Also; game over, Hannan forfeits with his analogy of the battered wife. If he actually knew anyone in such a situation, or had ever pulled his head out his arse and researched abusive relationships, he would know that it’s on a par with wheeling out Hitler.

Daniel Hannan British Government Official

Yeah that’s right, Dan Hannan is going to be Cameron’s Secretary of State for Health!

(OK, I accept that the “U.S. Citizens Association” are an amateurish bunch of halfwits, and my apologies to those who suffered a heart flutter after reading the above.)

I wish I had the money to take that creep to court, he spouts so many lies about waiting lists. Where is Cameron’s leadership? Calling him merely “eccentric” just shows that Cameron has no control over his party.

I have a friend who works in the NHS and the stories he tells me about the way some GPs act makes you wonder. Although not every GP does this, there are many out there who will do the absolute bare minimum needed to get their money. So, in Nick’s case the GP just makes things up about not being allowed to commission an MRI (when the real reason is they couldn’t be bothered with the hassle of it and any follow up appointments) but counts as having seen the patient so will get their money.

Nick, I hope you have reported this GP to whoever needs telling. I wonder though, would the GP have miraculously changed her mind if you got her to put into writing her claims about not being allowed to commission an MRI.

But I can see where the disagreement is emerging here. You seem quite prepared to accept a GP’s 30 second decision as impartial and presumptively more valuable than our information, whereas I am more suspicious, that they are far from perfect and that institutional factors might be affecting their decision. Now if pushy middle class people are able to extract better health outcomes from the NHS, and I think they can quite often, then I think my view has something to it.

The GP wasn’t in any position to judge how serious her condition was or indeed, what it was.

Presumably the GP didn’t agree with this assessment in their professional judgement, otherwise they would have commissioned the MRI.

Douglas Clark – As I said before, I am not advocating the US system so you are not really meeting my points. I have said that US happens to work out better on a number of clinical outcomes than the UK. But both are fairly mediocre so I would suggest we look to the more competitive markets in healthcare that are used in Europe instead to produce rather better results.

John B – I think you are being rather naive. The MRI scan was needed to discover if, in fact, she needed greater intervention. The GP wasn’t in any position to judge how serious her condition was or indeed, what it was. In the rest of Europe, it would be perfectly normal to have an MRI scan quickly in order to get an idea what is going on. Instead, we had to deploy cash and the middle class “voice” in order to get anything like acceptable treatment.

This actually bears on the equity of the NHS too. It is well established that middle class people in the UK get more money spent on them by the NHS as a whole, and many people think this is because they are more capable of requesting (assertively if necessary) the treatment they are due. In the end, with some extra money and some haggling with the doctors, my partner and I are able to get something like the best treatment in the world (a little late). But that is not the standard NHS package, which would have been “wait 3 weeks” and then come back for several weeks. All standard care pathways point away from seeing specialists.

I’m sure we all accept that improved survival rates are a good thing

Yes, all other things being equal. However, I think that the survival rates we get for our money in the UK are about right.

That was my point. The fact is that UK cancer survival rates are worse than the US (and many other countries for that matter). You say I’m cherry-picking but I’m not out-and-out criticising the NHS for that. What we need to do is ask what can be done to improve those survival rates (I’m sure we all accept that improved survival rates are a good thing). If reform of the system is required then we need that debate too.

Oh, and on heart disease

Around 6.3 per cent of patients who have suffered a heart attack have passed away within 30 days of entering a British hospital – significantly higher than the 4.3 per cent [OECD-wide] average.

http://www.telegraph.co.uk/health/healthnews/6765210/Britain-has-among-worst-cancer-survival-rates-in-developed-world.html

So we’re not great at that one either….

- US GPs are incentivised (by the fact that they aren’t held to budget but can easily be sued) to err on the side of commissioning unnecessary tests and scans whenever patients visit for a checkup. Therefore, cancers in the US tend to be detected slightly earlier than in the UK, in random tests rather than in tests based on symptoms. This obviously has a direct impact on survival time from detection, even though survival time from getting the cancer is the same (there is also some real impact in catching the cancer earlier, although this tends to be small).

- cutting-edge treatment in the terminal stages of most cancers is vastly expensive, in exchange for at best a few months of low-quality life.

Cancer is a disease where spending colossal amounts of money raises reported survival rates. The NHS is based on not spending colossal amounts of money. The US system is based on spending colossal amounts of money.

Therefore, choosing cancer (rather than heart disease, infectious disease, trauma…) is really really obviously a cherrypicked measure to favour the US system over the NHS.

My partner needed to lay down cash for an MRI scan that her GP was unprepared to commission

If her GP was unprepared to commission it, that’s because she didn’t need it.

and is keeping £7,000 aside in case the NHS fails to provide surgery for a very disabling condition she is suffering from.

If it’s a very disabling conditition, then the NHS will provide surgery for it.

I am sorry that you partner isn’t being provided with these services free at the point of use. I’d rather advocate a service where they were free at the point of use rather than the American one where it appears to be a complete lottery, based on wealth……

Do you see the difference?

Yes fact. We live longer in the UK. How on earth is that “not necessarily”?

We, the people, don’t want US style health care over here and people like Hannan can get lost.

We don’t realise how lucky we are!!!!!!!!!!

Not necessarily. My partner needed to lay down cash for an MRI scan that her GP was unprepared to commission, and is keeping £7,000 aside in case the NHS fails to provide surgery for a very disabling condition she is suffering from.

The point we are making is the fact that we live longer doesn’t have all that much to do with the quality of our healthcare.

Lets all do that, but then again there is no need:

we live longer in the UK, our heath care costs significantly less than that in the us, everyone is covered and we don’t have to worry about money when we get ill.

Again you aren’t discussing the facts. The point is that our 5-year cancer survival rates are worse than America, in this instance, and pretty much the rest of the world in general. I don’t see how that can be termed as “halfwitted right-wing dogma”. Now, had I suggested that we should privatise the health-system because allowing profits would lead to improved care then perhaps you could describe it as “halfwitted right-wing dogma”. But that’s not what I said.

If we’re going to debate in facts show me some where, for instance, the success of treatment received in the UK is among the best in the world. Then we could discuss why the NHS struggles to match that world-class performance in cancer care and whether there was anything that could be done about it.

@16

No, he’s a politician. If you can show me a politician who, when asked, refuses to give his opinion on a matter he feels strongly about then… well you’re probably showing me one who wants to be a minister. Politicians resigned to backbench life will tell you their opinion every time, if you ask for it. Is that ‘slime’? Perhaps, but then Hannan is no more guilty of it than others. But isn’t it amazing that US talk shows don’t manage to get politicians from the UK on to talk about the good parts of socialised medicine? You’d think there’d be some sense in that debate too.

I honestly think he sees more money in US TV deals than politics and no doubt will be off soon.

You’ll notice that the US has worse overall outcomes in terms of life expectancy than the UK. Once you factor in amenable mortality, the US stays more or less the same, while the UK flips over the US and goes considerably down the OECD rank. Both countries have pretty poor outcomes compared to the rest, it just happens that the UK’s NHS appeared (back in 2000 anyway) to be adding rather a lot less value than the US system. This is far from the only way of measuring a health system, but it doesn’t strike me as outright dishonest to take a view on the basis of these sort of measures.

What I think really bugs you guys is that you know he’s right about 5-year cancer survival rates but you can’t bear any criticism of our glorious socialised healthcare. You can’t match up the belief that the NHS is the envy of the world with the fact that our cancer treatment is sub-standard and rather than alter the belief, you choose to ignore the fact.

Andy G clarifies well on points 1 and 2.