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It is the first snowfall of Winter. And, this will, once again, signal the season for fear of unnecessary death in the UK’s National Health Service (NHS). This is both a recurring vision and fear###.

The snow will be outside the hospitals and ambulances will be crewed with their engines running. Meanwhile, sisters will be busy discharging elderly people early because of the acute beds crisis, once again. Things were always bad in Winter, even before austerity. But austerity now promises to inflict a savage toll this Winter. The ambulances, will not be available to take the elderly, recently discharged, patients home. The ambulance drivers must take their instructions from proper authorities. Proper authority seems to be a computer system, with carefully programmed parameters, and manned by inexperienced bureaucrats, unable and unwilling to deploy individual judgement. The bureaucrats, comforted with their carefully crafted scripts and iPhones, typically have little experience in dealing with elderly people.

 I am old enough to remember when the NHS was the proud beacon of the future, setting the gold standard of public healthcare around the World. Post austerity, the NHS is a bureaucratic monster that is seemingly feeding off its own exposed entrails, decaying and cancerous. The vision of universal healthcare for everybody, irrespective a class, income, or wealth remains a quaint memory for idealists.

BUT why are people dying unnecessarily because of the NHS?

Firstly, the political classes will deny that there is a problem nor an escalating crisis, or more precisely, series of escalating crises. The politicians will continue to argue in support of the NHS, that it is still a venerable institution. In all probability, as new evidence of failure emerges, the politicians and the mainstream media will target the NHS bureaucracy as being responsible. Just like in George Orwell’s “Nineteen Eighty-Four”, the objective will be to anesthetize the UK public and render them powerless to improve matters. The politicians will smile and promise, sharing their own first hand experiences with the NHS.

Meanwhile, the NHS bureaucrats will be a credit to Joseph Heller‘s “Catch 22”; the bureaucrats will block endorsement of subjective reality, preferring an objective reality with doctored statistics. Most importantly, the bureaucrats will create rules and barriers to stop the public from complaining and asking for independent investigations of NHS failures. The reality is that a large and increasing part of the NHS budget now goes to settling negligence claims from former patients or their families. Further, institutions like Parliament’s venerable Public Accounts Committee (PAC) will investigate and cite repeated failures in the NHS but, in reality, little will change. At the same time, the UK media will report each failure of the NHS at length, and from every angle, with each newspaper competing, with their own expert assessments as to what should be done to reform the NHS. Sadly, perpetuating the NHS myth sells newspapers, and gains political capital with the political classes and their sponsors. The public are apparently subordinated as irrelevant to the major decisions.

To summarize, I maintain that the political classes, their sponsors, the NHS bureaucracy and the media are all biased, with vested interests to perpetuate the myth about the NHS. The truth is that the NHS is well past its sell-by date, and is poor value-for-money, with UK healthcare ranking very poorly in global benchmark comparisons.

On the other hand, UK doctors, nurses and other professional staff are generally hard-working people, with the interests of patients’ welfare foremost in their minds. However, sadly, these professionals have collectively become political stakeholders, along with the bureaucrats and the politicians, with the health of the UK public not represented at this high stake poker game. When reform options are added to the equation, the stack-holder list is expanded to include major consulting firms, outsourced service providers, and major recruitment firms who provide contingency workers to the NHS (contract labour).

Based upon my own experience and judgement as a change-agent, who has delivered radical change effectively many times, both in the public and private sectors, I firmly believe that the NHS is way beyond effective reform. Meanwhile, most stakeholders, including the political classes and the mainstream media, with their vested interests, are unwilling face the escalating risk of NHS reform; they, seemingly, prefer to throw good money after bad.

For me, as a one-nation conservative, there is a compelling case to scrap the UK NHS, and replacing it with a blue-sky, best-practice system of public healthcare, based upon benchmarking global best practice in countries like Germany, France and Italy.

With each season’s first snow, I am saddened to think of the unnecessary death likely to be triggered by the NHS bureaucracy. If the snow arrives before Xmas, it will be a particularly distressing time for people in hospital and their families’, all dependent upon on the NHS.

### I would like to acknowledge that the inspiration for the above article came from John Gelmini’s account of his late father’s discharge from hospital in Winter. 

Any thoughts?

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