For the last week, Labour, the Tories and the media, have again clubbed together (Always a sign something is up) to try and claim, that a video shot more than two years ago, proves that UKIP are going to privatise the NHS. Lets just address that before we go any further. As Nigel Farage has said many times now, UKIP is a democratic political party, which has internal debates on policy, before they're formed. This word debate, whilst new to many in the Labour and Tory parties, basically means that differing opinions are put forward and people discuss those opinions, hopefully, coming to a conclusion, an agreement amongst all, or at the very least, a consensus. Furthermore, if we are to accept the point that Labour and the Tories are putting forward, that something Nigel said 2 years ago is secretly UKIP policy, then surely we must also assume, that Tory policy is to NOT under ANY circumstances offer a referendum and in fact order a 3 line whip against it and it is Labour party policy that immigration is absolutely fine and to say otherwise, is WACIST!
Now then, what Nigel said in the video, which was a Q&A session I might add, not a speech, not a policy proposal, simply a Q&A where theories and ideas get batted around, was this "I think we're going to have to think about healthcare, very, very differently. I think we are going to have to move, to an insurance based system of healthcare." So I'd like to have a go at suggesting what that might look like, from my perspective. It's worth stating, just because the media don't believe in free thought these days, that this is my opinion and not UKIP policy.
An insurance based system, doesn't necessarily mean that the health service itself is privatised, it could simply mean that everyone has to have insurance. Now the first thing people tend to do when the idea of insurance comes up is rail against it and protest that the USA system is insurance based and is screwed. With that I'd agree too, the American system is dire for the poorest people in the country and can even lead to well off people ending up in a medical bankruptcy. It isn't good and we shouldn't do anything like it.
Fact is though, if the insurance was provided by the state and various other, regulated, approved insurance providers, with the NHS itself retained in public hands, things could work out very well for everyone concerned. At the moment in the UK, if you want to go private, you can do so, but in most cases, you'll need to go through the NHS first, in order to get a referral, before the private companies like Bupa will even consider treating you. Also, the private companies have the right to refuse end of life care, to treat anything life threatening and they can refuse to do operations that may harm their statistics when things go wrong. This is not good, this essentially means that you have to go to the NHS first, who might cure or kill you before you can get referred to your private provider for one thing, but also, it wastes NHS time, money and resources. It also means, that if you're dying, say you contract cancer and it's incurable, your private company won't cover you at all and will simply send you on your way, back to the NHS!
Personally, as someone who might be able to afford private health care, if I thought it was actually going to be useful to me, I'd love the opportunity to die in a private room, with a 42" Samsung on the wall, Nurses who aren't over-run, under-staffed, under-paid and treated like shit, looking after me. But as things stand at the moment, that wouldn't happen. I'd end up on a mixed NHS ward in Doncaster Royal Infirmary, which stinks of human waste, looks like it's going to fall apart and costs me £20 an hour to use the crappy little television above my bed, where the headphones are missing their muffs and the screen has a huge crack in it from the angry geriatric Dementia patient who died in the bed 20 minutes before I occupied it.
It seems to me, that the thing which drives quality and customer service, is choice. If I have a choice of being treated by a hospital where the staff are shattered, the hospital is falling apart and the car park costs so much my visitors won't visit me, or a hospital with a marble floor, plate glass windows, big screen TVs on the walls, well dressed, happy looking Nurses who are paid appropriately and aren't over worked, I'm pretty much positive I know which one I'm going to pick. Now here's the trick, having an insurance based system, means that companies will actually want to start hospitals, in order to make money (Evil I know). If someone wants to make money out of a hospital, it's going to need to look good, sound good, feel good, smell good and most of all, have a very good success rate with patient care, in all aspects, as well as specialist subjects. Otherwise, in a world where there's choice, no one will choose them!
So if private companies start building hospitals, to compete with the NHS hospitals, then the NHS hospitals will have to step up their game, in all aspects. They will have to start paying the nurses more, employing more of them, keeping up the building to a decent standard, keeping the wards clean and everything else you would expect from a quality establishment. The way to keep this simple, is to legislate carefully, the way in which these private hospitals can do business. Ensuring that they cannot turn away terminal patients, they cannot refuse to do certain operations in favour of others, they must accept insurance as presented and they must do accident and emergency care, regardless of patient status etc. This puts them in the same position as the NHS hospitals, except the only way they can make profit, is to actually make patients WANT to use their hospital, over the NHS one, or any other local private hospitals.
Now, what about the insurance companies, who has to buy insurance? What do we do to keep the premiums down low enough? Well, simply put, we put a salary range in place. For arguments sake, without doing any hefty sums that would be required in reality to put this into practice, let's say anyone earning more than £60k per year, or has a household income of £80k per year for couples and families, will have to seek their own insurance. Anyone below that, including pensioners, children (Even children of those who have £80k per year coming in, these are CHILDREN!), unemployed etc. will have automatic state insurance, which will cover all eventualities, EXCEPT elective surgery, such as face lifts, breast implants, etc. Regulating the industry properly should see the insurance companies keeping the premiums low, as insurance companies will tend to prefer cheaper treatments and therefore will prefer NHS hospitals, so the private hospitals will have to keep their pricing at around the same levels, so that the insurance companies don't refuse to pay out the private hospitals, in favour of NHS ones.
The National Insurance system, will of course equally prefer cheaper bills, but would not be allowed to insist that it's customers (Anyone not in the income bracket I mentioned earlier) only use NHS hospitals, it could however, as a way of forcing private hospitals to keep their prices low, put caps on the cost of treatment it is prepared to pay for. NHS hospitals will obviously price accordingly and therefore, in order to attract customers from the NHS the private hospitals will also have to keep their prices in line. It almost becomes self regulating.
Whilst my proposal isn't fully thought through, it isn't costed and no doubt medical professionals can point at various bits that also would need to be addressed, in general, doesn't this sound like a better way to go forward with the NHS? Is it really right, that we should defend what is currently the UKs largest mass murderer, just because the Labour party says so? Or because we're afraid that a govt is actually going to dare to make it cost us money? Someone who is flat broke, can choose where they get treated, at no extra cost. Someone who's well off, can also choose where they want to get treated. Jobs are created, standards are improved, the financial burden is lessened on the govt. Seems like a fantastic idea to me, at the very least it's worth discussing, considering and investigating, but no doubt a bunch of frothing lefties will have not even read this far and will now be claiming that it's UKIP policy, because I wrote it on a blog.....
The simple fact we must face today, is that the NHS is broke, not just monetarily either, it is physically broken. It doesn't work all that well, it's going to take billions of extra funding in the decade to come and regardless of how much activists might jump up and down to shout "SAVE OUR NHS" they too are going to have to face the fact, that in order to save it, we have to change it. It might not be my proposal, it might be something entirely different, but one way or another, it has to change and if you want it to change positively, rather than at the hands of a couple of pompous nitwits who slag each other off once a week face to face and spend every other day engineering ways to do it through the media, then you'd better stop jumping up and down and start debating!
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