The Brits are confronting health care too

      After spending six weeks visiting my Auntie Ruth, age 88, and younger cousins in the Southwest of England, I am dismayed to report that Parliament is as ineffective as our Congress in balancing the budget while addressing the social needs of the population. I found some unsettling variations on the same tired themes we hear in the U.S.

     Take health care. It was true that the National Health Service provided a model for good quality medical services available to all subjects of the British Isles. My working class relatives, including Uncle Cornie, ambulance driver for 40 years, would attest to this.

     However, an aging population, the availability of ever more forms of treatment, the obesity epidemic—the NHS faced burgeoning costs. What to do?

     The NHS system is organized around hospitals in each region, or district, of the country. Cost containment became the responsibility of hospital administrators, who were given annual financial targets, aka budget caps, within which to operate all health care programs in the district. Administrators who met the targets were rewarded with salary increases and other perks.

     With cost containment, standards of care declined. In one district, Staffordshire, “hundreds of patients died unnecessarily,†of neglect. Their relatives were marching in the streets while I was in England.

     The resulting investigation uncovered a management practice initiated under the recent NHS regime: the inclusion of a “nondisparagement clause†in the employment contracts of doctors, appropriately dubbed a gag order by the media.

     I especially enjoyed watching a BBC interview with one doctor who accepted a very substantial severance package from the NHS before blowing the whistle on his district hospital and the nondisparagement clause. He received a letter from an NHS solicitor hours after that interview aired.

       In a response remarkably reminiscent of our own political landscape, Sir David Nicholson, head of the NHS although not a doctor, claimed he knew nothing of the nondisparagement clause or the “culture of silence†in the agency, called for increased transparency, and promised to look into the “uneven death rates†in hospital districts. After receiving furious criticism from the public, he will take an early retirement.

     Example #2 of a pinhead response to a real problem: the ever-expanding costs of disability benefits, caused by the aging of the population and the increasing number of disabled children.

     Parliament declares: “The present system is not sustainable; reform and cost-cutting are essential; there has been a 34% increase in claims in the past 10 years.â€

     Proposed changes include the appointment of a private company to review the circumstances of every recipient of disability payments, making a “tick box assessment†as to allowable services. The Disability Living Allowance of three million adults will be phased out and a Personal Independence Payment will be introduced.

     Privatization, and a name change. Does nothing to actually address the needs of disabled people, but perhaps scares them into making more of an effort?

     Down and dirty #3: hitting the citizenry where they live. The Labor Party suggested a “mansion tax†on every taxpayer whose home is worth more than a million pounds. Members of Parliament nixed that one immediately but the concept is gaining traction as Brits learn how many London homes valued at over two million pounds are owned by foreign princes and moguls.

      The “bedroom tax†on the poor was passed into law, and becomes effective in April, 2014. The Tories argued that many single individuals and families living in government-subsidized housing units had more bedrooms than they really needed. To alleviate the housing shortage in Britain, the Tory Party proposed that residents of Council Houses should refund fourteen pounds a week to the Government, for every spare bedroom. In theory, this rebate would save the Government money, and motivate those receiving a “spare room subsidy†to move into smaller quarters, thus freeing up housing for new families.

     Unfortunately, it turns out that under the new scheme, at least 20 smaller units are needed for every one unit available. Also, half of the residents of subsidized housing are handicapped, and have already built into their “under occupied†homes accomodations for their disabling conditions. As things now stand, there is no alternative for the spare room crowd, other than to tighten the budget.

     Up to now, disabled children have been allocated an entire bedroom. Under the new law, a disabled child can share a bedroom with a brother or sister, the same as any other poor kid.

    Class warfare is not new to the English. They practically invented it. But it is painful for me to see the politicians in my mother’s beloved country engaging in tactics so mean-spirited and stupid that they make the empty No, No, No pronouncements of American lawmakers look mild-mannered by comparison. The latest British social welfare legislation proves that the Devil really is in the details.

            On a lighter note, these are the winter prices (converted from grams and pounds sterling) for fresh fruit in an upscale department store: grapes from South Africa-$2.83lb.; blueberries from Chile-$8.07lb.; strawberries from Egypt-$3.54lb.; raspberries from Morocco-$6.98lb. Prices for more plebian fare are a little lower at ASDA (Walmart in the UK). The Brits spend a far greater portion of their much lower incomes than we do, for food. And a gallon of petrol costs $9!

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Vivian Munson