The Point

Last updated: 27 June 2022.

Matters of Life and Death

Steve Mowat – The NHS, an international comparison, and where private profit ultimately leads

Following World War II the British people collectively realised something.  If money could be spent killing fellow human beings in millions, it can be used to cure and prevent illness. This revolution of ideas had resulted in the commissioning of an official report into healthcare. The Beveridge report recommended the working populace pay a small national insurance, guaranteeing free health care at the point of necessity. This system has sustained the population for over fifty years. The National Health Service (NHS) is a proud symbol of democratic achievement.

The funding of this icon has come under increasing pressure in England and Wales. Here private corporations are given expansive responsibility for health provision. The government recently attempted to ditch duty for upkeep via shoddy wording of a health care bill. The following article is a word of caution on dismantling public accountability for the private profit. These words are based on personal experiences of a healthcare system operated for profit, as a business. The realities are startling and grotesquely inhumane. 

Imagine if you will you are nineteen years old. Your first year at University is a roaring success, the family is rich. Life in a large home complete with landscaped grounds and a maid is relaxed. Your father has spent an age engineering road projects all across his country. Drawing in expertise from Japan and Europe, he does well for his country and his family.

Envisage then your father became critically ill inside hospital in his mid 50s. Lying in his bed nurses and doctors refuse to treat him. This is because medication is not paid for on the spot. Visualise: if you don’t pay for the bed, medicine, meals, and consultations they will be withheld. If you need to shell out, you use a credit card. It could be that’s not enough, maybe your finest watch, a television, fridge, furniture, and car are sold. Perhaps the sale of these things will secure the existence of your Dad. After all what price can be put on human life?

Imagine the doctor prescribing treatment for your father’s chronic lung condition. He asks you to purchase prescriptions from the chemist before he’ll administer to his patient. You go to the hospital pharmacy to collect the medicine. Your father lies gasping for breath. He is capable of recovery. But without payment the medication is withheld. It’s kept back just long enough for your father to give up fighting.  Some arm twisting, tears, and expensive jewellery exchanged at the pharmacy gets the prescription.

However time has run out; the delay results in your father’s death. Picture such a scenario in the National Health Service (NHS). Conceive of his life lost, for money. Envisage you couldn’t keep paying. The situation is criminal and those responsible for such a state of affairs in a UK hospital would be rightly jailed and publicly humiliated for a crime of murder.

Unfortunately this story is not fiction. It is the experience of my partner. This is the plight of an upper middle class family in Indonesia in the early noughties.  The scenario is replicated tens of thousands of times on the archipelago. Free health care at the point of need seems an unattainable fairytale for huge numbers of human beings.  Even the rich, if they don’t take the appropriate insurance policy, or rely on inadequate government schemes, can find themselves caught out. Entire families can end mired in debt and death. Not because they have to suffer. The values of ‘business’ triumph over humanity itself.

Take another tale, reported in Jakarta broadsheets recently. An impoverished Jakarta rubbish collector was frantic for worry in 2011. His daughter, only five years old caught diaorrhea. This is a minor and curable complaint.  But on his wage of less than three pence per day he could not afford medicine for her discomfort. His daughter’s body, young and dehydrated, couldn’t recover.  Impoverished and broken, the girl’s father had money for neither medicine nor ambulance. He wrapped her in cloth and boarded a train, hoping to reach help. The little girl gave up her battle for life on the way. Tales such as these are tragically common in Indonesia. For the sake of less than five pounds a child’s body lay helpless in Jakarta. Crowds of onlookers together with her father were unable to assist.

The reason I wanted to publish this comparison in The Point is to highlight the realities of a health care system without public ownership and collective responsibility. The scheme doesn’t work. It doesn’t flinch at letting people needlessly die in the most distressing circumstances. Private health does not worry for the scores of others left penniless and distraught. The leprous wrecks with whole chucks of their limbs missing on Jakarta’s flyovers are testament to that.  Motorcycle accidents and collapsing bystanders are not automatically sent to hospital.

When protesters express concern for wishing to keep the NHS public, they deserve to be listened to with some urgency. For me, the minute it is compared to private healthcare, the NHS is what defines Scotland and the UK as democracy. It is an expression of justice and collective responsibility. The very touchstone of any kind of society that wants to call itself society is a National Health Service. In some countries it is still to be fought for and achieved, in others it is to be defended against the onslaught of cuts and creeping privatisation.

The NHS sets us apart from a life of barbarism. Those words are not too strong in their use. Indonesia would do well to follow the principle examples of the NHS. Cries ring out from Indonesians that the nation is excessively poor, and too corrupt for success. Granted, endemic corruption is a knife in the nation’s back. But look at the example little Cuba sets. For its size and economic clout, the petite Latin American island punches well above its weight in public health care provision. Havana even surpasses the standards of its large northern neighbour the United States.