On the NHS, I tried for years to push for improvements to switch to digital cancer screening invitations after they missed my mother (offering to build the software for free), which is now happening, but suggesting the NHS isn't perfect is against the religion here. My sister who works in NHS DEI hasn't spoken to me since publishing a book on it.
Every time someone with the finances, vision and ability leaves I think the situation gets a little bit worse, it increases the proportion of people remaining willing to put up with all of it. Anecdotally, many of my friends have already left, some of the older generation want to leave but feel tied in. My flight out is in 6 weeks. Good riddance, no doubt.
- this kind of authoritarian nonsense is just what Home Secretaries do. David Blunkett brought in RIP (then, to his very slight credit, changed his mind). Jack 'boot' Straw was famous for his I-AM-THE-LAWing. I don't think the Tories are any better.
- No, criticizing the NHS is not against the religion there. The newspapers are forever getting in digs about long waits, unpopular (but perfectly rational) decision from NICE about what drugs to pay for, and junior doctors and their apparent insistence on being paid properly.
- And with that in mind, having lived in three countries (four if you accept that the NHS in England and Scotland are different) I personally think the NHS is fucking fantastic. Someone close to me was diagnosed with a serious illness and immediately swept up in a production line of modern, effective treatment. Sure, it was somewhat impersonal, the biscuits are rubbish, and they were a widget on the production line, but they're also still alive ten years later, and we still have a house and savings.
- kudos to your sister. The UK is an ethnically diverse place, one of the least racist and divided that I've seen, but - like everywhere else - imperfect. The NHS always seemed to me to be a reflection of what things could be elsewhere with doctors, nurses and cleaners hired from all over the world. [which reminds me that while the right-wing press hates the NHS for being free, the left wing press occasionally hates the NHS for bringing in medical staff from poorer parts of the world. They just can't win]
This is exactly what I'm saying. The NHS are seen as perfect by some. All criticism is digs that are wrong.
I'm pro-NHS. But this perspective that it's infallible is beyond all reality.
Often, when people criticize the NHS they have an ulterior motive, like privatisation. Consider all the political difficulties the NHS has had in the past few years. As such, negative remarks can be read or misread as dogwhistles for other views, so they're something that have to be phrased carefully and within context.
I was unclear: did you publish a book, or did your sister?
In general, for something both as key and as endangered as the NHS is, criticism isn't always useful -- support is. Problems can be recognised and addressed through support.
I'm not anti-NHS, I've no agenda to see it privatised, I just want it to be better. I tried many, many private routes first. I tried NHS England, NHS Digital, the Innovation Service, AHSNs (many sections having since been renamed/reorganised). About 20 different contact points over two or three years, most of which seemed inappropriate but I made sure if anyone told me it was someone else's responsibility I checked with them.
The problems had already been recognised through public inquiries and yet were still ongoing.
I even offered to build the software for free, which, hopefully, for an individual dealing with an organisation with a budget into the hundreds of billions, falls under supportive. But as far as I could see, offering support was getting me nowhere.
I just had people acknowledging the issue and then shrugging their shoulders, pointing fingers at everyone else. So I wrote a book on it, spoke about the issue publicly and within months it was decided to spend tens of millions on sorting it.
I think it's wonderful that you offered to do that but it simply isn't realistic. Who is going to support this software in the long term? How are you handling privacy concerns? What guarantees can you offer about server security? Who is paying for and maintaining the servers in the long term? What happens (to be blunt) if you die the day after the software is delivered?
There's so, so much wrong with the way governments provision software projects from outside parties. But there is good reason to have contracts the length of the Bible. Picking up work from individuals on a whim is courting disaster.
One guy had a brain infection and was told to wait four months for an appointment. Another went in for a root canal, left without a tooth, and fainted outside the clinic. Someone else was refused an X-ray after an accident.
Meanwhile, in my tiny country, we have a dual public-private health system, and the facilities, doctors, and dentists are top notch. It really makes you wonder what's gone wrong in the UK, considering how much taxes British people pay.
And, it's very much a "public-private" health system. E.g. all GP's and most dentists are private businesses, paid for by the NHS to varying degree, but also with many providing private services.
The NHS uses an extensive network of private providers, including (when sufficient funding is provided) to drive down waiting lists. I've personally had a procedure carried out at a private hospital at the NHS's expense.
The NHS has many problems, but at the root of a whole lot of them is that the NHS needs a funding increase of 20%-30% to get to similar levels of funding per capita as similarly wealthy countries.
The UK spends about as much per capita on the NHS, providing universal care, as the US does on just Medicare and Medicaid.