Hi Neverthesame.
Is Canada much better? I thought it was either illegal or at least extremely difficult to get anything outside of the state sector system there, unless you crossed the border?
I was both pissed off and pleased when I read that site. It is such a clear illustration of the failure of the NHS to achieve its own stated aims.
It shows that those who work in the NHS are aware that there is a big problem with confidentiality, hence the seperate service.
and that the claim made on the founding of the NHS that it would be a top quality service for all, is also contradicted by the site, as there is clearly a higher quality service being provided for select NHS insiders.
to contrast the present system with it's predecessor system of many competing doctor's surgeries and hospitals of different sizes,
no claim was made for equal quality of service, just as clothes shops, car makers, and coffee shops don't make a claim for a universal standard accross the board for their market, providers competed to provide the best value for money service they could, and sited their practices where there were potential customers
and any provider who got a reputation for poor confidentiality, probably lost those customers for whom confidentiality mattered, to a provider who took more care of confidentiality.
There is also the side issue that unless we opt out of it, our very poorly anonymised NHS medical records are now available for research and commercial purposes. The programme was sold in the media as being a benefit to the patient, as any hospital can now access our records online, for things like blood and tissue group and allergies.
I got a different view on that from a GP (he's not a libertarian, he's a socialist), who pointed out that when soldiers began to have their blood group tattooed on them, deaths due to transfusions of the wrong blood group increased. It is easy to get the records wrong or mixed up. The correct procedure even if an urgent batch of blood must be administered immediately without knowledge of blood group, is apparently to mix a sample of the patient's blood with the transfusion blood in a test tube, and keep observing it for reaction, and if a reaction occurs to treat the patient for it immediately.
He reckoned that having records would lead to the same complacency and hence avoidable deaths that the tattooing of soldiers had lead to.
as to the why s, I don't think there is a need to invoke anything more malign than the mal incentives of a well meaning but misguided policy.
Without market signals, the decisions of what to provide, where, at what quality and in what quantity, pass from paying individual consumers, and what they are willing to pay for, to politics.
In politics, an organized special interest is far more effective in getting a political decision to go its way, than diverse public opinion is.
A small pressure group is easier to bring together and hold together than a large and diverse one.
the motivation to organize is stronger when there is a large potential reward, than when there is a smaller reward or cost.
Hence the decisions about the NHS (as with any other politics) tend to be most influenced by small groups of organised special interests, who stand to make big concentrated gains (all values are subjective, so the gains are not necessarily monetary, they might be moral, egotistical, religious etc)
and least influenced by the large mass of un organized individuals over whom the costs tend to be spread.
Who are the most concentrated special interests who stand to make the biggest gains?
big pharma and doctor's associations. followed by the various nurses and clerical unions.
Who is the largest and most diverse group, over whom the costs are spread - the public.
A system which was supposed to put the healthcare service in the hands of the many, has taken the decision making away from all paying customers for whom each penny spent was effectively a vote, and has inevitably put it into the hands of the most privileged and most self interested few.
and as the link shows, there is a system within the system, for some of those select few.
