As a socialist, I still feel oddly guilty in confessing this. But like many middle class people, I get an annual full medical from a well-known private sector health care provider as a perk of my job.
I’ve thought about foregoing it on principle, but what would be the point? It’s essentially part of the wedge.
The contrast between such a service and the way the NHS handles me is more then marked. Perhaps the most obvious difference is the amount of time and attention I get from the doctor.
The last time I saw a GP, I didn’t feel that my worries were even listened to; she seemed mainly intent on chiding me as an overweight alcoholic hypochondriac, and was generally keen to get me the heck out of her surgery within the minimum number of minutes possible.
In contrast, at my private sector check-up I get an hour or more to go over the results of every single test. Any worries I have are assuaged with personally-tailored advice. I still get told to drink less and exercise more; it’s just that the bollocking is administered rather more politely.
But it remains reassuring to think that, if anything serious was about to go wrong, the likelihood is that it would be picked up while there is still time to do something about it.
Again speaking as a socialist, I have long believed that this the kind of medical MoT should be available to everybody. I’m no health economist, but surely the maths stack up on any cost-benefit analysis. Prevention is nearly always cheaper than cure.
So on the surface, Gordon Brown’s announcement today that he intends to increase the availability of screening for early signs of heart disease, stroke and kidney disease on the NHS marks a major step forward for health equality. As the old trade union maxim has it, nothing’s too good for the working class.
Unfortunately, I am still going to need convincing that this is more than a gimmick, as New Labour and the Tories slug it out over the title of ‘party of the NHS’. Doctors’ leaders point to a certain lack of joined up thinking:
Dr Richard Vautrey, deputy chairman of the GPs committee at the British Medical Association, said: "What I do find extraordinary is just two or three weeks ago the prime minister insisted that funding be taken away from the treatment of patients with heart failure, hardening of the arteries and kidney disease - the very conditions that he's now proposing to screen for."
The Tories add that there is no proper timetable for delivery, and it remains unclear where the money will come from.
Moreover, New Labour makes it clear that much of the work involved will be carried out by the private sector. At the risk of sounding a monumental hypocrite, I’d still make the case that universal screening would be better and more economically achieved as part of a properly-funded, fully integrated, comprehensive public-sector health care service.
I really do hope we’ll soon see the day where a full screen medical is no longer the sole preserve of those in better-paid employment. But it remains to be seen whether the standard of service on offer be anywhere near comparable to my annual trip to Harley Street.
Comments (29)
Yes, I've also often thought it maybe even kind of odd that states haven't picked up on this sooner - it is money well spent by them in the same way that providing schooling for all benefits employers (as well as us). It is surely cheaper to screen rather than treat later.
But the dangers include what will happen to those who are screened and for whom problems are identified.
I didn't even take an AIDS test for years (until I had to, when working in the Middle East) because I read that just the act of taking it, regardless of the result, would load your insurance premiums the thinking being that if you take such a test, you must live more dangerously.
A unemployed friend dealt with his minor mental health issues on his own knowing a visit to the GP about it would be disclosed in any health report for any new employer.
Unions should demand such moves are accompanied with stricter confidentiality e.g. compulsory non disclosure of results to insurance companies.
And I also think actually the two DRs that Dave has seen have more in common (and more different) than one might think.
One is working for him/herself and the other is an employee.
It's the GP who is the small businessman/woman looking to increase throughput not unlike the dentist I recently visited who had three patients on the go in different chairs (and to whom he said nothing) whilst talking to me (in my work capacity) about how it's not up to him to 'raise dental health awareness' but to "maintain his business treating those needing dental treatment" .
Abolish 'independent contractors' in the NHS and salary all staff.
As someone with very little medical knowledge, these check-ups sound like a good idea. However, a little browsing on the net quickly reveals there are those who would beg to differ eg The BMA
"SCREENING tests done privately are often a waste of time and money, and can even be hazardous, the British Medical Association said yesterday.
Outside the NHS, inappropriate tests were often provided, with little evidence of efficacy, poor quality control and a lack of advice. The tests, aimed at healthy people, often caused them anxiety and led them to have invasive tests or even operations they did not need, the BMA Board of Science said."
For the full article, see http://www.timesonline.co.uk/article/0,,2-1747918,00.html
and more recently another broadside against these types of test "Medical screening services may do more harm than good, warns expert" was in The Independent http://news.independent.co.uk/health/article3241924.ece
So far it seems to be only the most 'vulnerable' who will get it. Its not going to be universally offered . The recent death of a young fit footballer shows that its not easy to tell who is at risk.
btw , Im rather disappointed that Punchie did not call for your shooting after you admitted seeing a private doctor ;-)
Can I be the first on this thread to call Dave a sell-out?
Well I opted out of by private health insurance on principle and I have never regretted it, even when I contracted a serious illness (CIDP) and had to wait months to see a consultant on the NHS.
It is simply wrong to jump the queue because you have more dosh. I regard it a basic and elementary class solidarity to decine private health insurance.
Of course my opting out has also meant my children are opted out, as they would otherise have been convered, so it is a big step.
But what is the next step for you dave, sending your daughters to private school? There is no difference in principle to private health care is there?
Just how you come to your conclusion after telling us your personal experience defies logic.
Private sector experience - good. Public sector experience - bad.
It is better, therefore, to make the public sector responsible for all healthcare.
Bloody Q bloody E bloody D
"But what is the next step for you dave, sending your daughters to private school? There is no difference in principle to private health care is there?"
You mean like that well known socialist member of RR, Yvonne Ridley ?
Well, I did think long and hard about it, Andy. But when you're well paid, everything about your life is 'priviledged' to some extent.
Is it a breach of class principle to get a cab home rather than wait for a nightbus, just because you can afford it?
What about eating in a pricey restaurant or going on an exotic holiday out of reach of someone on an average wage?
I took the view that I'm not ready to take any chances with my health. That strikes me as fundamentally different from buying class priviledge for one's offspring.
How the princesses will be educated will not ultimately be my decision. But in so far as I do have any input in the matter, I will argue that they should be state-schooled.
I don't see the comments about Dave using private health to have any validity - you take the employers for what you can get (or rather, they take you) although I would certainly argue that any union I am in should negotiate to try and be paid cash rather than have that money support BUPA and the like.
When I am paid above the mean average wage I don't say to the employer - keep that which is in excess.
Andy
re private healthcare. I don't have access to it from work, nor can I afford it. I do think that when its a life or death or health issue its not always easy to be so principled.
I know when my mother was ill , and receiving a very poor service in the NHS, if I had had the money and it would have saved her life or made a real difference I would have used it to help her.
Does that make me an unprincipled socialist ?
I saw her suffer . Her treatment lacked any dignity . When it comes down to it I would have helped her and not worry about my principles.
I do though believe that health is a fundamental issue and all should have the same accses to good quality services and not have to wait.
I actually paid for private health for someone - she had a broken cartridge, was self employed, couldn't work and thus had no income. It was £2000 for a private operation in a few weeks then quickly back to work rather than not working for (6?) months whilst awaiting an NHS op.
It was a no-brainer that it was right to lend her the money and her to go private - it saved her thousands. It is also a no brainer that she shouldn't have needed to go private. I would have done as Stroppy would have, as well.
Which brings us back to Michael's 'logic'. I don't accept that private inherently means better. The problems Dave and I reported are based upon the private medics, not public.
When I worked in the NHS I would deal with GPs who would do things like claim they were paying their reception staff a good wage (and they would get back half? of it - I forget the percentage now - from the NHS) whereas in fact they would pay them just the minimum wage with the rest going into their own pocket. If found out they would just have to pay the 'excess' back (as opposed to criminal action that would be taken about people making false benefit claims).
I think the NHS would be immeasurably improved if all the private work of GPs, consultants, parasite piggyback private hospitals next door and the like were removed.
To amend what I wrote above you wouldn’t always accept something on offer from an employer e.g. private education.
About five years ago I had a life-threatening neurological condition. Despite umpteen visits to my GP, and other doctors in the group practice, I could not get them to take it seriously. Finally, my husband paid for me to see a consultant at the local private hospital. Although he could tell that I was very ill, he could promise me nothing better than the next bed that became available on the neuro-surgical ward. I had to sweat it out for ten days, there was no way we could afford the thousands that it costs for a MRI scan, although perhaps if we had realised that that was what I needed we would have made ourselves afford it. Anyway, eventually, the hospital rang up, and I may say it was just in the nick of time. I would almost certainly have been dead within two weeks. When I did get to the hospital, and received a scan, an operation was scheduled for the next day and I lived to tell the tale. The point being that screening is all very well, and most likely something that private medicine has pushed for as it's a nice little earner for them, but who picks up the tab? At the same time we are told that it is going to be harder than ever for junior doctors to obtain further training posts. Ha, bloody ha, who said the NHS is safe in their hands?
Since I'm in a good position to make the comparison, let me give it a try.
I used to get my healthcare from my local doctor in Montgommery County, Maryland, which at that time was the wealthiest county in the United States. When I went to the doc, I assumed I was going to lose the whole morning or afternoon, and get no more real time with my doc than I get here in down-market East London.
In Monkey County, I waited a long time past when my appointment was scheduled before I was seen, and when I was led into an examining room by the nurse I ended up reading a chapter or two of my book while sitting there in one of those stupid gowns.
When the doctor finally arrived, he usually just put the stethiscope on my chest and back and left me alone some more. Eventually the nurse led me back into his office. Eventually the doc showed up there and we spoke for a few minutes, maybe he gave me a scrip. Then I had to give him a whole bunch of money.
Here, I'm usually seen within ten minutes of walking through the door, walk into the doc's office, I talk a bit, he talks a bit, we discuss, he takes my blood pressure (no matter what I'm there for), he sends me for tests or says he'll refer me or writes me a scrip or whatever. This takes exactly as much time as it ought to.
Why was your private health care experience better than mine? Because there's an NHS here, and you're not in constant competition with every single sick person in your neighborhood, while your doc is in competition with a free service that is perfeclty adequate.
But is your healthcare really any better than what I get on the NHS? Probably not. But I bet the furniture's nicer.
I think one of the differences , and im going by what dave says as Ive never had a private consultation, is that the doctor has time for you. I always feel really rushed when i go to my GP and often come out realising I havent said all I wanted to. Thats fine if its something straight forward , but not if its more complex.
Dave
There is nothing odd about you feeling guilty about this confession. If you find the concept of private healthcare objectionable (and I don't see how anyone on the left cannot) then you should not use it.
The rhetoric you use to justify your decision can just as easily be used to defend any individuals decision to choose private healthcare and buy preferential access to health professionals while sicker people who rely on the NHS have to wait.
Sorry to sound sanctimonious.
So, Andy, what would you say to a woman who lives in one of those postcodes where it is nigh-on impossible to get an NHS abortion? Is it permissible for her to go private, or should she just bloody well have the unwanted child to satisfy your standards of her principles?
(Let's not ask George Galloway's advice on that partiuclar moral conundrum.)
Good point Janine.
I have never had to have an abortion, but if I had needed to and I was in an area where it was difficult I would have paid. The reality is its a lot quicker and easier if you pay for an abortion.
Oh dear, I must be a very unprincipled socialist, but one who perhaps realises that real life can sometimes makes principles very difficult.
btw, im curious as to what people would do in the scenario I put re paying for healthcare earlier on. Punchie was the only one to respond to that.
If you could help someone, ease their suffering or increase their chance of survival, would you pay for treatment ?
I used to work for the Government (!) and was offered annual private check-ups as part of a freelance contract. I declined as I would have felt hypocritical taking advantage of a system I am supposed to be opposed to. For the same reason, I would not send children ( if I had any) to a private school.
Earlier this year, I had a mammogram on the NHS.I had to wait two horrible weeks for the result. In the private sector,it's immediate. But if we say we support the NHS well that's what we should do. I owe the last 15 years of my life to the NHS ( thanks to A and E at a hospital in salford) It has many many shortcomings but it's an institution much maligned - and we should do all we can to support it. IMHO, that means not opting for private healthcare - in whatever context.Lifeand death matters are normally the preserve of the NHS anyway....
Susan
It depends how you define life and death. If someone is seen quicker it can improve the chance of early and often more successful treatment.
Yes A&E will deal with life and death emergencies, but its often the slower illnesses that face most people and get undetected until too late.
My experience of A&E and the local hospital with my mother was awful. This was not just about resources but the attitides of many of the staff. There was little dignity afforded to an elderly ill woman, and some of that was attitude not money.Many were rude, unsympathetic and less than sensitive . I have no idea of whether that would be any better private, probably not. Private would not help with A&E either.
So my argument is not that private is good but the the NHS should be better resourced and staff should have better training. All should have access to high quality speedy health care and should not have too go private to get it.
In terms of life and death I suspect that those who can access regular healthchecks do get earlier treatment and perhaps improves the chance of a better prognosis .
Of course I want a decent NHS, but if I had the money and it would have made a difference (and never having used private I have no idea) I would have got my mother out of that awful hospital where she was distressed and treated as a nuisance for being so.And i wouldnt care if I was called unprincipled either if it meant I could reduce her distress.
When those we love are in pain or distress then of course most of us would sell our souls to help them. No question.
But I think there is a difference between that kind of awful situation and opting for private MoTs..... so I hope Brown is serious about making more of these procedures available on the NHS. Plus the preventative stuff. I just wouldn't feel comfortable with shoring up the private providers in the meantime....possibly also scared what I would find out.......!!!
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I work in intensive care and frequently see the potentially life threatening consequences of errors made in "routine" operations performed in the private sector.
Of course things go wrong in NHS performed operations too - but there are differences in my admittedly limited experience. One is that the NHS ops that have complications have to rush their patients down the corridor to us, whereas the private patients have to be ambulanced across town. Another is that we have often treated private patients who were discharged home after their op only to present in casualty a week or two later in horrific pain. A much greater proportion of our NHS patient load are patients who are "high risk" patients going into the operating theatre who then have an intensive care bed booked and waiting for them after the op. In the private sector those people just get refused the operation in the first place.
I can completely understand people feeling like private health care gives them more "facetime" with the doctor, but if its a matter of life and death? give me the NHS every time.
I agree with Susan.
I think there is a difference between making a pragmatic decision to go private when there is a serious problem and choosing to opt into the morally repugnant health care industry when there is nothing wrong.
I can't defend this position as logical but I think you have to accept that some major personal issues will always take precedence over principals. It's just that we all have a different threshold of when this kicks in.
Out-lefted by Luke Akehurst!
http://lukeakehurst.blogspot.com/
Luke A more left than Dave,yet Punchie agreeing with him...the world has turned upside down!
This post has certainly given me pause for thought - maybe I’m wrong and certainly situations such as Cllr Press’s refusal is undoubtedly principled stand by her - but I don’t fundamentally see a difference between accepting a subscription to a private gym (and the private leisure industry can have a parasitical relationship with what remains of council leisure facilities) and accepting a private health ‘MOT’. (I’ve never personally had any such perks, save 1st class rail travel, in any job).
I still also think the NHS is not so different to private health - it operates to capitalist principles and with many businesses within it. I wouldn’t feel obliged to use the still state owned (I’m pretty sure it is) Parcelforce to send a package rather than DHL etc.
I do think there is some woolly thinking about the opting out basis of some of the Labour party members here. I recall, even in right wing Labour groups, in the 80s that councillors would be deselected or at least have the whip withdrawn for buying their council house. (I refused to buy my flat that would have made me thousands).
Do all the Labour elected representatives and party members confirm that they never utilised ‘Right To Buy’ and would they also like to give a checklist of similar measures like that that area mark of being a socialist and which they have never done?
DHL's still state-owned, SPP. The German state, though.
Incidentally the descriptions of the NHS I hear are very different to my experiences in the German state health system, where you can "go private" (though in a very different way to in the UK) - but as a consquence, your husband/wife/children are prevented from opting into the (usually cheaper) state system, ever. Private patients do get seen quicker and don't have to wait long (though 'queues' don't really exist here like they do in Britain), but you can't just offer some cash up front and get seen immediately for a one-off operation or check-up. There were even *talks* of outlawing private healthcare before the last election, and it was nearly the main issue, before Schröder decided to call an early election and all issues disappeared and instead the parties focused on personalities.
Disgustingly, those who earn a lot are *banned* from using the state health system (the 'reasoning' being that paying ca. 10% of your wage as health contributions if you earn a few hundred thousand Euro or more per year would be unfair and unconstitutional) - this also affects politicians. Every MP in the Bundestag is therefore a private patient - and at the same time they have in recent years introduced charges to see GPs, increased prescription charges, increased the things patients have to pay extra contributions too, and struck a lot of things out of health service provision (basic eyecare, much dentristy, etc.).
Broadly here I agree with SPP, incidentally.
Occupational Health by employers for employees and even physicals for jobs never really were on the NHS were they?
And I think it was Denis Healey way back when who went private for his mum as he had lots of cash, she was in desperate pain, the waiting list was two years, he could afford to pay.
Now there are virtually no delays on NHS - thanks to Labour - then he wouldn't have to make that choice but agreeing to have a private physical is no betrayal - they always were non-NHS.
And getting something similar for all - thanks to Labour - can hardly be a bad move. Though it may increase demand for some acute services where things are found.
"Virtually no delays on the NHS"?
My parents have to wait a few months for nothing more than a consultant check-up re. a long-term (minor-ish) illness. Here I'd be astonished to have to wait for more than a week for such an appointment.
I suppose it depends what you're used to...