My partner recently had to go into hospital. The Queen Elizabeth Hospital in Glasgow, Accident and Emergency. It was recently slated for having up to a thirteen-hour waiting time. We know there is little point phoning for a GP appointment on the Tuesday, after a Bank Holiday. The phone will ring off the hook. My tactic to avoid this is go to the surgery window and wait to catch the receptionist’s gaze. We’re an ageing population with more money needed to be channelled into health care.
What we get instead is Thatcherite ideology of the market knows best. The market does know best. It knows best how to take money from poor people and give it to the rich. In this case Operose Health, which is a subsidiary of private healthcare firm Centene. In the United States their looting of welfare funds led to them being sued by a number of State bodies for fraud. They paid the fine, but, of course, didn’t admit guilt.
What we have here is a different kind of fraud. A rentier class, who are paid a fixed amount for providing a service where there is no risk to the rich. We also did it with trains. Subsidised other nation’s rain networks and it gave them a guaranteed income.
70 GP surgeries and 600 000 patients. Jacqui Wakefield logged 300 patients waiting to get through to her. And she couldn’t offer any GP appointments for any of them. One ruse was to offer appointments with a cheaper option. Put them in a white coat. Give them a fancy title. Work them with appointment after appointment so they do the equivalent work of two GPs. That’s called efficiency savings. In other words, profit for destroying the worker’s health and the health of the people he or she is trying, but failing to help.
A study of the equivalent of Norwegian GP’s, for example, found that the more highly qualified those practicing medicine the better outcome for the patient. Not only were they able to pick up early signs of disease and treat it earlier saving more costly treatments with knock-on effects at later stages. A virtuous circle.
A vicious circle looks something like this model. Underqualified staff. Clinical correspondence – medical reports, test results and hospital letters – that had not been read for up to six months.
In the Thatcherite model of health care, patients would be able to shop around for better treatment, where they weren’t treated to the indignity of having to spend days on the phone. Similarly, GP practices would compete against each other to bring in the brightest and best and innovate, while making a profit. In the same way we did with our prisons, or the probation service, before that was scrapped as being unworkable.
Scotland has largely rejected this carpetbagger model of modern finance. But the Queen Elizabeth Hospital was extended with many of the same principles. Give money to rich people for building something you could do cheaper and better with forward planning. We can clap NHS workers, while not giving them a pay rise and look for savings elsewhere. We know how this looks. It looks very much like the one rule for the rich and one rule for the poor of Centene and their ilk. Efficiency savings are only efficient if they end up in a tax haven. We all know how that feels. Because we’re all in it together. In George Orwell’s Animal Farm, ‘some animals are more equal than others’. Some patients are more valued than others.