Nhs

Last week, the New York Times ran a very un-New-York-Times-y article, ‘Resentment Grows Over Who Gets Health Care Aid’. It contrasts two women in New Hampshire. Married with one child at 30, last year Gwen Hurd paid more than $11,000 for her family’s health insurance, purchased through the Affordable Care Act exchange. They had to shell out $6,300 per person — $18,900 — before the insurance kicked in. Both parents were working. Their pre-tax earnings just exceeded the $82,000 cut-off for government insurance subsidies. The couple dropped date night, and couldn’t save for retirement. A few miles away, single and living at home, an aspiring opera singer of 28 is

Donald Trump recently disparaged Britain’s National Health Service for “going broke and not working,” leading Health Secretary Jeremy Hunt to express his pride in a system “where all get care no matter the size of their bank balance.” But the news has been filled for months with stories of people unable to access care they need under the NHS, regardless of their efforts or financial resources. Beyond the nationalistic pride and defensiveness of politicians both sides of the Atlantic, how do British and American healthcare really compare? Are both sides as crazy as the other imagines, or do they each know something the other can learn from? Sweeping generalizations regarding

The NHS is in dire straits. I never thought I’d say this but as a doctor, and having seen the extent of the current crisis, I’d be scared if a family member had to go into hospital. Despite the best efforts of staff, the pressures are such that it’s all too easy for mistakes to be made. Doctors and nurses are going to work fearful of the situation they will find. They know how unsafe it is, and yet they are utterly powerless to do anything about it. The predictable response is to call for more money to be hurled at the NHS. It’s all because of cuts, they say.

Donald Trump has found himself in the midst of another international spat, fuelled this time by his attack on the UK’s national religion. In an attempt to verbally jab the opposition in his own country, the President has managed to rile up many thousands, if not millions, of people who have deep reverence for Britain’s National Health Service: I’m rarely on the side of Trump’s Twitter provocations, but this one, I’ll admit, isn’t half bad. While Trump is wrong about the protestors’ motivations (giving the tweet ‘top troll’ status), he is right that they march in the wake of a ‘broke’ system. Only extreme ideological dedication to those three little letters

I am in a good position to report from the NHS frontline, having been in hospital with pneumonia for just over a week from 28 December. I was admitted following an early evening visit from a district nurse to the home I share with my younger daughter, her husband and their three children. The nurse rang A&E to advise them of my impending arrival but warned us that there was a four-hour wait for an ambulance. My daughter therefore decided to drive me in, and we arrived at a packed casualty unit. I was desperate for oxygen and my daughter begged at the reception desk for me to be triaged

This piece first appeared in this week’s Spectator magazine.  Recently the NHS postponed a large number of non-urgent operations to cope with what is known as the ‘annual winter crisis’. Naturally, this outcome was treated as a scandal in the press, and there were predictable calls for Jeremy Hunt to resign. But the fact that non-urgent operations are postponed is not by definition bad. It might be evidence that the NHS is working well. Or at least that it is doing what it is supposed to do, which is to deploy necessarily finite resources on the basis of patient need, rather than some other criterion — such as profitability or

Cabinet today was not the dramatic showdown over NHS funding that some expected. Boris Johnson was, unsurprisingly given that Theresa May knew what he wanted to say, not called on to speak first. Those Ministers who went before him emphasised that it would be better if these debates took place in private, not public. When it was Boris’s turn to speak, I am told that he slightly pulled his horns in. He made the case for more money for the NHS but he didn’t argue for a specific figure, I understand. Interestingly, and in a sign of how May still views the International Trade Secretary as her bridge to Brexiteers,

On Tuesday, the Cabinet will discuss the NHS and how it is coping with the winter crisis. But, as I say in the Sun today, the Tories need more than update on what’s going on, they need a proper plan for the NHS. It is one of the issues that could cost them the next election. When David Cameron became Tory leader, his main focus was on the NHS. He used to say that you could sum up his priorities in three letters, N H S. He reckoned that until voters trusted the Tories with the health service, they wouldn’t win an election. But right now, the Tories aren’t talking

Some very clever people are rallying around the idea of a specific NHS tax partly because of what has been called a ‘winter crisis’ in hospitals. It’s an idea that has been around for yonks, but Nick Boles’s book, Square Deal, has kick-started the debate again. He argues for National Insurance to be repackaged as National Health Insurance. This would ‘give the NHS what it needs while removing it from running financial battles in Whitehall,’ he says. Boles makes a strong case, not least as someone who has survived two bouts of cancer thanks to NHS treatment. The key to his piece, I think, is this bit: Currently, we spend

Recently the NHS postponed a large number of non-urgent operations to cope with what is known as the ‘annual winter crisis’. Naturally, this outcome was treated as a scandal in the press, and there were predictable calls for Jeremy Hunt to resign. But the fact that non-urgent operations are postponed is not by definition bad. It might be evidence that the NHS is working well. Or at least that it is doing what it is supposed to do, which is to deploy necessarily finite resources on the basis of patient need, rather than some other criterion — such as profitability or ability to pay. Making people wait for less urgent

Theresa May likes to boast at Prime Minister’s Questions that mental health spending is increasing. The problem is that this is rather difficult to see on the ground. The King’s Fund today published a report saying the gap between spending on hospitals and mental health widened further in the last year. The think tank even said that there was an increased risk to patient safety in more than a half of mental health trusts because of staffing shortages, and that ‘the government’s mission to tackle the burning injustices faced by people with mental health problems will remain out of reach if things stay the way they are’. The King’s Fund’s

In George Bernard Shaw’s play The Doctor’s Dilemma, written early last century, the knife-happy surgeon invents a nut-shaped abdominal organ, the ‘nuciform sac’. It is situated near the appendix, ‘full of decaying matter’, and requires removal, assuming the patient can afford the fee. The surgeon, Cutler Walpole, has the line: ‘The operation ought to be compulsory.’ Bernard Shaw labours the point that removal of the nuciform sac equals 500 guineas, and not removing it equals nought guineas. He then suggests, wickedly, that we want our surgeons to be mortal, ‘quite as honest as most of us’, not God-like. Which of us, he asks, would not be influenced by the financial

Rationing did not end in the 1950s. The largest-scale rationing programme is still in existence: our beloved National Health Service. Its austere regime is part of our national life. We no longer queue for bread or sugar, but we most certainly do to see the doctor. We no longer wait in line at the butcher’s, but we do in A&E departments and on interminable lists for appointments and procedures. There are no books or coupons, but rationing it remains. Indeed, the government has announced it is withholding elective operations and routine appointments this month. Rationing by any other name would smell as sweet. And, like our drawn-out post-war rationing, it

The whose-fault-is-the-NHS-crisis game has taken some strange twists and turns this week, with the debate bouncing from patients costing the health service £1bn last year to Jeremy Hunt having to apologise to patients for cancelling their non-urgent procedures as a result of the increased pressures on hospitals. Political debate tends to prefer black-and-white and easily identifiable scapegoats, but the health service is too complex for that. Take the missed appointments story. Yes, patients failing to turn up cost the health service a staggering amount. But who are those patients? It turns out that the most likely people to do what the NHS classes as a ‘DNA’ (did not attend) are

Whose fault is the current NHS crisis? Today Jeremy Hunt apologised to patients whose operations have been cancelled as a result of serious pressures on hospitals. There are ‘major incidents’ at 16 hospital trusts, and the Royal College of Emergency Medicine is warning that patients who do end up in crowded and chaotic emergency departments ‘are much more likely to have a poorer outcome and even die as a result of their experience’. The Health Secretary said the current situation was ‘absolutely not what I want’, while Theresa May argued that ‘the NHS has been better prepared for this winter than ever before’. The government has not met Simon Stevens’

Could cancer break the NHS? This was the provocative title of a debate at the British Museum hosted by The Spectator and sponsored by Philips. Two of the expert panellists suggested that it just might. Others were more optimistic. But all seemed to agree that, for the NHS to survive, bold action was required. First, Neil Mesher, CEO of Philips UK and Ireland (UKI), presented some frightening statistics. One in two people will be diagnosed with cancer – a proportion that is rising because we are living longer. Greater awareness of cancer, too, means that more people are being referred for tests – so much so that the demand on

Memory, neuroscientists tell us, is fallible. It is a dynamic process whereby each time we remember something, it will be changed. Our first memories are probably even less reliable, but I think mine is of Christmas 1953, when I was three. My mother was German and we celebrated Christmas in the German way. An English Christmas is a dull affair in comparison, with presents handed out by underslept parents on a cold and drab Christmas morning, around a tree decorated with electric lights. German Christmas would start on the first Advent Sunday with my mother making a wreath of fir branches and red ribbons, with four red candles. On each