The NHS vs the AHS
2nd December 2019
Dear Brothers and Sisters,
It doesn’t feel a lot like Christmas. Being in Australia, with summer now officially started, its strange to see Christmas trees, shopping centres with Santa’s and even the beginnings of some Christmas music (although I have noted the comparative lack of the endless piped music – I still havn’t heard ‘I wish it could be Christmas everyday’).
This week we also said goodbye to Peter and Jodie Blair – who after four years of studying at Moore College are returning to work with the Anglican church in Belfast. It is encouraging to see people going from here to work in the UK – I met with another couple who are planning to go to Scotland as missionaries. We need them!
I also had the opportunity to get out on my bike for the first time in Sydney. It was
wonderful. There is no better way to get to know a city than to cycle it. My impressions so far? It’s hilly and sweaty but absolutely beautiful. I’m not sure that drivers here are any more bike aware/tolerant than in the UK – so where there are cycle paths they are appreciated. For those who always nagged me about not wearing a bike helmet in Dundee – your worries are over. I have to wear one here or face a $344 fine! https://www.abc.net.au/news/2019-10-27/nsw-bike-helmet-fines-too-expensive-researchers-argue/11640722
A Dental Bill Shock
Cycling will certainly improve my health (providing I don’t get knocked over). Which brings me on to the whole question of health care. I had to go to the dentist this week and ended up paying a bill of $375 (about £200) with more to follow! It was a real shock to the system because in Scotland I would only have paid £20 for the same treatment. Every time we go to the doctor here it costs $70 (with about half that coming back through Medicare). At home it was free. There is something deeply ingrained within me which says that this is wrong. Surely healthcare should be ‘free to all at the point of need’ – the basic principle of the NHS?
Having experienced the American health care system – one of the most expensive and inefficient in the world – I am fully in support of what some of my American friends call ‘socialised medicine”. I love the NHS and owe it my life! However I am having to rethink some of my views because of my experience of both the UK and Australian systems. And thinking is what our politicians and media generally do not do (at least out loud!), because the NHS is the nearest thing secular Britain has to a religion – to dare to question any of its doctrines is to commit blasphemy and electoral suicide. But think about this.
Paying for Health Care?
Why should those who can afford it not pay for health care? We pay for many other things – why not health care? The problem is that a universal health care system comes at a cost. Firstly there is the financial cost – and with an ever aging population and an ever increasing bureaucracy it is very doubtful whether the UK can afford to continue the NHS in its current form. The system is already breaking down and I suspect if people are not willing to pay for health care directly with their own money, they won’t appreciate the government indirectly paying by raising taxes and crashing the economy! The numbers being banded about are just nonsensical – the Tories promise 50,000 more nurses and to build 40 more hospitals. Labour state that the government plans to sell the NHS to American Pharma – with the nonsensical claim that £500 million per week will be sent to American drug companies. Given that the total NHS bill for drugs is ‘only’ $18 billion this, to say the least, seems unlikely! (do the maths!). The SNP have an appalling record on the NHS and their only defence is the disputable claim that ‘it’s better than England!”. All the parties promise that they are the only ones who will save the NHS. None of them will.
But even more importantly there is the people cost. Firstly for the patients. What’s the point of having a service that is ‘free at the point of need’ if the service is poor or even unavailable? Take our experiences here at three levels.
The Doctor –
I don’t have to queue in the freezing cold to get one of the few ten minute appointments available. I can phone up and get an appointment if not the same day, probably the next. And its for a lot longer than ten minutes. If I require a scan I don’t have to be put on a waiting list for six months – I will get it within six days. The level of service is way higher than anything I experienced in Scotland’s NHS. When you have had friends who died because they were diagnosed far too late because of waiting lists and lack of resources it makes you question whether the cost is worth the ideology. When you think of the waste that is caused by missed or unnecessary appointments (in some areas 30%) it makes you realize that paying for something would greatly reduce that inefficiency.
The Dentist –
My dentist in Dundee (who is an excellent dentist) warned me that when I came to Sydney they would probably laugh at the level of treatment I had received. I thought he was joking. He wasn’t. When the dentist here opened my mouth I saw the look on his face – so I told him what my dentist said. His reply? “I can see why! I was trying hard not to laugh”! Even in my one visit – the consultation was a guaranteed hour; equipment and machinery was used which I had never seen before. It felt like I had come from some primitive tribe in comparison. Please note that I am not blaming my dentist. Health workers in the UK can only work with the resources and equipment they have.
The Chemist –
Our local chemist is incredible. When we pop in to get our prescriptions he/she gives advice, checks if we would be better with something else and takes time with us. I regard it as an absolute nonsense that in Scotland millionaires and middle class people get free prescriptions. When I come home to Scotland I could stock up on drugs – at the expense of the cash strapped NHS. Here I am much more careful about how I use medicine because I have to pay for it.
Can the NHS Change?
There are lots of problems with the Australian system. I’m sure that there are people who suffer because they do not have enough money and somehow slip through the net. But I am also sure that the NHS cannot survive in its present form. It’s too bloated, too expensive, too much a machine and not people-centred enough. It’s becoming both an ideological fantasy and a bureaucratic nightmare – far removed from its original Christian roots. As a result both patients and staff both suffer.
I find it interesting that when you suggest that perhaps private insurers should be involved there is outrage – and yet this is the system that prevails in most European countries. In fact it is fascinating to compare and contrast how different countries in the world seek to deliver healthcare. https://www.theweek.co.uk/nhs/87658/the-nhs-vs-global-healthcare-systems
When you have a health care system that is supposed to cover all, but is not, and cannot be adequately resourced out of the public purse, then it is not the wealthy (who can afford to go private) or the middle class (who know how to work the system) who suffer. It’s the poor. Why can’t we have a system where the poor get free or subsidized health care and others have to pay according to their ability? From each according to their means to each according to their needs!
And yet the NHS won’t change – except through decay and implosion. Because none of the political parties will be honest and face up to the challenge. They will all do the soundbites, make the promises, blame each other and bury their heads in the sand. But the bigger problem is with the electorate. It is deeply ingrained into us that somehow health care should be free – and someone else pay for it. Why? Why is that not true for servicing our cars? Or eating food? Why should we not pay towards our own health care? My own view is that we either pay directly or there should be a specific and progressive healthcare tax – where the wealthy pay more.
I will reflect on this more. But its strange having one of your most profound convictions challenged in such a way that you feel compelled to change!
Unsubscribe
One other change is that finally I have ‘unsubscribed’ from the DCA (Dundee Contemporary Arts Centre). It was a Friday night tradition for myself and Annabel to go to the DCA and I still liked seeing what was on. But the time has come when, in their words, I no longer ‘wish to hear from them’. Sometimes I come across Christians who are struggling because they have stopped reading their bibles – its as though they have said to the Lord “I want to unsubscribe…I no longer wish to hear from you”…and they are surprised when he gives them what they want!
I hope none of us are like that. Hope you had a great Lord’s Day and that you will have a blessed week,
Yours in Christ
David
Letter from Australia 17 – Joy in Serving
The Christian Heart of Modern Medicine