequent enforcement action. Enforcement action can mean state sanctioned agents entering a debtor’s house and removing the debtor’s property in satisfaction of the debt. So it is not just the State (Crown) that has this right; private individuals and companies have this right too.

          Tolls work on specific road projects such as a bypass, a motorway, or a bridge. You won’t find any country in the world where all, or even most, of its roads are tolled. This is because such a system is inefficient and governments possess enough sense to realise this. The transaction costs would be enormous.

          You are free to live in another country if they will have you. Alternatively, if you don’t wish to pay UK tax then you are free to eschew all the benefits of our Society and to become a tramp.

      • Tomsmith says:

        @BO LOCKS

        As previously pointed out, debts are not owed to governments because nobody voluntarily contracts with governments for provision of anything (i.e. the way all other debts are arrived at). Government merely takes whatever it wants to take from whoever it wants to take from using force. This is not comparable to debt recovery for goods or services provided but not paid for. It is instead plunder or tribute.

        Private individuals do not have the right to demand tribute from other private individuals, nor do they have the right to provide so-called services to unwilling or unknowing customers, charge them whatever price they fancy, and then use violent force to collect the “taxes” they believe to be owed to them.

        Road systems are the way they are because they are controlled by governments. It seems that you are merely ignorant on this issue. There is no reason for motorways and intercity road not to be privately owned: they are rivalrous and excludable and therefore count as private goods. Feeder and collector roads may appear to present a more difficult issue since it is difficult to exclude people from using them given their complexity and the large number of entrances and exits. In the past this might have been a place where government administration could provide a competitive solution but technology solves this problem now that everyone on the road has GPS and distance traveled can be charged to customers by the owner. Lastly there are local streets which are excludable but are typically non-rivalrous (apart from the most congested). These are what is known as club goods and are most efficiently owned by groups (e.g. resident associations). There is no place for government involvement in road administration at all. All the government can do is introduce inefficiency and distortion, resulting in the woeful road system we see today. Charging by use is inherently more efficient than charging a via the tax system because it involves pricing and the information conveyed.

        The fact that I am “free” to move to another tax farm with whatever pittance this government will let me keep, or to sacrifice all worldly possessions and live like an animal in the woods does not make my failure to take either of these choices a tacit agreement with the rules of tax/tribute collection in this country. For this social “contract” to represent a genuine agreement on my part I would need to be able to opt out of the UK tax and benefit system all together, with all of my possessions intact. Obviously I am not allowed to do this. I wonder why?

        Here is another analogy for you: if you are born a slave on my plantation and I suggest that you must agree with your captivity since you haven’t volunteered to move to the slave plantation of my evil and sadistic friend or made a break for freedom in the malaria infested swampland leaving your family behind, am I being disingenuous?

        • B.O. Locks says:

          Yes, GPS could facilitate road pricing. Road tax could conceivably be abolished as a consequence. The government could then invoice each road user at the end of each month for road miles used. No need for private sector involvement.

      • Tomsmith says:

        @BO LOCKS

        Eureka, lets just have the government running everything because that isn’t inefficient at all. Oh..wait…

        Joking aside, government is inherently incapable of providing services as efficiently as markets do because markets involve pricing, competition and choice. The only economically defensible role for government involvement in providing anything is in the case of public goods, and roads are not public goods.

    • zeb says:

      Why should I pay to:
      have the legal system work for you if a crime has been committed against you
      have you or any children you might have educated
      subsidise the roads that you use either directly or indirectly through road delivered services you use
      etc

      • Tomsmith says:

        Zeb, you shouldn’t have to pay to have any children of mine educated or to pay for my use of roads. These things are better provided by the market. You wouldn’t expect me to buy food for you would you? Why then should I buy healthcare, roads and education?

        • B.O. Locks says:

          Because of market failure.

        • Tomsmith says:

          Markets are perfectly able to supply healthcare, roads and education. None of these are public goods. It is not any issue of mine if Zeb or B.O. Locks are unable to buy exactly the the healthcare, roads and education they desire. I would like a wine estate in Burgundy, an Aston Martin, a hand made Swiss watch, and the financial freedom to retire young and yet I cannot afford any of these things. Needless to say, the reason is not “market failure”

        • B.O. Locks says:

          Our government has a legal obligation to ensure that every child has access to education. Provision of universal education would not be delivered if it was left to the market. Parliament has enacted legislation at various points in time to ensure universal access. Pre-legislation, the market failed to provide education to vast swathes of the population.

          With health care, we only need to look at the USA to see how the market fails to provide for all. This has already been discussed on this blog and includes a contribution from at least one US citizen who gives a first hand account of how the NHS is superior and the absence of universal coverage in the USA.

          With private roads, the transactions (administration) costs would be so high as to make it inefficient. This is a type of market failure.

          Incidentally, would you be happy to have outbreaks of typhoid, say, go untreated? Or perhaps in your Libertarian world you would have a right to kill someone so afflicted and to burn their remains? No need for court action or legal sanction, eh? Blasted nuisance.

          When you talk of Aston Martin’s et al, I suggest you are confusing luxury items with basic needs.

        • Tomsmith says:

          @ B.O. LOCKS

          “Our government has a legal obligation to ensure that every child has access to education. Provision of universal education would not be delivered if it was left to the market.”

          Tautology

          “With health care, we only need to look at the USA to see how the market fails to provide for all. This has already been discussed on this blog and includes a contribution from at least one US citizen who gives a first hand account of how the NHS is superior and the absence of universal coverage in the USA.”

          Provision of healthcare in the US is not via the unregulated market. Government controls the provision of healthcare in the US and complaining about this government distorted market is equivalent to complaining about government.

          What does universality have to do with anything? We are not all able to have access to the most desirable things in life. This is merely a complaint about the physical reality of existence and so irrelevant. It isn’t unjust that through their own efforts some people have access to more desirable things than some other people. We cannot all have access to the best healthcare currently available. Provision of healthcare, like most other things, is best rationed by price.

          I would be completely comfortable for mythical typhoid outbreaks to go without government intervention (which obviously is not to say that nobody would do anything). I am sure that most people do not wish to have typhoid and so would take appropriate sewerage and medical measures to make an outbreak absurdly unlikely.

        • B.O. Locks says:

          Market failure occurs when market mechanisms fail to deliver desired outcomes efficiently or at all.

          Universal coverage is an outcome desired by elected UK government for roads, health and education. Market mechanisms have yet to demonstrate they can deliver universal coverage efficiently or at all in these fields. A brief study of the development of the UK education and welfare systems will demonstrate this.

        • Tomsmith says:

          @ BO LOCKS

          “Market failure occurs when market mechanisms fail to deliver desired outcomes efficiently or at all.”

          No, market failure occurs when allocation of goods and services by a free market is not Pareto optimal.

          “Universal coverage is an outcome desired by elected UK government for roads, health and education. Market mechanisms have yet to demonstrate they can deliver universal coverage efficiently or at all in these fields. A brief study of the development of the UK education and welfare systems will demonstrate this.”

          Ignoring for a minute that you repeat your tautology, universal coverage is not and can never be Pareto optimal. Market failure doesn’t happen when markets do not do what the government wants them to do.

        • B.O. Locks says:

          @Tomsmith

          Healthcare is not a commodity. it differs from consumer goods. It is a social good.

          The government mandates universal coverage of health care because it is a social good and because the electorate wills it. You may resent democracy but that is what we have got and long may it continue.

          I reject your philosophy because I suspect it is a cover for a hidden agenda. Marketising healthcare would exclude the poor and the chronically ill from medical treatment. They would not be able to pay privately for their treatment. They would consequently be left to suffer and to die prematurely. This is your true agenda, I suspect. It is the agenda of a new and self-appointed “ubermenschen”. It now has a large presence on Twitter and on the World Wide Web.

          In your scheme, only people who you and your “ubermenschen” brethren approve of are worthy of life. In your philosophy, only those deemed worthy of life should receive medical treatment when they fall ill.. Essentially, you wish to eliminate the poor, the so-called “feckless”, and the chronically sick by depriving them of health care. Advocating a marketised allocation of healthcare is just a disguise for this policy of deliberate and malicious killing.

          Hopefully, people will wake up in time to the real agenda of so-called Libertarians or “small statists”. it is a murderous agenda.

        • Tomsmith says:

          @BO LOCKS

          “Your statement that the US healthcare system is no less government controlled than the UK system is just plainly and simply wrong. For a start, healthcare in the UK is DELIVERED by the government. In the USA it is delivered by PRIVATE healthcare providers. Secondly, in the UK healthcare is free at the point of delivery. In the USA, treatment is conditional on payment and those in employment who are unable to pay go without.”

          Delivery does not amount to control. That the US government chooses to ration healthcare in a way that is different to that of the UK government does not change the fact that both are systems of rationing or command economics, rather than market systems.

      • Tomsmith says:

        @ BO LOCKS

        “Healthcare is not a commodity. it differs from consumer goods. It is a social good.”

        Healthcare is a service that is both excludable and rivalrous, meaning that it is most efficiently provided by the free market. The only social good is freedom because different individuals require a myriad different things, not an irrational personification of institutions or groups. Any “social good” that deprives individuals of the ability to freely choose what they want and instead presents them with the imagined desire of a personified group is self defeating

        “The government mandates universal coverage of health care because it is a social good and because the electorate wills it. You may resent democracy but that is what we have got and long may it continue.”

        As previously discussed, democracy is the forcible imposition of the desires of some people over those of some other people.

        “I reject your philosophy because I suspect it is a cover for a hidden agenda. Marketising healthcare would exclude the poor and the chronically ill from medical treatment. They would not be able to pay privately for their treatment. They would consequently be left to suffer and to die prematurely. This is your true agenda, I suspect. It is the agenda of a new and self-appointed “ubermenschen”. It now has a large presence on Twitter and on the World Wide Web.”

        Why on earth would I want people to suffer and die prematurely? Are you claiming that people do not currently suffer and die prematurely?

        “In your scheme, only people who you and your “ubermenschen” brethren approve of are worthy of life. In your philosophy, only those deemed worthy of life should receive medical treatment when they fall ill.. Essentially, you wish to eliminate the poor, the so-called “feckless”, and the chronically sick by depriving them of health care. Advocating a marketised allocation of healthcare is just a disguise for this policy of deliberate and malicious killing.”

        Not at all, a free market system of healthcare is simply the most economically efficient way of providing healthcare. This is because it is not a public good, just as roads are not. Being free from the forced spending of my money according to the desires of some other people is not equivalent to wishing to eliminate the poor. Elimination of the poor by definition would have to involve, you know, actually eliminating poor people. Are you responsible for eliminating the (insert popular victim group) whenever someone dies that you didn’t do everything in your power to help? To claim this is absurd.

        “Hopefully, people will wake up in time to the real agenda of so-called Libertarians or “small statists”. it is a murderous agenda.”

        You seem rather hysterical

      • Tomsmith says:

        A merit good then is something that someone believes the state should cause to be given to certain individuals as a positive right for various reasons. These typically include things like negative externalities, conveniently forgetting of course about the vast negative externalities of state interference in the economy, or the corresponding positive externalities which are thoroughly buggered in attempting to address the negatives.

        Of course the “right” to something that is not legitimately owned, earned or freely given is not a right and so the concept of merit goods, social justice, the common good, or whatever you want to call it reduces down again to extortion by force or the threat of force via the coercive power of the state. It is impossible to say that something obtained through extortion is obtained by right, unless you believe that the victims of extortion are less deserving, less human even, than the intended beneficiaries. It is also logically self defeating since it relies on (whoops) people to make the kinds of decisions it claims people are incapable of making in support of state intervention.

        • B.O. Locks says:

          @Tomsmith

          You made an economic argument to support your views (“the market knows best”). The link I provided shows the economic case you make is actually contradicted by most professional economists. In other words, in the case of healthcare provision, the free market does not know best.

          So having lost the economic argument for privatising healthcare, you now resort to unsubstantiated assertions about “extortion” and “force” and the alleged infringement of property rights. These are just assertion and are not objectively refutable. For this reason, I am going to bow out, if you don’t mind

          Thanks very much for conducting a civilised argument.

      • Tomsmith says:

        @ alexnunns

        By definition free markets deliver the most economically efficient outcomes for provision of services like health care which are not public goods, especially when compared to central state control with its tractor stats and bread queues. This is why statists tend to introduce flaky ideas like the common good (here cunningly disguised to sound like an economic idea as “merit goods”).

        • alexnunns says:

          So I take it you don’t have any evidence at all, because I asked for empirical evidence not philosophical assertions and you responded with a philosophical assertion.

          Just to be clear, you said “a free market system of healthcare is simply the most economically efficient way of providing healthcare”. That’s a specific claim that can be tested. If you’re going to make a claim like that you should be able to back it up with evidence. If you can’t, it casts doubt over everything you’re saying.

      • Tomsmith says:

        @BO LOCKS

        You misunderstand. Merit goods do not amount to an economic argument- they boil down to an appeal for positive rights, and so it is your argument that has veered off into political and philosophical rather than economic territory. It is more than a stretch to claim that most professional economists acknowledge the validity of merit goods (and even public goods, although these are more difficult to argue against from a liberal position and so I am happy to acknowledge that a lot of economists do believe these are part of economics).

        But of course healthcare, roads and education are not public goods.

        • B.O. Locks says:

          @Tomsmith

          Whichever way you cut it, economic analysis demonstrates that the free market will fail to provide healthcare to everyone who needs it. This is not politics or philosophy – it is the conclusion of an entire academic discipline. if you don’t like the term “merit goods”, then that’s fine. The preferred label doesn’t alter the fact that there is market failure when it comes to healthcare provision.

          I am all for freedom from State oppression. My concern s that “small statists” and Libertarians do not put forward viable alternatives to ensure that healthcare and other merit goods remain available to all. Markets may be good for some things but not for others, healthcare provision being a case in point.

      • Tomsmith says:

        @ alex nunns

        There are no examples of free market healthcare provision on the planet, and so what we are left with is reasoning from basic assumptions. The basic assumptions made in making common good type arguments are logically self refuting and so invalid.

        • alexnunns says:

          So you’ve asserted without a shadow of doubt that free market health provision is the most efficient, but it turns out that there is absolutely no evidence for what you say. Of course in the real world there is a spectrum of methods of health provision, ranging from the predominantly state provided, like the NHS, which tend to be the most efficient, to the predominantly market provided, like the US, which tend to be the most inefficient.

      • Tomsmith says:

        “So you’ve asserted without a shadow of doubt that free market health provision is the most efficient, but it turns out that there is absolutely no evidence for what you say. Of course in the real world there is a spectrum of methods of health provision, ranging from the predominantly state provided, like the NHS, which tend to be the most efficient, to the predominantly market provided, like the US, which tend to be the most inefficient.”

        This is a misconception on your part. The US system of heath care provision is no less government controlled than the UK system. Control is just affected in a different way. Both are about as far from a free market system of healthcare provision as you could possibly get.

        Free markets provide an allocation of goods and services which is allocatively efficient (meaning different types of health care will be provided in a mixture which accurately reflects consumer demand, in comparison to top down command systems like the NHS). Markets are also productively efficient and so deliver health care for the lowest possible cost. There is no downside unless you evoke non economic arguments involving the so called “common good” which involve how you would like to see other people’s resources spent in the service of your personal desires.

        • B.O. Locks says:

          @Tomsmith

          You really should study a bit more economics!

          What do you mean by free markets?

          Have you considered market structure in your analysis, eg, monopoly, imperfect competition, etc? Issues of productive and allocative efficient are dependent on the market structure that firms operate in.

          Your statement that the US healthcare system is no less government controlled than the UK system is just plainly and simply wrong. For a start, healthcare in the UK is DELIVERED by the government. In the USA it is delivered by PRIVATE healthcare providers. Secondly, in the UK healthcare is free at the point of delivery. In the USA, treatment is conditional on payment and those in employment who are unable to pay go without.

          Please use facts and evidence to support your position. It is very difficult to take your arguments seriously when you don’t.

          I don’t wish to appear rude but I don’t think you know what you are talking about.

      • Tomsmith says:

        @ BO LOCKS

        “Whichever way you cut it, economic analysis demonstrates that the free market will fail to provide healthcare to everyone who needs it. This is not politics or philosophy – it is the conclusion of an entire academic discipline. if you don’t like the term “merit goods”, then that’s fine. The preferred label doesn’t alter the fact that there is market failure when it comes to healthcare provision.”

        Not providing healthcare to everyone who “needs” (i.e. desires) it is not an example of market failure. Arguing against physical reality in this fashion is a political argument, not an economic one.

        “I am all for freedom from State oppression. My concern s that “small statists” and Libertarians do not put forward viable alternatives to ensure that healthcare and other merit goods remain available to all. Markets may be good for some things but not for others, healthcare provision being a case in point.”

        Not at all. A free market in healthcare provides healthcare to all according to price, the most efficient way of allocating any good or service. Are you arguing that rationing is more economically efficient than price allocation?

        • B.O. Locks says:

          @Tomsmith

          Someone with a chronic heart condition, say, needs healthcare. Need is a much stronger word than desire. Someone may desire and Aston Martin but they don’t need one. Healthcare is distinct from most other consumer goods which is why it is termed a term merit good.

          Goods and services have different attributes – they are not all the same. Economists recognise these different attributes. So for example, there are Giffen goods, there are public goods, there are merit goods, there are capital goods, there are consumer goods, and so on.

          Allocating health care via the market would mean that a large proportion of the population in need of health care would be excluded. From a societal point of view this is market failure because the market will have failed to supply healthcare to all those who need it.

          As I have said in a previous reply, Libertarians and “small statists” do not have the well being of others in mind when they call for privatisation of healthcare and tax cuts. Advocating the allocation of healthcare through the price mechanism amounts to murder by stealthy indirect means. Those unable to afford free market provided healthcare would be excluded.

      • Tomsmith says:

        “Someone with a chronic heart condition, say, needs healthcare. Need is a much stronger word than desire. Someone may desire and Aston Martin but they don’t need one. Healthcare is distinct from most other consumer goods which is why it is termed a term merit good.”

        A merit good is merely a claim on the property of another person based on how someone believes things ought to be. It is therefore a political rather than an economic idea. In terms of healthcare, what is the economic reason you believe my property ought to be redistributed to someone else based on your perception of their need?

        “Goods and services have different attributes – they are not all the same. Economists recognise these different attributes. So for example, there are Giffen goods, there are public goods, there are merit goods, there are capital goods, there are consumer goods, and so on.”

        “Economists” do not recognise “these different attributes”; merely the ones you agree with for the purposes of this discussion. This is an argument from authority and so does not constitute a valid argument

        “Allocating health care via the market would mean that a large proportion of the population in need of health care would be excluded. From a societal point of view this is market failure because the market will have failed to supply healthcare to all those who need it.”

        Market failure is not the failure to allocate a good or service to everyone that needs (i.e. desires) it. Is this the gist of your problem with markets?

        “As I have said in a previous reply, Libertarians and “small statists” do not have the well being of others in mind when they call for privatisation of healthcare and tax cuts. Advocating the allocation of healthcare through the price mechanism amounts to murder by stealthy indirect means. Those unable to afford free market provided healthcare would be excluded.”

        Murder is killing people without reason (i.e. while not defending life or property from them). Not preventing the death of people from natural means is not murder. There are people dying right now. Did you murder them by failing to prevent their deaths due to something entirely unrelated to yourself, either natural or man made?

        My own personal motivation for wishing to see an end to government interference in healthcare provision is the benefit that would accrue to all people including myself.

    • Karl says:

      I’m sure that you go to where you are today without any help from anyone in society. You probably paid for all of your schooling and never walk on roads, benefit from public sanitation or have your way lit by streetlights. If you don’t want to take the moral stance of mutually aiding your fellow man through taxation and public spending then may I suggest somewhere that has embraced your ideals… Somalia maybe?

    • Tomsmith says:

      @ BO LOCKS

      “Whichever way you cut it, economic analysis demonstrates that the free market will fail to provide healthcare to everyone who needs it. This is not politics or philosophy – it is the conclusion of an entire academic discipline. if you don’t like the term “merit goods”, then that’s fine. The preferred label doesn’t alter the fact that there is market failure when it comes to healthcare provision.”

      Not providing healthcare to everyone who “needs” (i.e. desires) it is not an example of market failure. Arguing against physical reality in this fashion is a political argument, not an economic one.

      “I am all for freedom from State oppression. My concern s that “small statists” and Libertarians do not put forward viable alternatives to ensure that healthcare and other merit goods remain available to all. Markets may be good for some things but not for others, healthcare provision being a case in point.”

      Not at all. A free market in healthcare provides healthcare to all according to price, the most efficient way of allocating any good or service. Are you arguing that rationing is more economically efficient than price allocation?

  62. Tomsmith says:

    Did the labour party decide to dispute this blog post or something? Lol at the hysterical response

    • dsfdsdf says:

      Er.. ‘lol’ that your randomly generated icon in here resembles a swastika. By the way the Labour party are just as bad as the tories.

  63. Tomsmith says:

    Leftists: “we want your stuff and will take it by force”. Hilarious that they see themselves as part of some moral crusade

    • matthew says:

      “The Right” have been taking from those unable to defend themselves throughout history. It is how they have become rich and dominant. Never heard of the Enclosure Act, or the Highland Clearances, or the many, many, acts of theft by the powerful upon the defenceless? Hollow, vapid argument. If you operate under the edifice of ‘might is right’, don’t be surprised when the masses get together to be mightier than you.

      • Tomsmith says:

        But of course I don’t operate on that principle. The use of force is a statist ideology. Voluntarism is the ideology of liberalism. If your left to right spectrum merely comprises various types of statism then it is no wonder you are this confused.

  64. JM says:

    @ Trundle:

    “Share ownership is a means to the ownership of capital open to the masses and it needs to be encouraged, not tamed”. A modern take on Rousseau’s Marie Antionette. “The masses” don’t have money to invest, in large part because they’re underwater due to insufficient regulation of traders creating credit default swaps and then betting against them immediately. And the subsequent bail-out that they paid for from the NHS budget. To take a position that deregulating traders further would allow them to work on behalf of the masses is like allowing the lions out of the Collosseum to roam the streets. That they might turn into unicorns and piss rainbows.

    I think by “the masses” he means the folk who can only afford to live on the edge of Surrey.

    Notable that Google’s intelligent Ads engine analysed the blog – as a non-biased algorithm – and came up with a Mitt Romney campaign ad… Hey if you like this, you’ll love this shit-stain.

    The misogyny in the Peugeot article would be harsh even coming from Jeremy Clarkson (the moniker by which he trolls the BBC News comments).

    But this is about healthcare. Reform and funding would make it better. Breaking it up so that fat cats can bribe the government to allow them to cherry pick lucrative services and then off-shore the profits (which he advocates more than once) is absurd. Being libertarian to the point of providing more rights to individuals is one thing, being so in order to bypass government and allow corporations to replace them and then plunder healthcare for profits sounds pretty far right to me.

    His blog contains the rantings of an inhumane trader, angry at the world because he’s still not getting enough. Angry at women, possibly for similar reasons. Angry at cars because, at 30-odd, he’s already too much of a curmudgeon to drive an automatic. Angry even at the Tories, for whom he votes, because they’re too far left. Angry at the left, because they are the people – just not the ones he went to school with, angry at government because they represent the people very occasionally – but that’s still too often. Just an angry dude with no skooby doo, a blog and, seemingly, one fan (who may or may not share the same IP address).

    If you don’t like “far right”, how’s evil, misogynistic, selfish, lonely trader sound?

    • matthew says:

      “deregulating traders further would allow them to work on behalf of the masses is like allowing the lions out of the Collosseum to roam the streets. That they might turn into unicorns and piss rainbows.”
      sheer beauty!

  65. David Perry says:

    Magnificent!

  66. Ian James says:

    I personally would love to see a in-depth look at the flaws of privatising public services. The theory seems sound. Public institution are massively inefficient, so privatise and subject them to the free market to get the best possible value for money.

    For me there’s two fundamental flaws with that. Firstly, privatising public services and subjecting them to free market is rarely achievable. Look at the trains, the utilities, where’s the competition – it doesn’t really exist. Unless you call the murky world of bidding for taxpayer contracts competition.

    Secondly, the belief that competition is the best way to get a great service. Competition just creates a race to the bottom – delivering the cheapest nastiest product as cheaply and as mass market as possible.

    The truth is that privatisation is the way governments wash their hands of difficult decision, ones that will doubtless lose them elections.

    • actuallybothered says:

      You’ve forgotten the third point.. that when you make companies private, they are in it for THEMSELVES and not for the majority. They are in it for the profit, to grow and dominate, and not for the care or concern of society. This is the case for any company, big or small, but much more upsetting when it’s was once a public company which we can no longer retrieve or revive. Just you wait… we will become exactly like these countries with private healthcare, with an ever widening gap between haves and have-nots.

  67. Ed Westaway says:

    Public services can be inefficient. I’ve worked for one for 30 years and I could quote individual instances of money-wasting that would make any taxpayer gulp. But when private providers are brought in, in the belief that no such waste could possibly be tolerated in the private sector, here’s what happens, at least in my experience. The private firms do not operate in a completely separate way from the public body. Frequently, they use the public body’s premises, equipment, and even staff. And when they do this, the public workers ask their managers, shouldn’t we be charging the private company for this work we’ve just done for them? And the public managers say no. Why? Because the public managers know that their job is to make the private intervention work. They are expected by their superiors to help the outside suppliers succeed. So don’t bill them for hours of services provided by public workers, it will make them look inefficient. And so the private suppliers turn a profit AND look more efficient than the creaking old, union-ridden public services. But they are feeding on the body of the ‘patient’ they purport to be ‘saving’.

  68. Pat says:

    I always find it amusing when rampant right-wingers like jackart sing the praises of socialist countries like France. The reason France has such a great health system is because of the enormous social contributions everyone has to pay – I can just imagine jackart’s face if the same were to be introduced in the UK.

  69. Steve says:

    Brilliant! When is the interview?

  70. Mr Black says:

    Made me laugh!

    But its reality chilled me to the bone.

  71. What a brilliant – and very funny – way of highlighting some of the inequities of a private healthcare provider. Did you actually send it? I think this will go VIRAL anyway… let’s just hope Care UK are working to ‘just in time’ efficiency rules and do not have stocks of the inoculation to hand!

  72. Mary says:

    Tom said go to the USA if you don’t have money you won’t get much care. As my mom used to say HORSES**T!! You can come here get on welfare and get free medical. I, on the other hand, have to pay a co-pay for Dr.s visits. I have to pay for hospital visits, walk-in or longer. Why do I have to pay? Because I have a job, people on welfare do not. I can’t afford the co-pays so I don’t go to the Dr.s as often as welfare’s do. Sister-in-law, every tiny ache every sniffle EVERYTHING, she’s off to the Dr.s. I am so sick of paying for deadbeats. Obamacare is going to fix it. No! I’ll now have pay higher taxes to get the illegals on the healthcare rolls now. Thanks Obama.
    I was always told TANSTAAFL. Except in the USA.

  73. Reblogged this on patricktsudlow and commented:
    A blog from someone who like many right-minded people have fought against the privatisation of the NHS.

  74. Guy says:

    I was in a car accident last weekend. The care I received at a central London A&E was exceptional. Polite staff, helpful nurses, a good doctor and a spotless hospital.

  75. maseadi says:

    wow… i like this pos

  76. fly says:

    Reblogged this on MrsMEnotNICE and commented:
    This is a fantastic piece

  77. Mr Sa says:

    The starkest example of NHS privatisation is cleaning. A Conservative government replaced committed local staff who were part of the hospital and treated with respect with contract cleaners drafted in on much worse wages and conditions. Relationships with staff and patients deteriorated. Many were inexperienced workers hired and fired by agencies only interested in the bottom line. A few hundred thousand pounds was saved. Millions was spent on putting right the damage caused by the hospital acquired infections that resulted.The business models of Enron and their ilk should be kept out of the NHS.

  78. chasser says:

    Brilliant!

  79. [...] article on one of the companies leeching onto the NHS and making millions to boot; Read it here “RIGHT NURSE, WHICH ONES ARE COSTING TOO MUCH! THE BOYS WILL DO THE REST” Share [...]

  80. Very nicely done. Inspiring.

  81. [...] Going private? My reply to a job offer from a private health company. What the heck is this? I’ve been trying and failing to stop the government from privatising …Read more here. [...]

  82. Charley says:

    I’ve had some amazing treatment on the NHS, and I’ve seen some dreadful treatment. I’ve also been sent to a private hospital on the NHS when they didn’t have the resources to give me the treatment I needed but I’d already got septicemia on the waiting list – and the treatment at the private hospital was an utter disgrace.

    On the whole, it’s not perfect, bu it’s as good as any country has, and it is an awful lot better than most do. If we resourced it properly, it has the potential to be outstanding. Don’t privatise it, but do bring in people from the private sector to bring their knowledge in – and do the same with people from the third sector – sharing knowledge has always been the best way to broaden horizons.

    The only disasters I’ve seen from the NHS come not from the hugely dedicated staff, but the resources they have. There’s a simple answer to that!Look at the patient satisfaction indices by nation vs percentage of GDP spent. Our NHS does amazingly well against this global criterion.

  83. JohnW says:

    Alex. would be funny if it weren’t so tragic. Anyone who has experienced privatisation from the inside will be in no doubt about the level of cynicism that exists or the conflict between service and ‘shareholder value’. Alex, go for the job and then blow the whistle.

  84. I was in an NHS hospital five times in the last year. Saved my life. Was “encouraged” by my (now ex) employer to see a private cardiologist. Took my money. Told me I was okay and I was admitted to a high dependency NHS ward ten days later.

    Guess which system I prefer?

  85. Mark says:

    I would have just shat in a box and posted it to them. Each to their own.

  86. careintheuk says:

    You have just made my day! I can’t thank you enough – well, perhaps I could if I really tried.

    If you don’t get the job, I might consider applying so please put in a good word for me.

  87. careintheuk says:

    You’ve made my day!

    If you don’t get the job, I’ll send in my application so please put in a good word for me.

  88. Wonderful. Enraging.

  89. ash says:

    Sad to read such a one sided piece about private companies trying to perform the same as the NHS. Firsty, private companies work to make a profit – that is a fact of life however those in the public sector don’t seem to really understand this concept as they never really have to grab the understanding of profit and loss.

    If the NHS could run itself properly then you wouldn’t need private companies to take on contacts to do the job more efficiently. Why don’t the NHS build onto their balance sheet a cost representing the future pensions liabilities? – because it would immediately be declared bankrupt……! You pay for these out of current earnings meaning that more and more of the budget is grabbed by this ever increasing liability. Not to forget perks like 12 months Mat leave which is very rare for any private company.

    Secondly, it is widely acknowledged that there is huge waste in the NHS so the cuts are to promote getting rid of this waste – why don’t you promote that? Or why don’t you talk about the fact the people left to implement these cuts are the very people who are taking most out of the NHS (the managers) so they cut frontline staff and facilities rather then their over generous pay and numbers. Why don’t you talk about them doing this because they support Labour and are members of unions so they try to upset everyone so Labour get back in to power (so help me God) so the unions can go back and ask for silly wage increase and pensions making the NHS more crippled by it’s future liabilities.

    I’m not saying the NHS is bad, but it’s lack of understanding on how to run itself is amazing.

    Many of my friends have been managers in the NHS, made some fantastic changes and improved services. Their reward is to be moved onto another project. Six months later they return to their old area to see hoe it is going and the new manager has come in and changed everything once again as they want to be seen to be making changes (any changes). This leads to confusion to frontline staff and the return if inefficient practices. They have all left the job now as they couldn’t understand why it was run in such a way.

    Instead of private companies taking on services, private companies should take on the running of whole hospitals so they can be run like a business and to a budget and if the hospital fails change the management.

    They problem with the NHS and the Unions is you can’t sack anyone. If a hospital is run badly no one gets sacked, no one is held accountable – it’s just a case of saying sorry and carrying on as you were. If you sack me i’ll get the union on to you! Ban Unions!

    • B.O. Locks says:

      Yeah, let’s run the NHS like the private sector ran Enron! Or Lehman Bros! Or Barclays!

      • ash says:

        Yeah, let’s run the NHS like we run the NHS – waste, waste, waste!

        Also, the NHS IS run like Enron and Lehman Bros, you missed my comment regarding adding pension liabilities to the balance sheet. The NHS is bankrupt!!!

        • B.O. Locks says:

          So is your prescription is to dissolve the NHS?

          Please don’t say you would sell it off to the private sector. It is difficult to see how the private sector would want it if the financial state of the NHS is as dire as you say. Profit maximising firms are not interested in taking on net liabilities. So there seems to be an inconsistency in your argument.

        • Tomsmith says:

          The good thing about badly run private companies (apart from pretend private companies like the government run cartel known as “banks”) is that they tend to go out of business when they are badly run. The same cannot be said for the NHS and its ilk. A shame

        • Tomsmith says:

          The end of the NHS and the massive tax cut due to every one of the net payers in society would indeed be a great thing for everyone.

        • B.O. Locks says:

          @Tomsmith

          I doubt you’re a net taxpayer. You don’t earn enough.

        • B.O. Locks says:

          @Tomsmith

          A very good thing too that the NHS won’t go out of “business”. It’s a completely different concept from a profit seeking commercial enterprise. It has people and their well being as a core value, not the rape and pillage of the earth’s resources and the exploitation of others.

  90. Sean says:

    My wife is Australian and trained to be a midwife and nurse in Australia.

    She has worked across the world. Mideast, Germany, Japan. United States as well as Oz. We came back to the UK in 1998 and within a new gave up on being a midwife here in the UK. I think you will find there is still a shortage of midwifes at the present time.

    The simple problem with the NHS is that it is too big, Just like the banks it becomes a creature of its vested interests as I have observed in these comments.

    The NHS is a poor system, it was set up for the soldiers who returned from WW2 without much real change when society changed numerous times since then.

    If you really want your children to live in a nation with good health care provision, I have to warn you the clock is ticking and like the banks a failure in one part of the system will lead to the failure of the whole system. PFi Could well be the trigger. The UK Govt is insolvent and will probably remain so for many decades to come. Health care will not escape that fact.

    My family has of course NHS cover but we do also have private health cover, just today ive jumped a big long queue to get treatment for my foot which if left untreated would result in not just pain and discomfort but loss of earnings.

    I urge you to put aside your observations about the US system and have a good look at the German system. You purchase a health insurance premium annually and if you cannot afford the premium the state will purchase one on your behalf. This is not a inhuman system. There are many different hospitals both state, private and mutual. You learn as a result of the cost of health care to take your own health a lot more seriously.

    Obamas new system is much more German than it is UK NHS.

    No one is criticising the staff of the NHS, but the system also lets them down too. Tolerating incompetence and bad practice in bureaucratic stasis, acting as a sort of corporate antiseptic. As it did with my late mother, whos experience was a little like this.

    http://www.itsafamilything.co.uk/had-a-brain-tumour-stay-on-the-drugs-kids.html

    Doctors missing notes, instead of one doctor having one set of notes directly accountable to the fee payer. Its in Insurance Companies interest to keep you well dont you know?

    My Gran in her 90s sits at home wondering how unfair it is that she survived cancer and lives on and her daughter is now just a photo on the Mantlepiece. She was diagnosed and treated in Australia, my mother was treated here. Both the very same cancer.

    NHS envy of the world? Idealistic Nonsense.

  91. careintheuk says:

    Reblogged this on Care in the UK and commented:
    Absolutely brilliant! When I’m feeling down I just read it again and again!

  92. galliac says:

    Is there any chance of James Naughtje getting to interview the managing director,Mark Hunt?Or even Andrew Marr.Or perhaps both of them.

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  95. Jaguar says:

    The letter is long winded; a more solid follow-up should simply list all the events that can be collected and then listed. Then there should be a list of requests for Care UK to answer. Publish that and wait for their response. When that is not forthcoming we need media exposure preferably on TV.

    This strikes me as somewhat similar to G4S.

    Where are all those good British companies?

  96. Private says:

    Thank God for our NHS where people lie in bed so desperate for a drink that they have to call the police, who in turn are turned away by the staff who sedate the victim so he dies of dehydration. It may not be indicative of the NHS as a whole, but neither is the diatribe you delivered indicative of what the private sector does. Your article is self indulgent and its tone would be more in place in a playground. Grow up.

    • @Private

      I found the letter amusing as did many people.

      Just to be accurate, it is a (spoof) letter of application for a job with Care UK, not an article. Without wishing to appear overly pedantic, I would also re-direct you to the letter’s content which is specifically aimed at Care UK’s track record of providing health care, not the private sector in general. .

      Do you know how many times NHS patients have died in the way you describe? I ask this because you use the plural in your comment. I know of one reported case and I wonder whether you could enlighten us to other similar occurrences? Of course, it may be that you have used the plural mistakenly. Understandable – to err is to be human. Either way, it would be helpful for followers of this site to know one way or another. As you rightly say, cases of this kind are not typical of the NHS.

  97. Patricia R says:

    Say it like it really is Alex, in the real disintegrating NHS world. Well done. There are still people out there with a conviction and ethics to keep what is left of the NHS x. From an NHS employee who can see and feel the apathy and slash and burn in the NHS

  98. Should have taken the job then released that as official press statement.

  99. Patricia Cox says:

    Can you come to America and do the same to the Republican Party? You poor British folks just got a taste of Mitt Romney. Corporate interests are pouring hundreds of millions of dollars into his campaign and they need to be exposed for the greedy puppet-masters they are. Well done exposing your own corporate vultures.

  100. DArson says:

    Good day! I just wish to give a huge thumbs up for the good info you might have right here on this post. I shall be coming again to your weblog for more soon.

  101. Secretary says:

    NHS needs to be run centrally, to reduce local bureaucracy, so it is run fairly and efficiently, like the army and old-style civil service. All these fines and targets and golden staff awards, just reduce morale and insult the intelligence of staff. They also need the sort of funding for their buildings and infrastructure that local government enjoy.

  102. jillbed says:

    have just tweeted this – brilliant – thank you

  103. [...] to the highest bidder. With remarkable speed a few gluttonous companies—Virgin Care, Serco, Care UK—have secured dominant positions in the market, gobbling up services from Cornwall to Cumbria. The [...]

  104. [...] to the highest bidder. With remarkable speed a few gluttonous companies: Virgin Care, Serco, Care UK – have secured dominant positions in the market, gobbling up services from Cornwall to [...]

  105. chloe says:

    The world needs more of you!

  106. NHSworker says:

    Great letter and very interesting debate. It is odd that no one arguing for privatisation is addressing the issue of private companies running NHS services for profit with seemingly little regard for quality or range of care (vs cherry picking). I wonder if there ARE examples of privately run services offering quality care in the UK. I work in the NHS and have witnessed a private US owned company taking over a group of GP practices in the borough I work in. One turned out to be less profitable than anticipated so the company pulled out, the surgery closed and 4500 patients were left with no GP (see link at end for more details). They were not informed of the closure in advance or given any information or support of finding a new GP.

    I work with people with mental health problems, some of whom have long terms difficulties and GP care is an extremely important part of their ongoing care. The thing about the NHS is that whilst it is of course flawed in many ways, there is a certain set of values and ethics that guide how it operates. The private companies providing services in the UK do not seem to have the same values hence the examples cited by Alex in his letter and United Health not feeling any reponsibility to address what their 4500 patients would do when they closed down their surgery (or even tell them that this was going to happen).

    I am interested in why other European coountries seem to have privately run services that do seem to provide good quality care as this suggests that it is not necessarily the model that is flawed, but something about the way it is being applied in the UK.

  107. Scott Hurran says:

    I am currently directing a piece of theatre on the NHS and would really appreciate it if you could contact me

  108. […] Going private? My reply to a job offer from a private health company. […]

  109. stevenmal says:

    did you get the job?

  110. Mon says:

    impressive

  111. Fiona says:

    Genius!

  112. Brilliant stuff – I approve entirely keep it up

  113. terry says:

    Or you could have replied with a simple “Thank you for your offer but I will have to decline due to a conflict of interests.” That is if this was actually a reply to a genuine job offer (which would go into their ‘deleted’ folder probably around halfway through the second paragraph) rather than a media stunt you’re attempting to pass off as a genuine reply.

    • alexnunns says:

      You seem to have simultaneously stumbled upon and completely missed the point of this letter. Of course my main aim wasn’t to influence a solitary individual who works for Care UK, but the 183,000 members of the public who have read the letter so far. Thanks for the advice though, really good.

      • terry says:

        You have a point I suppose, it’s not that I don’t agree with what you have said in the email and it has obviously stuck quite a chord, I just found it slightly wasted as a reply that would probably not have been read by the person it was intended for.

        • V I C says:

          I really don’t understand why people think that private companies can do a better job. Look how well (not) companies like TNT are doing with the mail (they lost thousands of letters from my hospital and I regularly get a selection of neighbours post) or group 4 security with the prison service. Look at the state of the Carr in many privately run care homes.
          Any private company is always going to be profit driven at the expense of service. Yes the smart private hospitals may currently look the business because they make so much money out of private patients. They’re not going to go to that expense for NHS patients who they get paid considerably less for.
          For those who have had bad experiences in NHS facilities I am truly sorry but there is no guarantee you wouldn’t have had equally bad service in a private run facility, particularly if you weren’t paying for it.
          Do the people who are pro privatisation really believe that all staff in the private sector are brilliant, hard working and caring whilst those in the NHS are lazy and incompetent? There’s good and bad in both sectors. I work many unpaid hours for the NHS because I care. Most NHS workers do the same. I wonder how many in private healthcare do this.

        • B says:

          Wow….Terry…wow.

  114. oliviasview says:

    Reblogged this on oliviasview and commented:
    Just wonderful…and tragic.

  115. James Brinton says:

    The NHS is in need of total reform and it’s greatest failings are also the greatest obstacles to change: bureaucracy & politics. Socialist models (in general, not just in the context of healthcare) tend to create more bureaucracy, privatised models tend to favour efficiency, I can therefore fully understand why it is argued that by allowing private companies into the mix we will improve efficiency and, in turn, create a better service.

    The NHS was groundbreaking when it was launched and it is something we should be proud of as a country, but at the end of the day, it’s not the organisation that we should be proud of but the pledge behind it: universal healthcare which is free at the point of delivery. How that pledge is honoured is far less important than the fact that it is honoured. In my opinion it doesn’t matter at all if the NHS is completely torn apart and a completely new organisational structure is created, it doesn’t matter if private companies profit or even if a foreign company gets contracted in to provide some of the services, so long as the £2000 a year that is spent per capita by the treasury on our healthcare provides the best value for money possible and that little Johnny, whose single mum works a minimum wage job and hasn’t got two spare pennies to rub together gets exactly the same level of treatment as Lord Montague the third when he walks into his local A&E. IF we have to privatise areas of the service to fulfil that pledge, so what? and at this point I’d like to point out that the NHS isn’t there for the nurses or the doctors, if they’re not happy they can look elsewhere for work. The NHS is there for the patients.

    The second obstacle I mentioned is politics. The NHS has developed for almost 70 years, the world was a different place when it was formed, the world of medical treatment was virtually unrecognisable in comparison to today. The electorate feel so strongly about the NHS that successions of governments have used it as a political weapon when in opposition, denigrating the incumbent party’s management and promising sweeping reforms when they take power. The organisation has been pulled back and forth for decades, we need more managers… We have too many managers..etc etc etc until we have ended up with a complete mess. Billions get spent on reforms only for the next government to start undoing them before they have embedded and start spending billions more on their own set of reforms. No party really has the best interest of the service at heart, they see the NHS as a way of securing votes. We have ended up with a service which was built for a different world and has since been pulled through a continued succession of incomplete reforms based upon dubious motives.

    Then you have to factor in the basic ignorance of the electorate, sorry if this sounds arrogant but consider the following. In the Scottish referendum over 30% of those that voted ‘YES’ did so because they were worried that Westminster was going to take away the NHS, despite the fact that control of the NHS in Scotland is a devolved power. The ‘NO’ camp probably would have won by a considerably higher margin had those 30% of ‘YES’ voters been aware of the facts and hadn’t been deliberately mislead by the ‘YES’ camp.

    The same applies to the next UK general election. How many people will vote Labour because they think that the Tories are trying to sell the NHS, when at the end of the day no move has ever been made to take away the foundation on which the NHS was created: universal healthcare, free at the point of delivery? If Labour then win on the back of a misconception then how much money will be wasted reversing an incomplete set of reforms and instigating another.

    If the NHS is to be saved (and by that I mean the underlying principle of Universal Healthcare, free at the point of delivery) and not collapse, then not only does it need to be saved from it’s own bureaucracy but also from politicians. Let’s face it some pretty unpopular decisions will have to be made and no political party likes making unpopular decisions.

    I would propose removing the NHS from the political spectrum, allowing management to be headed by a cross party team of experts in the medical field (clinical and commercial) who are given a simple mission: to create the most efficient and effective system for providing universal healthcare which is free at the point of service, and then giving them the time and resources to make the fundamental and dramatic changes that need to be made, free from political interference. My personal guess is that their reforms would include a streamlining of bureaucracy and a certain level of free market competition to improve efficiency but that would be up to the experts, not me and not a newly appointed minister for health who took his role after, for example, a career in publishing.

    There are certain things which political parties cannot be trusted with (remember when they had control over interest rates?) and the NHS is one of those things.

    • alexnunns says:

      Please show me a privatised health system that is more efficient (hint: you’ll struggle). If you can’t, you’re just making stuff up.

      • James Brinton says:

        I didn’t say that the healthcare system needs to be privatised.

        • alexnunns says:

          Tell me what evidence you have for the claim that increased private involvement makes a health system more efficient.

        • James Brinton says:

          For some reason there is no ‘reply’ button on you post below?

          Look at my wording. I said:

          “I can therefore fully understand why it is argued that”, and;

          “IF we have to privatise” (note the capital IF), and;

          “My personal guess is….”

          They are assumptions (all it takes, by the way, is a basic knowledge of GCSE economics to understand the argument – not the fact – that competition encourages efficiency) and only really there to demonstrate that I can sympathise with that economic philosophy but they are largely irrelevant to the overriding point of my argument.

          My first point is that IF privatisation is needed to reduce bureaucracy (and let me reiterate I never said it is the answer just that I can understand why it might be) then why does it matter, if the end result matches the basic goal of the NHS?

          My second point is that for any effective reform to take place politics needs to be removed from the equation and suitably qualified experts (not me!!) need to be put in control.

          If you would like to debate that point then by all means do so, but don’t ignore the entire point of my argument and then put words in my mouth.

          • alexnunns says:

            On your first point, marketisation undercuts the basic goal of the NHS, and cannot further it – it’s not the neutral tool you imply (GCSE economics has a lot to answer for). Your second point I find quite bizarre. Why should a £100 billion budget be beyond democratic control? Who in their right mind would hand over £100 billion to a quango over which the public has no influence?

        • James Brinton says:

          1- ‘Marketisation undercuts the basic aim of the NHS’ How? As I said before if market forces can help achieve the goal of providing universal healthcare then so be it. Effectively your response is “it can’t”. I am afraid that no mater how eloquently it is worded I have no desire to get into a childish “oh yes it is”, “oh no it isn’t” type argument (and by the way I am fully aware that things are a little more complicated than GCSE economics, if you take the time to digest what what I have written rather than pick things you can argue against you will would probably realise why I said it).

          2- I didn’t say that management of the NHS should be removed from democratic control. I said that is should be removed from party politics. I maybe could have been clearer and I realise that I haven’t offered a detailed proposal of how this could be achieved but, as we are at a point in British history where the constitution is being carefully considered, I am sure that there is scope to look at ways of developing the NHS as an independent organ of state in its own right, limiting the ability of short sighted MP’s to use it as a tool for party politics. You’re right however, it would not be wise to put it completely outside of public control and I would not (and did not) advocate doing so. Do I have the full answer? no, but does that mean that the point can’t be raised?

          I am going to sign off now. Looking over some of your other posts I am afraid that I have come to the conclusion that, while you are concerned with the welfare of the NHS, for which I respect and thank you, I feel you are equally concerned with your own self-promotion and seem to enjoy being argumentative just for the sake of it. You have a very good grasp of the English language and are clearly not stupid therefore I can only assume that when you choose to ignore peoples points and put words in peoples mouths you do so purposefully. I am afraid that undermines any desire I have to have a conversation with you. I think that perhaps you have bright future ahead of you in Westminster although maybe you should steer clear of academia.

  116. DontThinkThisHelpedAnyone says:

    An unnecessary vitriolic response which served little purpose besides misuse of your own time. This email will have been sent to you by an assistant in the company’s HR department, they will have received this and it will have ruined their day. Totally agree with your point, the NHS shouldn’t be privatised, but I really think this was either wasted time for you or it unknowingly hurt a faceless person in the lower echelons of the company – didn’t so much as graze the people at the top.

  117. T Decker says:

    Why don’t you take the job and do exactly what you said you would – bring them down from the inside.

    Now THAT would take balls.

  118. Somehow I had missed this in 2012, the fact that people are posting defending privatisation completely floors me.

    It’s rather like Ian Duncan Smith’s approach with the DWP, the facts don’t suit their view but if they lie and ignore reality often enough, eventually they begin to believe their own lies. 4

    Anyway, your argument is every bit as valid now as it was in 2012, I’ve been sharing this extensively with requests for further shares.

  119. delboydave says:

    Reblogged this on delboydave and commented:
    A very thoughtful response to a job offer

  120. Dr Jeremy Bartlett says:

    Superb article!

  121. Dr Nick says:

    The problem with marketisation in the context of the NHS and health is that there is no evidence it makes a jot of difference to quality.
    What it DOES do is increase the variation. The best of the NHS is at least as good as the private sector in any nation.
    The worst of the NHS isn’t as bad as the worst of the private sector. The NHS doesn’t try to persuade you to take drugs, have operations, tests and procedures that are unnecessary. There’s no incentive. But private medicine WANTS to find stuff to do – or make it up if there’s nothing there.
    Unless they’re insuring you, in which case they will sometimes do ANYTHING to avoid treating you, or paying for it.
    There is also no evidence that the “internal market” of the NHS makes any difference to outcomes. Even the health select committee has said that. It does, however, cost more to run than it ever did before the “IM” was created.
    Then throw in the scandal of PFI builds, which have contributed to hospitals going into huge amounts of debt to pay off the loans, but it doesn’t appear on the Treasury figures so that’s alright.
    Abolish the internal market and the NHS financial problems would be pretty much solved.

    But that goes against the ideology of all the major parties (and the prospect of cushy consultancy jobs), so not much chance of that ever happening.

  122. David says:

    For examples of the variability of private healthcare, consider the revelations about care homes for the elderly, disabled and children.
    Also,
    With un-privatised parts of the NHS, taxpayer money in = services out
    With privatised sections of the NHS, taxpayer money in = services out + private profit

  123. A gold-filled gag from the establishment.

  124. Reblogged this on davidsimpson21 and commented:
    Most succinctly put – Wake up People!!

  125. Tim Arnold says:

    Delicious. I wish I had written this. I am not sure the average person will get the parody of the PR proposal, but I love it. I would have given you an interview just to wind you up. I have just seen it, two years after you wrote it, thanks to FB. You can serve in my legion any time. Best wishes.

  126. 25 days Holiday? The law says a minimum of 5.6 weeks, which equates to 28 days

    https://www.gov.uk/holiday-entitlement-rights/entitlement

  127. Ed says:

    The NHS is already using private companies and doing it very well in some places and unbelievably badly in others. IT is the biggest embarrasement for the NHS and the billions wasted could have transformed the NHS. Unfortunately as the NHS like to do things in house it wastes billions on software projects as its managers know nothing about IT. so i can only guess there are similar examples for the other procurement they do, the PFI shit is another disgrace. So i dont see the problem with private firms running services in the NHS including surgery. But the main thing the NHS needs is its useless senior management replaced with effective people who know how to run organisations.

  128. leonc1963 says:

    Reblogged this on Diary of an SAH Stroke Survivor and commented:
    Excellent

  129. David Scoins says:

    Fantastic. One of the rare occasions I find joined up English, reasoned comment and genuine disagreement that doesn’t default to name calling but instead provides education, adding to the information pool.
    I think an enlightened manager would (even should) consider employing you, though £21k is way too little for such a high profile position. Your original points are so good, it might represent a successful market strategy. Among other ideas, it occurred to me that a possible result of your up-front and open strategy would be that service might improve. We’re going to have a mix of public and private in Britain while expectations exceed budget. Until we persuade the populace to be responsible for their health (and I don’t mean financially) – to take responsibility for their own well-being – the provision of free health care is destined to spiral upwards.

  130. Sherworld says:

    Reblogged this on Sherworld. and commented:
    A brilliant read.

  131. […] Going private? My reply to a job offer from a private health company. […]

  132. […] Going private? My reply to a job offer from a private health company. […]

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