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10 Mar 04 - 01:47 PM (#1133200) Subject: BS: Private versus public medicine From: McGrath of Harlow Recently I had reason to go along to two hospitals with someone who was having some tests. One was a private hospital, and the other was the local NHS hospital. And both of us agreed that we vastly preferred the NHS one. The private one had soft seats and soft lighting, and acres of waiting space. Anonymous looking doors, behind which anything medical was shut away. Mysterious figures appeared occasionally and drifted around, some of them wearing smart suits and very high heels. There was really nothing whatsoever to make you think it was a hospital rather than a hotel or some kind of waiting area in an airport on a quiet day. If you wanted a cup of tea there was a machine. A few copies of the Telegraph and the Daily Mail were placed on some seats. The NHS one had higgledy-piggledy seats, and lots of notices pointing the direction to various medical facilities. Public health notices stuck on the walls, some with drawing pins or sticky tape. Lots of people busily dashing around, wearing a range of working uniforms – nurses, doctors, cleaners, builders - it couldn't have been anything other than a hospital. A scatter of tattered old paperbacks were there to buy or borrow in various places, and the normal random selection of out-of date magazines. Up the end of one corridor there was the WRVS tea bar. Downstairs was the canteen shared by staff and patients and visitors. Make your own toast - and when I burnt mine, a large nurse showed me how it worked. A couple of the men working on the extension that's being put up were at the next table, looking like Bob the Builder, with their yellow safety helmets on the floor beside them. As I said, we both agreed we vastly preferred the real hospital to the private version. And yet, I am sure that the very things that made us prefer it are very largely the very things which the people in charge would probably like to get rid of; and the very things that we didn't like about the private hospital are the very things that they would like to introduce into the NHS. They would see them as improvements. Make it more like a business selling an image, and less like a working community. |
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10 Mar 04 - 03:46 PM (#1133274) Subject: RE: BS: Private and public medicine From: GUEST I would prefer a hospital which I can phone to make an appointment, and be given one within the next couple of weeks as opposed to be put on a six month ( or longer) waiting list. I would prefer a hospital where I can be admitted for an operation if necessary, and not stand a good chance of it being cancelled at short notice, and at times on the actual day of the operation. I would prefer a hospital which is staffed at realistic levels,and the staff paid at a realistic rate, so that they feel valued and able to put their all into nursing. I would prefer a hospital which is able to offer private rooms or small wards. Thus decreasing the risk of MRSA being spread throughout an over crowded ward. Under the current NHS being offered, I would have to pay privately to ensure all of the above criteria are met. I would prefer my taxes be directed towards our current NHS system so as to improve it. |
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10 Mar 04 - 03:51 PM (#1133277) Subject: RE: BS: Private and public medicine From: GUEST,MMario I would prefer a hospital which I can phone to make an appointment, and be given one within the next couple of weeks as opposed to be put on a six month ( or longer) waiting list. I would prefer a hospital where I can be admitted for an operation if necessary, and not stand a good chance of it being cancelled at short notice, and at times on the actual day of the operation. I would prefer a hospital which is staffed at realistic levels,and the staff paid at a realistic rate, so that they feel valued and able to put their all into nursing. *IF* such conditions exist in the UK they probably only exist because NHS exists. Those conditions don't pertain in much of the US and we don't HAVE NHS. |
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10 Mar 04 - 04:43 PM (#1133315) Subject: RE: BS: Private and public medicine From: GUEST They don't exist within the NHS. That was my point. |
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10 Mar 04 - 05:05 PM (#1133333) Subject: RE: BS: Private and public medicine From: Walking Eagle Don't even go there British, Canadian, and Aussie (I believe)friends, DON'T EVEN GO THERE! |
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10 Mar 04 - 06:10 PM (#1133385) Subject: RE: BS: Private and public medicine From: McGrath of Harlow The thing that strikes me is was not just the issue of when the things we need can best be provided through public organisations (which need not necessarily mean government organisations, as the BBC's existence should remind us, and there are other possibilities here as well) or through private enterprise. Over and above that is the matter of what these organisations and enterprises should be like. There is a dominant culture which sees the kind of outfit I described when I was talking about the private hospital as the way things really should be. It's the model we should be pushing for in the public sector, and if we can't achieve it, that's a pity. Lean and muscular and fairly harsh for the workers, while for the customers it's to be a combination of cushions and blinkers, and stick on your own side of the counter, so to speak (even when the physical counter has been eliminated.) And it goes right across the board, not just hospitals. Increasingly it seems that how the world is supposed to be. The human style of operation in the private sector is equally under attack. And I don't like it. And I don't think its even efficient, in the long run. I remember a piece by Hilaire Belloc, I think, contrasting two ways of organising horse-artillery harness in two armies. One was shining leather, beautifully designed so as to eliminate any unnecessary material. The other was bits of rope knotted together. But break one strap on the shiny leather state-of-the-art harness though, and you had real problems. With the old rope harness, just tie another knot and you were back in business. That's what I call efficient in the real world. |
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10 Mar 04 - 06:52 PM (#1133412) Subject: RE: BS: Private and public medicine From: Johnny in OKC Speaking as an American ~~~ and I am presuming NHS means the British National Health System, I recently spent a few days in our local V.A. hospital, the Veterans Administration facility for ex-military. I was really astonished at the service, both medical and nursing, that was evident. There was nothing fancy, no frills. But they cured what was wrong with me, and the two other fellows in my room. And the food was great -- better than what I eat at home. The cost was about one tenth what it would have been at a private hospital. I can do without the plush cushions in the waiting room. I wish we had a VA (or NHS) type of public hospital system for all US citizens, not just ex-GI's. Love, Johnny |
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10 Mar 04 - 06:57 PM (#1133415) Subject: RE: BS: Private and public medicine From: GUEST Having an NHS system is not enough. It needs to be funded to be operable. That is the problem in the Uk. It is crumbling through lack of resource. Yes, the idea is wonderful, in reality it can be horiffic. I don't need fancy cushions either, just reliable healthcare. |
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10 Mar 04 - 07:10 PM (#1133422) Subject: RE: BS: Private and public medicine From: McGrath of Harlow Where I am it's not crumbling, it's recovering. But then we all see bits of it, and we judge by the bits we see. But even when it's recovering, I see the signs of this management smoothie culture, which to me seems to see a particular style as more important than the substance. Funny what Johnny from OKC was saying about the Veterans Administration hospital, because I was watching a Mash re-run on the box tonight, and I suddenly remembered what it was that hospital canteen had reminded me of. (Though our food was a lot better I imagine.) The utility approach, keep your eye on what actually matters. |
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10 Mar 04 - 09:56 PM (#1133512) Subject: RE: BS: Private and public medicine From: artbrooks I spent 3 days in our local VA hospital last week, and I agree with Johnny from OKC entirely...and I didn't have to wait 6 months, or even six days, for admission. |
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10 Mar 04 - 10:13 PM (#1133528) Subject: RE: BS: Private and public medicine From: Peace I required a hip replacement about four years ago. I had to wait five months, but then, I'd waited nine years by my own choice. Another five months was no big deal. The total cost was maybe $50 dollars in fuel driving to and from the the hospital for pre-op appointments. Even the follow-up health care was covered. The replacement gave me a life that was not filled with daily pain. The biggest hardship I faced was having to share a room for a week with a fellow who'd had a knee replacement. Some hardship. Oh, yeah, I had to pay a rental fee of $20 for articles I needed after the operation: walker, seat to raise the toilet seat level, special chair to use in the shower. I cannot understand why countries do not develop universal medical coverage. I do not understand. My nephew was treated for leukemia. He died at the age of eight from it. Had the family had to pay the bill for his treatment and care, the cost would have been $585,000. Who the hell can afford that? Public medicine has drawbacks, for sure. But the alternatives are unthinkable. The cost of coverage in Alberta for a family is about $70/month. There are arangements for people who can't afford the $70/month. A single person pays about $40/month. |
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11 Mar 04 - 11:47 AM (#1133937) Subject: RE: BS: Private and public medicine From: Strollin' Johnny Not crumbling through lack of resource, GUEST, but crumbling through mis-direction of available resource. Check out how many 'Support Staff' support how many nurses in the average hospital. I bet the ratio is the reverse of what you'd expect. |
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11 Mar 04 - 11:54 AM (#1133942) Subject: RE: BS: Private and public medicine From: jimmyt Well, to comment on the other side of this issue, is it conceivable to you that over time, fewer and fewer of the brightest students are not going to be attracted to medicine and nursing if they are not financially rewarded well for their efforts? Would most pphysicians have made the effort to deal with the eight to twelve years of higher education, the lack of any reasonable lifestyle for them and their young families, the 18-24 hour oncall schedules for years as residents, if they knew that they would be earning about the same as a university professor when this time was over? I don't think it is reasonable. In a perfect world, maybe but realistically? No, I don't think so. |
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12 Mar 04 - 07:42 AM (#1134656) Subject: RE: BS: Private and public medicine From: McGrath of Harlow How much people get paid is a different issue from who pays them. Low pay is just as characteristic of "the private sector" as high pay. |
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12 Mar 04 - 07:53 PM (#1135212) Subject: RE: BS: Private and public medicine From: Peace Wal-mart has been cited as one example of low pay in the private sector. Safeway pays fairly well. Guess it all depends. |