'...In order to know where we are going, we need to know where we are.
And order to know where we are, we need to know where we come from...'
Julian Tudor Hart (2008) Lecture
(available on You Tube)
I am not sure what is more dismaying; Roger Taylor's work, or the high ratings given by so many of the reviewers on this page. I do wonder what exactly Taylor is trying to achieve here.
The NHS is the means by which the English people look after each others health. This is not an 'emotional attachment', it is a rather obvious practical necessity - or at least it should be obvious.
Another obvious fact is that we all, at some point in our lives will become ill, and require medical attention.
*I would not want to be denied healthcare. I know that my life has no more value than another persons, so I would not want anyone to be denied healthcare either.
The NHS is based on Dorling and Shaws 'Positive Care Law' (Google Scholar). The Positive Care Law demonstrates the essential decency of human nature. It needs to be said that this is not romanticizing people. People look after each other because they know this is the only way that they can ensure that they will be looked after. It is a pragmatic response. In 1948 the NHS represented this response to health needs in a higher form by radically bringing a patchwork of private provision and charity into a unified system of planned healthcare delivery.
The result, despite right wing propaganda to the contrary, was an exceptionally efficient healthcare system (see Guillbaud report 1956 - [...]), as compared to other systems.
One gauge of a a health systems efficiency is the level of internal transaction costs (admin costs). In 1990 the UK NHS system had admin costs of 6%, which equates to £6billion from a £100 billion budget, and had the lowest running overall costs of any western system. This was due to the NHS operating as a 'Gift Economy' where market forces were pushed to the periphery, and where no one knew the price of anything.
Post 1990 saw the Internal Market (Via Thatcher) which turned hospitals into independent businesses, in which clinical staff were increasingly forced to prioritize commercial considerations before clinical ones. Pre 1990, thatcher had bought in a supermarket man to bring his wisdom acquired through running supermarkets...to running the NHS. If you cannot see what is wrong with this then you may as well put your head in an oven. Sorry.
Cleaning was outsourced to contract firmed which removed the control over hygiene from nurses. A huge rise in infections then resulted.
The internal market saw a rise in transaction costs (lawyer's bills, accountancy bills, invoicing etc.. ) moving the Admin costs from 6% to 10-12% by 1997. This move to an US healthcare system (officially planned in 1987 see - Julian Tudor Harts 1994 article 'A Plot Exists' [...])which ultimately will lead over time to similar administration costs of the US system (20-30% representing £20-30 billion from a £100 billion budget.
This is the economic argument. The clinical argument against privatization is that commercial considerations distort clinical decisions. Evidence for this abounds in the US. Doctors there are forced to serve the hospitals need to generate income. The result is that people receive treatments, (operations, investigations etc..) that they do not need.
Also the lack of comprehensive coverage has lead to huge rates of bankruptcies in the US (see Michael Moore's film 'Sicko'- [...])- This is all in a system that costs twice as much to run per capital as the UK system.
I could go on - but I don't want to write a book!
Taylor is not an expert in his field. Will have learned more in my review than will through reading Taylor's book. He fails totally to provide the reading public with the information/concepts they need to understand the situation.
Also it seems to be lost on Taylor the fact that people are going to die as a result of the NHS's destruction. This is real and a lot of suffering will result. We need writing that demystifies and informs. The best current book out there is 'NHS SOS' by Jackie Davis et al. (2013).
All I can do is to ask you to please read the following authors -
'NHS SOS' Dr Jackie Davis (2013)A current work designed to inform the public of the 'reforms' history, mobilize the public behind the NHS Reinstatement Act drafted by Prof Allyson Pollock and David Price, and taken to the House of Commons by Lord Owen this Spring. The Act supported by Owen is designed to reinstate the legal duty upon the Secretary of State to provide universal equitable health care for the population.
Allyson Pollocks seminal 'NHS Plc' (2006)Plot Against NHS Stewart Player
'The Plot Against the NHS' by Colin Leys and Stuart Player (2011)Plot Against NHS Stewart Player
Julian Tudor Harts work -Political Economy Health Care Society
John Lister's WorkHealth Policy Reform Management Educatio
The first two are aimed at the Public - the last two are more challenging but are worth working at