Fascinating documentary on the formation of the NHS, and where it all went wrong, on at the moment. Unfortunately I can't follow it all too clearly because the sound's turned right down, because my daughters are just dropping off to sleep.

However, my over-riding memory of the name "Nye Bevan" comes from that classic Not The Nine O'Clock News sketch (Gangster Octopus to thread) where a spoof "Question Time" Panel are asked the question, "Given that the Soviet Union has just launched 200 nuclear warheads that will destroy the United Kingdom and everyone in it in four minutes' time, what would the panel recommend doing next?"

And Rowan Atkinson (I think it was he) playing the part of a Welsh Trade Union leader, mused, "Well, at times likes these, I like to think what Nye Bevan would have done. And you know, I'm pretty sure he'd have shat himself".

What a great programme that was. They could do contempt and anger so well.

Titting up and down on the willy bum goolie

I don't know why but I am heartened that Bevan was 51 when he brought in the National Health Service.

It means that there is still time for me to do something important like that - although not much time

I think that Harry maintains that the statue of Bevan in Cardiff shows him wearing a cardigan but I would say that it is clearly a waistcoat

QUOTE:
where it all went wrong

Not having seen the programme, can I ask where it has gone wrong. I mean sure, the NHS has been fucked around with, abused and kicked around for political and economic gain like nobody's business, but I'm always wary of people saying that the concept of things like the NHS, and for example comprehensive education, have been "proven failures", when no such proof really exists and in fact such arguments are specious bollocks.

Having the NHS is still better than not having it.

QUOTE:
Not having seen the programme, can I ask where it has gone wrong

Millions of pounds wasted on a shithouse computer system that doesn't work, the poor sods who do the actual work on the ground not getting paid enough, politicians shitting all over it, too much bad management, too much money being wasted, the people who do the work not getting paid enough, the general public demanding everything NOW.

Of course it's silly to describe the NHS as "a failure", but it's really not a good way of allocating healthcare in the modern age. It's interesting that no other country ever copied this model of provision.

Having used the German health system, which is unarguably superior. I think a compulsory insurance-based system, with the state paying the insurance for the people who can't afford it, is an inherently better model.

I thought we did have a compulsory insurance-based system, with the state picking up the tab for those who can't afford it? I don't think the funding model can be a root cause of why other countries' healthcare systems are any better or worse than ours.

QUOTE:
I thought we did have a compulsory insurance-based system, with the state picking up the tab for those who can't afford it?

Not really. National Insurance is essentially the same as income tax. In a lot of continental systems, you pay into an insurance system and the insurer (or government body) purchases healthcare on your behalf.

In the NHS, the NHS is purchaser and provider. Although the government do want to move towards a commissioning model.

It's not the only problem with the NHS. I agree it's not well managed, but I doubt whether the public is prepared to stump up more cash to pay better managers.

I've used the Finnish system, which is a similar model to the German one, and unless you have a good job it's utter, utter shit. Even if you do have a good job it's quite dodgy to have your doctor writing sicknotes and dependent on employers liking their work.

Of course, it's the 'most cost-efficient system in the world', which is great if you want to die slowly and in pain because they don't want to treat you.

QUOTE:
National Insurance is essentially the same as income tax

Not quite. The rate is 11% for income up to £40,000 per year- but only 1% above that threshold.

It's a regressive tax, even if those on incomes greater than £36,000 pay higher rate income tax.

Okay, but that wasn't the point I was trying to make. Putting it very simplistically, National Insurance and Income Tax go into the same government pot and are spent however the government chooses. In addition, National Insurance is nominally for all sorts of things -- state pensions, unemployment benefits and healthcare to name a few.

National Insurance contributions bear very little relationship to the health insurance I'm paying here in Germany. I also have the choice to pay into whatever insurance scheme I want to, be it state or private.

Yes, but the waistcoat/cardigan debate, what do we think?

Don't worry, Stumpers, we're getting all choiced up over here, oh yes indeedy. Who needs decent health provision when you can have choice, eh?

I think a compulsory insurance-based system, with the state paying the insurance for the people who can't afford it, is an inherently better model.

Not necessarily. That's the Canadian model which is better than the NHS in some ways but worse in others. I've had a fair amount of indirect experience of both in the past eight years and think neither system is a clear winner. The NHS is much more of a lottery. The difference in quality between individual trusts is astonishing when compared to Canada where, in my experience the standard of treatment, coast to coast, is reasonably uniform. Far better than the some of the NHS trusts, inferior to others. However the Canadian system is seriously, and increasingly, underfunded and, unlike the UK, private medical care virtually unobtainable. Given rising costs and aging population the pressure to maintain quality will become financially crippling in coming decades, unless there are fundamental changes to the Canada Health Act. A document that's viewed here with the same degree of sacredness as the Declaration of Independence is to the south of us.