Re: MD the metaphysics of free-enterprise

From: Platt Holden (pholden@sc.rr.com)
Date: Fri Jul 16 2004 - 15:41:11 BST

  • Next message: ml: "Re: MD the metaphysics of free-enterprise"

    Dear Anthony,

    Thanks for re-posting your response to my Sun and Skynews articles on the
    sorry state of NHS. Even though you're no fan of these two news sources,
    it seems the facts they reported were accurate. At least I have yet to see
    a rebuttal.
     
    > For your information Platt, the only British media references I have
    > received from Pirsig have been the Guardian and the BBC – which are,
    > despite their limitations, definitely the higher quality sources for UK
    > news.

    Regarding the "high quality" of the BBC I'm sure you're familiar with the
    recent Hutton Report which charged the BBC with broadcasting "unfounded"
    allegations that the government deliberately misrepresented evidence of
    Iraq's weapons of mass destruction, without proper editing or
    verification. Indirectly, the Report also called into question the BBC's
    coverage of the Iraq war, and the Corporation's much-vaunted claim to be a
    neutral observer of major international events. So much for the BBC as a
    high quality news source.

    I don't know whether the Guardian as undergone similar exposure as having
    a left-wing bias (like our NY Times), but taking your word for it that it
    can be relied on for accurate reporting I found the following about the
    NHS on its website. It begins like this:

    "The NHS has a severe shortage of capacity, directly costing the lives of
    tens of thousands of patients a year. We have fewer doctors per head of
    population than any European country apart from Albania. We import nurses
    and doctors from the world's poorest countries, and export sick people to
    some of the richest. More than one million people - one in sixty of the
    population - are waiting for treatment. They are waiting far too long,
    every step of the way - for the first appointment with a GP, for initial
    consultation with a specialist, for diagnosis and for treatment. Patients
    needing heart bypasses often have to wait over a year for treatment. One
    in four cardiac patients die while waiting and one in five lung cancer
    patients wait so long they go from being treatable to untreatable. The
    cancer survival rate in Britain is lower for cancers than almost all other
    developed nations. World Health Organisation figures show that if the UK
    had the same cancer survival rates as the European average, it would save
    10,000 lives a year; if we had the best in Europe, it would save 25,000
    lives a year."

    The article continues in the same vein for several pages--too much to
    reproduce here.

    Ant:
    > Yes (as the Sun would conveniently fail to mention) is that all these types
    > of problems arose in the 1990s after the UK Conservative party introduced
    > free market policies into the NHS.
    >
    > The ward cleaners were one part of this privatisation scheme and it is when
    > the cleaning contracts went to the lowest cost bidders rather than the
    > highest quality bidders that serious problems (such as the MRSA bug) became
    > evident. For instance, these private cleaning companies employ low paid
    > immigrants who often can’t speak English. This means they fail to even
    > understand many of the basic directions given by management when cleaning
    > wards.
    >
    > The overwork comment from the Murdoch adult comic is also interesting as
    > evidently last year (for the first time) there became more bureaucrats
    > (required to operate all the free market systems) within the NHS than
    > hospital beds. There also remains a shortage of nurses and of doctors –
    > another disgraceful legacy of Thatcherite free-market “economics” in the
    > wrong context.

    The above mentioned Guardian report addressed your "blame private
    enterprise" charge in the following manner:

    "The Conservatives made some attempt to redress these perverse incentives
    by introducing the internal market, which only came into partial effect
    and had little impact before being abolished. Labour has now partially
    reinvented the internal market by devolving most health care spending to
    primary care trusts, and has also invented bonuses for well-performing
    hospitals and sacked managers of poorly performing hospitals.
    However, the NHS will remain a centralised state monopoly, and all these
    reforms will do little to reverse the perverse incentives that undermine
    most attempts at reform. Sweden, which also largely funds health care out
    of taxation (in combination with extensive user charges), has undergone a
    far more radical programme of introducing an internal market with massive
    decentralisation, splitting up purchasers and providers, and establishing
    each hospital and department as a 'profit centre'."

    You can read the entire report on:

     http://observer.guardian.co.uk/print/0,3858,4388569-109293,00.html

    Finally, I notice you signed off by saying, Yours pragmatically." That put
    a wry smile on my face because we know what Pirsig had to say about the
    negative social value of pragmatism.

    Best regards,
    Platt

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