Thursday, 9 September 2010

Are we smoking NHS joints?

So here is the pickle; welfare now costs £192 billion a year and the NHS costs £119 billion a year. Together they constitute 46% of the annual budget. Hence I ask, what the fuck? There is enough money in those two items alone to finance an average-to-large revolution in some failed state somewhere.

Yet the NHS budget has been ring-fenced and they are made to pay for such ludicrous items as sex-changes. Now this is somewhat of an issue with me not because I want to change sex (I am perfectly happy the way I am thank you very much) but because there are a lot, a lot, of doctors in my family. A few of them, well actually, all of whom I have spoken to, think that it is okay that the NHS should pay for some dude wanting to be a lass or a bird wanting to be a bloke. How is that the concern of the taxpayer I ask? Is it an illness, a disease, will not changing lead to terminal decline and ultimate death, are there not more pressing issue than some guy wanting to remove his penis because it 'feels wrong' - etcetera? You can understand my frustration when I realised that a sub-partition of the budget of the third largest employer in the world, was used for funding such trivial and non-issues as the one described above (the price for a sex-change operation is somewhere in the ballpark of £50,000 to £100,000). This is of course not news, what was news to me was that sub-partitions of my family thought this was okay. What have they been smoking?

It is politically expedient to support the current status-quo of the NHS, to, in real terms, increase its budget. But I cannot for my life understand why politicians do not make the simple argument that 'if we reduce the budget for the NHS we will be able to give you better schools, roads, ports, town-centres, national parks et al.' It is not a particularly freudian notion to want to make life better for the majority at the expense of the majority. There is some ridiculous waste going on in the NHS that is without doubt. Yet I am dumbfounded when I consider what other countries are spending on healthcare.

Look at these numbers (source) they represent the amount of money spent, as of GDP, on healthcare by respective country.

Australia 17.7%
Canada 16.7%
France 14.2%
Germany 17.6%
Japan 16.8%
Norway 17.9%
Sweden 13.6%
UK 15.8%
USA 16.0%

Why is that universal healthcare brings out the worst in systems in the UK? Now I have experienced healthcare in one of the above nations (other than the UK) and it is absolutely great, the doctors even wear white bloody coats - the hallmark of doctors (apparently they spread viruses and bacteria these white coats, something which I have been assured by family doctors is completely and utter bollocks, it is politics apparently why they do not have them anymore in the UK). Hence as I have described there exists a certain climate in the UK where anything goes, whatever you want to do you are not responsible for your own actions and the state will clean up after you regardless. Everything is free. Do not get me wrong universal healthcare is probably one of the very few virtues of man that makes us morally superior to any other animal where survival of the fittest is law. However charging a simple nominal fee for seeing your GP would save millions a year by avoiding the hypochondriacs who drain the system of all its usefulness. Of course if you are feeling severely ill then you go and see a doctor but nor four times a week. Here is another fine story why the NHS is such a nightmare when it comes to saving taxpayer pounds:
I just went to see my doctor for a renewal of my omeprazole prescription. For ten years I have been taking 80mg per day, for hiatus hernia. That is two packets of 7 x 40mg per week.

The doctor called up the prescription on her screen and it showed £15.50 per packet charge to her practice. She asked whether I had tried a cheaper alternative. The answer was yes, without success. So I went to collect a month's supply - eight packets at a cost to the NHS of £124 less my £7.20 contribution.

Yet this is a generic, not a branded, medicine. When in Ghana I buy precisely the same medicine, by precisely the same manufacturer - Dr Reddy of India - in precisely the same packaging, for the equivalent of £2.80 per packet. It is genuine - believe me, with this unpleasant condition you would know very quickly if it was not genuine.

So why is the NHS practice paying £15.50 for a packet of medicine available individually at retail price for £2.80 internationally?

At the international retail price my medicine costs £291.20 per year. The NHS pays £1,612 per year.
This is a very prevalent practise amongst medical companies. They charge the NHS 10 times or even 20 times the amount for nuts and bolts, than they would do the private person, because they know the NHS are stupid enough to just fill in any form without asking any questions. This is how it works: Craig has found the crazy little profit margin at work within the NHS. The government through the drug tariff sets what it believes a medicine will cost (the £15 mentioned). It will then remunerate the pharmacy that dispensed the prescription with this amount less your contribution and a percentage that is arbitrally decided every year (called the "claw back"). The pharmacy however is able to buy in the mediation at any cost it can find. Including you £3 pound packs from Ghana (provided it can prove a reputable supply chain). The pharmacist then pockets the price difference. As an additional note not all medications have quite such a vast price difference as omeprazole, some are even done at a loss. This does not however quite balance out and this is where the pharmacy makes its profit. Not from selling shampoo as they would like you to think.

There are a lot more ways this leviathan can and should be tamed, though under the aegis of political expediency I think we will have to wait for the NHS-Thatcher before something tangible will actually be done. Again I am going to pull the old oxymoron of woman with balls. With that note I end this piece, I cannot and will not, go into the impact of the EU and health tourism for then my own blood will start to boil and I will have to go the NHS and seek aid, which will make this entire exercise somewhat hypocritical (I cannot really criticise an institution one second, and the next seek its help).

1 comment:

Pavlov's Dalek said...

I'm afraid that because the NHS is taxed base, there is no downward pressure on costs - It's a company that is not allowed by the state to die, and is propped up by taxpayer collateral and fiat currency.

It's been running 60 years and it's still falling to pieces day by day. It's time to change to an engine that actually works.

V for Voluntarism