Britains National Health Service: Do You Get What You Pay For?
About Norman RampartI am an Englishman, originally from a small village in Lancashire where everyone looks the same - even, slightly worryingly, the sheep. I have been residing reluctantly in the general area of London for 38 years. I came here for three weeks, ran out of money and couldn't afford the coach fare home. I believe that an Englishman's home is his castle. Even if it is only a small end of terrace pile of bricks.
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If you get sick in Britain you get treated. It doesn’t cost you a bean. Not a penny cent. It’s free. This all started with the ‘Bevan Report’ somewhere in the middle of the 20th century.
Now its’ not entirely free as we pay something called ‘National Insurance’ as part of our income taxes. National Insurance is a very, very, small deduction of our pay. I’m no expert but I would reckon less than half a percent of a pound per month.
Up until the mass immigration policies of our last Labour Government, if you got sick you would be treated for free, treated well and, generally, unless you happened to die, be cured and sent home without so much as vague glance at your wallet or bank balance. They won’t even charge you if you die, which is a plus for your heirs at least!
The same applies today but, sadly, with all the mass immigration, this ‘free’ health service has struggled to cope. It’s tottering to put it mildly.
Still. It continues to be free – apart from the negligible National Insurance contributions, so perhaps we shouldn’t complain too much eh?
I once suffered a suspected heart attack back in 2001. I advised my manager and he had me whisked off to Ashford Hospital in a company van. The driver, Xavier, asked whether he should stay with me.
“It’s ok” I said confidentially, “this place will take care of me”
I tottered in clutching my chest and a nurse appeared.
“Hello, and what can we do for you?” she asked kindly
“I think I’m having a heart attack” I replied
“Oh dear. We only do ‘minor injuries’ here now – I could make you a cup of tea though” – the NHS cuts were already biting!
She plugged me into a heart monitor and wandered off in search of a kettle.
“Hurry up!” I called, “or I might not be here for the tea!”
I was transferred to Hillingdon Hospital, where my wife happens to work as a microbiologist in one of the laboratories. Shortly a doctor appeared, as did my wife and a couple of nurses.
It turned out I wasn’t actually having a heart attack. My blood was so thin I was just gravely anemic and, whilst my heart was pumping happily away, oxygen or whatever it is your heart sorts out was actually not being sorted out.
Having established that I wasn’t about to ’kick the bucket’ I was left attached to a heart monitor, just in case, and the doctor went on his way and the wife went back to work.
A very nice, and very small and attractive Filipino nurse called Rochelle was assigned to care for me but, as it was immediately apparent, I wasn’t destined to shuffle off, she wandered off to care for more urgent cases. I unplugged myself from the heart monitor and nipped down the back stairs for a quick cigarette.
On my return Rochelle grabbed me by the scruff of the neck and literally threw me back on the bed.
“Don’t you DARE ever do that to me again!” she said and gave me a middle range gentle slap on the face.
She was henceforth known as ‘Rocky’ to me.
The care I received was extraordinarily good – well, I came out alive anyway. Although I had paid a measly sum in National Insurance through my salary taxes, I was cared for, fed, given the use of a TV and internet and regularly checked by doctors and nurses.
I was slightly annoyed that Rocky continued to decline my request for a bed bath but, as she’d seen me wander off for a shower each morning I suppose it’s fair enough.
The stresses and strains that Britain’s quite extraordinary NHS has come under were never more clear than on my second last night in hospital.
Some poor chap with a coronary condition was transferred from the Psychiatric Ward who had no facility for coronary care. He spent the entire night trying to climb out of the window 4 floors up with only myself and the diminutive ‘Rocky’ hanging around his neck to stop him.
The British National Health Service has always been, and continues to be, quite unbelievably extraordinary. It is, to all intents and purposes, a ‘free’ health service for all – given the tiny tiny tiny amount of ‘National Insurance’ we pay.
If you are unwell and in need of hospitalization you get it, pretty much free and gratis. No ‘health insurance’, no ‘can you pay the bill?’ questions. You are ill and it’s free – or as free as matters.
Unfortunately, many British doctors and nurses have left the ‘madhouse’ leaving us with medical staff that often can’t even speak or understand English.
Free healthcare is now managed by businessmen and accountants.
We are losing so much allowing businessmen and accountants anywhere near this precious resource.
The British system of health care is still free for all, but it could so easily go bankrupt, or so says my wife, who works in the system.
The fact is you can’t have a ‘free health service’ if profits are involved – and now they are. So if you’re going to get sick in Britain get sick now, because even ‘Rocky’ won’t save you inside a decade if this continues.
God Save The Queen and The NHS!
Mind you, they saved me, so they probably are getting their come uppance eh? 
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Carol Maietta views
March 21, 2013 at 9:43 am
Great post. Those that receive “free” healthcare in Britain or Canada, for example, often seek high end quality healthcare in the USA. For that reason, large healthcare systems often market to the oversees clients and we call that tourism healthcare: go to the beach in South Florida and get your heart valve fixed.
Now, being a nurse myself, may I butt into your world…you can call me Rocky 2? IF you still smoke, you can expect another bout related to anemia (and shortness of breath). Please consider stopping if you have not already. We need your posts a bit longer
Bill Formby
March 21, 2013 at 3:51 pm
Nag, nag, nag.
Norman Rampart
March 21, 2013 at 5:49 pm
My wife is called Carol – so no change there then
Norman Rampart
March 21, 2013 at 5:41 pm
They would be longer but I run out of breath….must be those damn cigarettes
Carol Maietta views
March 21, 2013 at 7:30 pm
OK…you can laugh but I will always nag if it’s for your good
I will nag you too Mr. Formby.
James Smith
March 21, 2013 at 7:56 pm
Nag? Neeeiiiiighhhh!
Carol Maietta views
March 21, 2013 at 9:54 pm
Easy and fun to nag you, James… That would be my guess
James Smith
March 22, 2013 at 7:05 am
Not really. My attitude is, once is a request. Twice is a polite reminder. After that, it’s STFU, I’ll either do it or I won’t. If I won’t, I’d tell you.
I respect women so I see no need to patronize them by thinking, “She’s just being a woman, I’ll have to smile and ignore it.”
I admit, there is a lot of behavior from women I do not understand. For example, an obsession with shoes. Most women find it impossible to pass a shoe store without browsing the window display. I’ve said a store could only have the display and not sell any shoes, if they charged 50 cents to look. They’d make a handy profit at little expense.
To be fair, not many men can pass a tool or hardware store without browsing, too. I confess, it’s difficult for me not to take a look, too.
Norman Rampart
March 21, 2013 at 10:08 pm
If I wasn’t married for 28 years and still madly in love I might marry you!
Someone who cares.
Thank you babe.
Thank you x
Is it me or are there fewer and fewer people who actually care anymore?
er….excuse me while I pop outside for a ciggie
James Smith
March 21, 2013 at 10:10 am
Here in Brazil we also have universal health care as well as private health care. For several years, I was paying for Unimed health care, one of the two largest providers here, the other being Golden Cross. Now, I qualify for the government care and find that, except for relatively minor things, serious issues are taken to the Unimed hospital anyway. That saves me about $500 a month. That was for two people well beyond retirement age and included no co-pays and even home visits by a doctor if needed.
Before I was qualified for any plan, I contracted a serious intestinal bug and had to be admitted via the E.R. to the Unimed hospital. In three days, I was given 17 units (abut a liter, I think) of fluids as I was severely dehydrated. When I left the total bill was well under $500 USD including the E.R. admission and a private room.
The care was first rate and the cost was ludicrously low considering I had zero coverage for anything.
When on the Unimed plan, I had a bulging disk that was pressing on the sciatic nerve. After months of constant pain, I went to a local neurosurgeon who was one of the few in the world trained to perform an arthroscopic-style surgery for the condition. The procedure was invented in Brazil and, at that time available only in Brazil and the UK. I was operated on by 10 AM and home in my own bed by 10 PM. Again, not one centavo from me was needed. That was true quality health care.
I certainly would not consider going to the USA for any health care procedure. It is cheaper and better in Brazil So is dental care.
About three years ago, I had a friend from Alaska here. While here, he had oral surgery to remove failing teeth and dentures made. Total cost, including the hospital time was $3,250.
I personally had a couple of dental implants done. Total cost, under $1,000 and one is 10 years old, the other over nine.
Prescription drugs were not covered under my Unimed plan, but they are so inexpensive here, it doesn’t matter. What was costing me $115 a month in the USA in 2002, is still only about $40 a month here. That would not even cover co-pays in the USA.
Yes, the health care system in the USA is broken, ludicrously costly, and not really the best in the world be any measure.
Norman Rampart
March 21, 2013 at 5:52 pm
I admit that having heard from an American driving student about US healthcare I was gobsmacked. Amazed. Bewlidered.
Arguabley the most advanced of all western societies yet a healthcare programme like that?
Odd. Distinctly odd.
To me anyroad.
Michael John Scott
March 21, 2013 at 12:36 pm
The US health care system is about #50 on the list, with Cuba and Guam ranking higher. When it comes to trauma care, however, the US ranks in the top ten.
James Smith
March 21, 2013 at 12:54 pm
I have a short video about Health Care debate in the USA. I made it several years ago. When “Obamacare” (Nee Romeycare) was being debated. It’s at:
http://s1181.photobucket.com/user/slrman/media/HealthCare.mp4.html?sort=3&o=35
One of the most ironic things about it, is that American taxpayers are already paying for universal health care in two other countries. When you learn which ones, you might be outraged. You should be.
Norman Rampart
March 21, 2013 at 5:52 pm
# 50???? Good grief. I am genuinely shocked old bean! HOW??? WHY???
Michael John Scott
March 21, 2013 at 6:19 pm
Money drives the system. Doctors are encouraged to see lots of patients, in the shortest period of time, and order lots, and lots of tests. Those tests is where they make the big money. Little patient care, poor diagnoses, and lots, and lots of mostly useless technology.
Jim Moore
March 21, 2013 at 12:53 pm
Norman,
Thank you for sharing this. And thank you for a candid view of NHS…warts and all. It sure beats what we DON’T have here in the USA.
You estimate NHS levies a trivial tax on your salary each month. For comparison, I pay 14% of my gross billing (I’m an independent consultant) for health insurance with a $5000 DEDUCTIBLE before I get a penny of reimbursement. In other words, in addition to the $600+ per month I pay for my insurance premium – a total of $7200 per year – I must also pay the first $5000 in medical expenses I incur before I receive any benefits. $12,500 per year in out of pocket medical costs before I get any relief whatsoever. Mind you, if I were to have a heart attack or some other “catastrophic” illness, my expenses would be essentially capped at that $12,500 level…plus some modest add-ons…so that I don’t lose everything I own to a major illness or accident. That’s what the $7200 per year buys…catastrophic healthcare coverage.
Moreover, our health system is geared to gouging every possible nickle they can out of patients. A recent article in Time Magazine points out just how bad the system is. One example is that hospitals routinely charge patients $5 or $10 for a single aspirin or ibuprofen. We can buy a bottle of 100 pills for less in a drug store. And where they really gouge us is with expensive tests, such as CT scans, in which they will perform the test multiple times, and bill many thousands of dollars for each test, when in many cases best-practice guidelines do not dictate the test at all.
Furthermore, charges will vary from hospital to hospital in the same city. One hospital might charge $3500 for a procedure and the next might charge $23,000 for the same procedure. The way hospitals get away with this is by recruiting providers to sign exclusive contracts with docs, other medical professionals, ambulance companies and so on. Docs must struggle for “admitting privileges” to send patients to a particular hospital, and so the hospital will demand that the doc’s patients are sent there and only there.
Healthcare in the USA is a racket…a way for big corporations, both for-profit and non-profit, to bilk the maximum amount of money from patients. In many smaller communities, the CEO of a “non-profit” hospital with be, by far, the highest paid executive in the community.
And, insult to injury, Consumer Reports just came out with a scathing review of hospital safety. This focus on money has led many hospitals to become lax on sanitation, so hospital acquired infections are rampant, and readmissions for hospital acquired complications are VERY common. US hospitals are VERY dangerous place to be.
I realize that you did not say all is well in the NHS, but you did express respect and admiration for a system that actually tries to place patients’ health first and does a reasonable job of managing costs and limiting the egregious profits enjoyed by US healthcare industries – from pharma to equipment to testing labs.
Your message belongs in the hands of our healthcare reform advocates.
Jim Moore
March 21, 2013 at 12:59 pm
Oh…I forgot to mention that patients must also pay dearly for treatment of all those hospital acquired infections and complications. Hospitals and docs take zero responsibility for a successful outcome. If they infect you with MRSA, too bad for you, but they will extract their pound of flesh to treat the MRSA as well.
Norman Rampart
March 21, 2013 at 5:56 pm
You know what Jim? The more I here about American healthcare the more I realise that this incredibly precious resource we have is doomed.
Businessmen and accountants are taking it over and our governments, whether left or right or somewhere in between are letting it happen.
I feel like crying for our kids. We’ve had the benefit, they’ll have Britain’s American version.
John Bull
March 21, 2013 at 1:02 pm
Here’s another stupid bloody thing owned by America. You have to mortgage your house to get well if you’re unlucky enough to get sick. Like my countryman says we pay a wee bit but that comes from our taxes. No one wants to see your insurance card in the civilised world. America the great my arse.
Norman Rampart
March 21, 2013 at 6:00 pm
‘My arse’? – You are Jim Royal come to life!
America has many many things to be rightly proud of – although, despite the movie they didn’t grab the Enigma machine in WWII, The Brits and the Poles did – bloody good rip roaring movie mind you
America is a place full of beautiful people with no more share of scumbags than we have in Britain.
I could live there quite happily myself – as long as I didn’t get sick
Chelsea Pickering
March 21, 2013 at 1:15 pm
Here’s one time I’ve had to agree that America has a lot of problems, what with their guns and all of their profit health care. We’ve got our worries here in Britain, but we don’t worry about some fool shooting us, or being able to see a Doctor without paying. Glad I don’t live in America, although when a kid that’s all I wanted. No more. I got older.
Norman Rampart
March 21, 2013 at 6:05 pm
There are many many reasons why living in America would be a great thing babe (I can say ‘babe’ cause you’re English – apparently, Mike informs me, you have to be careful of things like that over there)
the people for one. Marvellous. A never say die attitude.
I find Americans almost frighteningly ‘open’ about themselves when you meet them. They ask you questions about yourself that us Brits wouldn’t dare ask until we’d known each other for months!
Extraordinarily ‘open’ people and all the better for it.
Perhaps it’s because we live on a small island and they live in a rather big place.
Still, their system of ‘healthcare’ is not only worrying – it’s heading our way right now.
Anyone for a revolution?
Michael John Scott
March 21, 2013 at 6:23 pm
Norman you are right about Americans being open about things. I lost a good friend because he misunderstood my humor. Even though he was dour prick, I was forever trying to make him laugh. I didn’t succeed.
Norman Rampart
March 21, 2013 at 7:11 pm
You should have tried the old ‘there’s a banana skin, step over it and fall down an open man hole’ – well it worked for Chaplin, or was it Keaton…I’m sure it wasn’t Laurel and Hardy
His loss mate
Jim Moore
March 21, 2013 at 7:18 pm
I’ll hypothesize that openness comes, in part, from a relative lack of formality in our culture. To a large degree, we eschewed the trappings of nobility when our ancestors came here. Most of us don’t really “get” kings and queens and such…although we have replaced fawning all over the queen with fawning all over celebrities and athletes.
There is a superficial equality here…mostly an unwillingness of the “great unwashed” to bow to what passes for our current “nobility”…the monied classes. There is even a bit of disdain for lineage–your father’s accomplishments bestow you only with his money and the head start in life that money can buy. But we are quick to criticize those who do not capitalize on their endowments, and we certainly will not revere the ne’er–do–well son or daughter of a mogul.
So, back to the hypothesis (not a theory, because I’m just making this up as I go along), I suspect our sense of equality also endows us with the freedom to blather on about ourselves, revealing “secrets” as if we are all peers…which, of course, in reality we are not. That, and so many of us have guns, of course, and so we carry with us the implicit threat that we’d shoot you if you were to misuse one of those secrets you never asked to hear in the first place.
Norman Rampart
March 21, 2013 at 8:27 pm
Jim, you are a very wise man – and an American, which, as I do adore Americans, is intended as a compliment.
er…don’t shoot me?
Jim Moore
March 21, 2013 at 9:24 pm
Go ahead. Make my day.
Jim Moore
March 21, 2013 at 9:25 pm
Only Americans would not only revere the guy who made that phrase famous, but also invite him to speak to an empty chair at a political convention.
Norman Rampart
March 21, 2013 at 10:12 pm
It was a wee bit of a classic as politics goes though eh?
Jess
March 21, 2013 at 7:21 pm
Being born a California babe, I will say this is the best place to live in the world. Well, except for the month long vacay in Italy where we rented an apartment instead of staying in a hotel, Italy is the best place in the world, oh except for the Costa Rican vacay we went on and that is the best place in the world or Thailand or name any place in this world. Everywhere is the best place, according to the residents there and that is how it should be.
That being said, unless you can afford it, the healthcare system here sucks big elephant balls because it’s all about coin for the CEOs and the shareholders to deny or delay care. We could have single payer in a heartbeat, for way less in taxes than I pay to CA for sales tax. I have excellent benefits, because I can afford them and now that hubby is working for the feds, we will have better than excellent benefits and it is just not fair. We can afford to pay a lot more than what we are paying in taxes, so that someone else can see that doc when they need to, no excuse for not having single payer here, none at all.
Norman Rampart
March 21, 2013 at 8:33 pm
Jess? Lead the revolution babe! You know it’s right!!!
I will now stand back in the safety of being in England and watch Jess lead the charge!
Half a league, half a league,
Half a league onward,
All in the valley of Death
Rode the six hundred.
“Forward, the Light Brigade!
“Charge for the guns!” he said:
Into the valley of Death
Rode the six hundred.
Don’t do it babe! We are the ‘little people’. We can rant and we can rave but, alone, we can do no more than that. x
Jess
March 21, 2013 at 9:16 pm
I’ve been doing that on LGBT equality, single payer here in CA and DC, anti war, pro choice you name it I’ve been for it or protested against it. Consider this, I was the first in my family to have an actual bail fund set up, in case I was popped for civil disobedience, oh and this was as a teenager protesting the death penalty
I’m only one voice and it’s being silenced by the “moral majority, who are mostly poor southern white straight protestant republicans with harpy voices” who want the wealthy to stay that way, because some day they have the thought they may be like that too.
Enough of us “little people” having had more than enough started the French revolution.
Norman Rampart
March 21, 2013 at 9:30 pm
If I wasn’t old and already married…oh the son of a bitch that is life eh?
Jess. Never stop being you.
I don’t know you and you don’t know me but. But. Reading what you say I would be so bloody proud of you if you were my daughter.
Keep the faith eh?
Someday the keepers of the faith will win – or at the very least we’ll stop the other bastards winning.
Love n hugs from England xx
You’d like my daughter – she sounds just like you.
I often apologise to my wife for Jax taking after me – and you eh?
Jess
March 21, 2013 at 10:41 pm
My ‘rental units were all about giving back so they raised me to be like this. Something else I can blame on them right?
my dad did the same thing, because I did a lot of following in his footsteps, much to my mother’s dismay at times and even though they were not bio parents I am really like my dad was in nearly every way.
Norman Rampart
March 23, 2013 at 7:06 pm
I was adopted too Jess.
Regardless I inherited my ‘adopted’ dads ‘gentleness’ – is that a word?
I wouldn’t hurt a fly. Unless.
My ‘own’ make up says differently.
I so often have the urge to ‘hurt’ someone so much I feel afraid sometimes.
Adoptees are what they are babe. We are what we are and we just try.
That’s all we can do. Try eh? Love n hugs babe xx