The National Health Service & lockdown rules: It’s the pandemic news from Britain

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Run for the hills, everyone: If the political tea-leaf readers are right, Britain’s National Health Service is going to be restructured. Again. Because in the face of a pandemic, it’s important to throw everything up in the air and see where it lands.

That information has a bit of history clanking along behind it. Remember the ghosts from A Christmas Carol? Didn’t one of them clank chains as it walked? Or did I make that up? Let’s pretend I didn’t. The clanking you hear is from The Ghost of the Christmas We Set the Tree on Fire and Burned the House Down Because We Wanted to Privatize the Candles.

Except it wasn’t the tree or the house that we burned. It was the NHS and–since we need two things to make this image work–the NHS.

Irrelevant photos: Hydrangeas.

Back in 2012, when the Conservatives shared power with the Liberal Democrats–this was in prehistoric times, before anyone dreamed the country would be facing a pandemic –the two parties passed a bill that restructured the NHS, putting elements of the NHS into competition with other elements and setting up bidding for contracts in ways that advantaged the largest, privatest contractors and disadvantaged the NHS itself. 

In the name of simplifying a complicated organizational structure, the bill created new levels of management. Then some poor soul was given the job of producing graphics illustrating how simple it all was. They were, by accident, by necessity, maybe even by some sly bit of honesty, very funny. They involved arrows running in all directions to illustrate how simple it was.

And in the interest of saving money, the restructuring was very expensive. 

One of the changes it made was to put some distance between the government and the NHS. At the time, I’d have told you that was a bad idea, and I had a lot of company in thinking that. The government had just denied its responsibility for the NHS and the nation’s health.

This re-reorganization–the current one–will give the government back control of it. The health minister will be able to say, “Fix this,” and see it fixed.

What do they want fixed? Staff shortages, long waiting times, budget overruns.Especially budget overruns.

Will the government having the power to say “fix this” help? Well, it’s been underfunding the NHS for over ten years now. And it’s made staff shortages worse by cutting the support that was available to nursing students and by the country’s hostility to immigrants, who keep the NHS working. Unless it’s planning to change that, then no. 

But it’s good to have a few weeks when you can point at the old structure, say it’s to blame, and wait to see if it works.

What will happen when the government has power over the NHS and none of the problems get solved? We may have to invade some small country to distract everyone. Or set the house on fire. 

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Since I mentioned contracts, let’s talk about contracts. One for £840,000 was given, without competition, to Public First, an outfit owned by two long-term associates of Michael Gove and Dominic Cummings.

Cummings is the prime minister’s brain and advisor. Gove? He’s a member of parliament and the minister for the cabinet office. I had to look that one up. It means he’s the minister responsible for cabinet office policies. If you feel like you’re going in circles there, it’s okay. I am too. 

Since the pandemic, a lot of contracts have been handed out without competitive bidding. Hey, we’re in a crisis. Who’s got time to find the lowest bidder or, god forbid, the most competent one?

Only part of this contract is about Brexit, not the pandemic. 

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Let’s not slog through an entire post without some good news: During the pandemic–and possibly before; what do I know?–the University of London is offering free online courses. I have no idea what they’re like, but if you’re interested, they’re there. I wish I’d known during lockdown. Sorry.

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A survey of what we have to assume is a representative sampling of British society reports that 72% of Britons followed lockdown rules more closely than the average person. 

Statistically, that means that, um–

Okay, I’m not good with numbers, but I’m reasonably sure it means that 72% of people are above average. I knew I loved this country. Now I understand why. 

 

65 thoughts on “The National Health Service & lockdown rules: It’s the pandemic news from Britain”

  1. I worked in the NHS from 1993 until I retired in 2013, and it was underfunded that whole time and from well before: the Tories have just made it worse over the past ten years. Part of my job was to compile bids for services being tendered, and it always felt like the odds were stacked against us, so that the Government’s rich mates (think Branson) could take their cut. The latest ‘reforms’ will, I’m sure, do nothing to remove the real problem: there should be no place for profit in healthcare.

    Is that figure of 72% being above average a Government statistic? It sure sounds like one…

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    • I can’t blame the government for the 72%. Sorry. I’d like to.

      Thanks for filling me on on your experience with the NHS. I’m not surprised. I know New Labour poured money into ridiculous schemes to build new hospitals that would siphon money off into private hands. They were more expensive in the long run but looked cheaper at the time. Further back than that, I can’t go.

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  2. Ellen, I know nothing is perfect, but many in the US have long wished for a National Health Service. We spend more for inferior outcomes. I am sorry to hear about the serious problems with the NHS in Britain. It seems we are not alone in having an administration that is weakening and destroying needed programs and departments! Hope things get better! Take care. Cheryl

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    • Thanks, Cheryl. The NHS is much loved here–I swear, it’s the national religion. And being American, I know what the alternative looks like. Which makes it particularly infuriating to see them sell off pieces, privatize it, disorganize it, make it about profit, not health. Many of the American health-care giants are circling the NHS like vultures.

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  3. In the last century, I worked for the NHS. During the 17 years I was there it was reorganised, I think, 3 times, possibly more. It had been reorganised the year before I started work and colleagues were already speaking nostalgically of how it used to be. Governments love to tinker, but never allow the end results of their tinkering to bear fruit before they tinker again. The NHS is a behemoth and doesn’t change quickly, so it takes a while (as in years) before you can tell whether or not the last reorganisation worked. I have no idea how the NHS works now, but I suspect that this isn’t the best time to change it.

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  4. I’m one of the 72% but also a maths teacher so my head hurts…
    Oh and a ton of comments will no doubt tell you this but it was Marley who was the ghost in chains. Or if you go with the muppet version then Marley and Marley…

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  5. Don’t you wish you had a magic wand so as to fix things? Make some people disappear, and stuff.

    Irrelevant info: the literal translation of Hydrangeas to Serbian is ‘little Bulgarian,’ which I always found odd. I have no idea what Bulgaria has to to with it. Who knows; maybe it does.

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  7. Ah ! Glad to see you knew about the exceptionality of Lake Woebegon’s population!
    Over here the Ruling Class is determined to do away with the only thing we have that approximates the NHS – in the midst of a pandemic. And, as it has since it’s administration began, there is no plan for replacement. Because all those people are the 99 % anyway. And many who have recovered from Covid now have preexisting conditions such as lung or cardiac damage.
    To paraphrase General Custer: “Bring on the Indians !”

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    • They really are irresponsible idiots–and vicious. I’ve read a lot about the lingering damage of Covid, although so far I haven’t seen anyone quantify it. I doubt anyone can, with the ongoing mayhem we’re living through, but it does seem to be leaving behind a trail of real damage. Someone I know–the friend of a friend–must have lung damage. It’s bad enough that when she left the house she had to be helped back in–she collapsed on the street.

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  10. Yes, not fixing but meddling. You sum it all up well: “it’s made staff shortages worse by cutting the support that was available to nursing students [loss of grants for nursing students has been appalling] and by the country’s hostility to immigrants, who keep the NHS working [shamefully true].

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  11. I clicked on the London University free online courses out of sheer curiosity, but it’s probably the most mystifying link I’ve ever come across. So don’t worry, you haven’t lost a thing….

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  12. To some extent it’s a systemic fault, that politicians can’t challenge the NHS on clinical matters, so they do the one thing they can do, which is reorganise structures. It started with the random assortment of services that existed at the time, and since then, there have been periodic shifts of power and re-definitions of duties up and down as between the centre, regional authorities and smaller local ones. It is indeed ironic that the party that insisted on (nominally) devolving power over the bulk of the money to pretty much the lowest level now complains that it can’t just wave a wand and have things happen. But once upon a time, it was rather the other way around: Nye Bevan once made it a boast that “the dropping of a single bedpan would echo down the corridors of Whitehall”.

    As for Gove: he has a pretty pivotal role in overall management of this government (insofar as there is any). Since Johnson is not a details person or particularly good at negotiating, Gove chairs no end of cabinet committees on his behalf, to get the different departments more or less into line. Once upon a time ministers appointed to do that sort of job used to be given one of the old titles hanging around from mediaeval times for various jobs to do with management of the monarch’s business, like Chancellor of the Duchy of Lancaster or Lord Privy Seal. In Gove’s case, keeping him busy this way helps Johnson (and Cummings) keep an eye on him: he has form for stabbing Johnson in the back, and they’re always on the lookout for signs that (as the slang has it) he’s “going on manoeuvres” to ready himself for another go at the leadership, should the vacancy arise.

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  13. There are too many managers in the NHS on fat salaries, and not enough nurses. This situation should be turned right around. In our hospital, 2 whole wards have closed and been turned into offices. That’s 60 beds gone, but more managers have moved in….

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    • After a certain level, you have to wonder what they find to manage. I’m reminded of a woman I worked with years ago who was known for having created a spectacular filing system. After she left, it turned out the there was nothing much in it.

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  14. Long wait times… I just want to cry when people explain to me how that reflects “rationing” of socialized medicine. Somehow they seem to think that private insurance companies aren’t rationing your health care when they are the ones in total control of what treatment for you gets paid for, and what doesn’t… I’ve never seen one of those people who actually had to compare the “long wait time” to see a specialist in a country with universal health care the wait times in the US. It’s not like you can just walk into a specialist’s office here and get seen, ever…

    Time to stop being depressed about this and go make donations to candidates who won’t try to end Obamacare. :-)

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    • Yes!

      My partner was a family therapist in the US before she retired and she saw plenty of rationing. But somehow when that’s done in the name of profit, it’s okay. Unless of course it happens to you. When it’s done by a health system the government runs (or set up), that’s awful.

      Some things will, inevitably, be limited. Should the NHS do nose jobs–assuming, of course, that your current nose is in working condition? Should it do IVF? If so, how many times before it declares your chances over? Should it fund very expensive cancer treatments and if so which ones? The decisions can be complicated and I’m grateful I don’t have to make them. But the idea that no one should say “I can’t afford that” when it comes to basic health care–that’s taken for granted here. As if should be.

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  15. When I was in eduaction (trapped, rather) we used to be subjected to this sort of nonsense where all the schools wanted to be above average…mathematically it just doesnt work but who cares about that?

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    • I was just listening to a radio discussion about what an increase in cases means in a local situation where they’ve increased testing. Should they introduce a local lockdown? Should they look at the higher numbers and decide they’re on top of it? It’s hard to know. And that’s an honest use of statistics. Not quite relevant to what you were saying, but–sorry, I think I just went on a tangent.

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