Category Archives: Mid-Staffordshire NHS Foundation Trust

The mass NHS delusion

No one on the Continent would choose Britain as their country of medical care, rather the reverse

Some people think, or pretend to believe, that if they fall seriously ill in any country other than Britain, they will be treated very badly or simply left to die. It is as if in such benighted lands without the National Health Service, doctors and nurses work with neither skill nor devotion.

But Dalrymple points out that the NHS

is neither necessary nor sufficient for medical and nursing staff to show devotion. The parents of a well-taught schoolchild do not thank the Ministry of Education.

If a German were to say, ‘For God’s sake, get me to the NHS,’ a psychiatrist would be called

Dalrymple says the UK ought to face up to the fact that

being ill and seeking treatment is a more unpleasant experience in Britain than in it is many civilised countries.

The NHS has not served the nation well, if international comparison is the criterion by which it should be judged. For example, says Dalrymple,

  • when the NHS was founded (when British healthcare was among the best rather than the worst in Europe) the population of France had a life expectancy six years lower than that of Britain; it is now two years higher.
  • The health of the population in Spain improved more under Franco than that of the British under the NHS in the same years.

Manifold deficiencies

The comparisons hardly

suggest any particular virtue to the NHS.

Survival from many serious illnesses such as cancer, heart attacks and strokes

is lower in Britain than in most European countries. These statistics are not apparent to patients or their relatives, and in any case the NHS is immune to criticism because its deficiencies are assumed to be departures from its essential goodness or the result of inadequate funding.

Innumerable scandals

No number of scandals,

such as that of Mid-Staffs in which hundreds of patients were neglected to a degree that often defied belief, all in plain sight of a large bureaucracy supposedly devoted to ensuring the quality of patient care, can dent faith in the NHS. Staff committed, and management connived at, acts of cruelty that would have made Mrs Gamp blush. Mr Cameron’s government, anxious not to seem an enemy of the NHS, which would have been politically damaging, swept the scandal under the carpet.

Dalrymple suspects that

the sheer unpleasantness of the NHS is reassuring to the British population. It evokes the Dunkirk spirit: we are all stranded on the beach of illness together. And if we cannot all live in luxury, we can at least all die in squalor. Justice is served.

The health service mess

Screen Shot 2015-06-12 at 08.50.52Dalrymple lists the failings of the Mid-Staffordshire NHS Trust:

  • the ravening ambition of bureaucratic mediocrities
  • institutionally perverted incentives that reward those who do worst
  • the creation of a nomenklatura at the head of an apparat staffed by bullied, intimidated, fearful but unscrupulous apparatchiks
  • an inability or unwillingness to speak or write in plain English
  • intellectual dishonesty with compulsory lying on a vast scale
  • the proliferation of procedural objectives and bureaucratic tasks unrelated to reality or to the welfare of patients
  • a revolting tendency to Pecksniffian self-congratulation and self-righteousness

He calls the NHS

that vast charitable organisation for the outdoor relief of second-rate bureaucrats.

He points to the slick insidiousness of Tony Blair, who made Labour, once the party of the working class, the party of the nomenklatura. There was also Margaret Thatcher,

with her crude sub-Marxist view of the professions as exploitative monopolists. She thought the methods and disciplines of the marketplace, imposed by ‘scientific’ management but in the absence of anything resembling a market, would eliminate chronic inefficiency. This was stupid. It called into being a managerial class, cunning and unscrupulous.

Of clysters and leeches

Dalrymple quotes, more or less at random, from Select Observations on English Bodies, or Cures Both Empericall and Historicall Performed upon Very Eminent Persons in Desperate Diseases by Shakespeare‘s son-in-law John Hall (from 5:40 in the video below, of a 2005 talk):

Mr Kempson, aged 60, oppressed with melancholy and a fever with extraordinary heat, very sleepy, so that he had no sense of his sickness, was cured as followeth. Leaves and mallows, beets, violets, mercury, hops, borage, epithymum, pennyroyal, wormroot, camomile, seeds of anis, caraway, cumin, fennel, nettles, bayberries, polypod, senna, bark of black hellebore. Boil them all in whey until half be wasted. Of this strain take an ounce. Confect, salt and mix them, and make a clyster.

This brought away two stools of a great deal of wind. It was given in the morning, and again at night. And after these were applied to the soles of his feet, radishes sliced, besprinkled with vinegar and salt, renewed every third hour. This hindered the recourse of vapours and drew them back, and so he slept far more quietly without starting and fear.

The following was prepared for his ordinary drink. Spring water, syrup of lemons, julep of roses, burnt and powdered finely, spirit of vitriol. After, the leeches being applied to the anus, there was drawn eight ounces of blood, after which was exhibited this: lapis bezoar, tincture of coral, mixed, given in drink. After this, the urine was very frothy, with a great sediment, and he was much better.

The clyster, drink and powder were repeated, with desired event. To remove sleepiness, he used to sneeze only with tobacco, and then he was given the restorative, and that was used.

But yet his stomach being very ill, I gave him this: emetic infusion, violets, oxymel of squirrels. This gave four vomits and nine stools, after which he was well for five days, and then relapsing into a shaking ague, a clyster being injected, he became well, bidding farewell to physick, and so was cured beyond all expectation and lived many years.