In summary: the NHS

As you may have noticed, brevity is not one of my strong points. In my defence, the world's much more complicated than Tories and associated know-nothings believe, and so I require more space to explain why.

But on the NHS, Charlie Brooker sums up my feelings in one sweeping paragraph:

What is it about Lansley that makes human beings hate him so much? It might have something to do with the suspicion that he's hell-bent on turning the NHS into a commercial free-for-all, which for some reason isn't going down well at a time when terrifying nightly warnings about the worst excesses of capitalism are broadcast in the guise of news bulletins. The theory is that introducing an element of competition will improve the level of quality and range of choice for patients. And it doubtless would, if businesses behaved like selfless nuns, which they don't. Any business that wants to succeed has to cut corners somewhere to turn a profit. It also has to juggle a strange set of priorities, which means if you entrust your health to a corporation, the cost of your kidneys could end up being weighed against the spiralling cost of the CGI budgerigar voiced by Joan Collins they want for their new TV commercial.

'Choice' is a mirage. Nobody wants to dial 999 and be presented with a menu of ambulance companies, police services or hospitals. All we want is to know that the local hospital is excellent, and that our taxes are being spent on incontinence pads, NMRI scanners and nurses' salaries rather than off-shored bonuses. Introduce a profit motive and you'll be sitting opposite your doctor wondering if s/he's on commission for that particular drug, got a free holiday (sorry, 'conference trip') from that hip manufacturer, or is on a tight schedule to see X number of patients to make it all worthwhile. And that's before we worry about the masonic and old-boy networks rife in medicine (disclosure: both my parents were NHS doctors).

The other problem with 'choice' is that it can't be informed. Unless you happen to be an oncologist, you won't have a clue which cancer treatments are best, for example. It's bad enough for doctors: the pharmaceutical firms never publish negative results, always publish papers carefully drawn to accentuate often minor gains, and constantly fiddle with treatments not to innovate, but to renew copyrights: the professionals find it almost impossible to make clear judgements. So how the hell is Joe Fatbloke meant to 'choose' his doctor and medication?

What the Tories want is the American situation, in which pharmaceutical companies spend 13.3% of their turnover on research, and 25% of their cash on advertising: $35 billion, or $61,000 per doctor. Yes, you read that right. Money isn't in medical innovation, it's in sales. Which leads to this (and this is only a mild example):

Prepare to be staggered

There's an NHS risk report detailing what will happen if the Tories' NHS Reform Bill is passed. Rumour has it that the bottom line is 'apocalyptic' - because the bill has nothing to do with improving the health service and everything to do with selling it off to private providers of the sort who've done such a bang-up job in the United States.

Obviously the Tories don't want to publish the report, because it will expose the bill as a selfish, ideologically-driven bit of class warfare.

Nobody, I suspect, will be surprised to hear that Paul Uppal, my local MP, voted against making the report public. He certainly doesn't believe that an informed electorate is an empowered electorate. Or perhaps he does - and fears it!

What else has he been up to recently? Well according to his webpage, nothing since February 9th - there's certainly no mention of his disastrous appearance at the Students' Union debate. Which is odd because the neighbouring Labour MP, Emma Reynolds, seems quite proud to have attended. Perhaps Paul thinks no news is good news.

Your handy guide to political consultation

This is the NHS Bill: the RCS likes it because they're all fat Tory rich men: the other RCP hasn't yet decided. All the other professional medical bodies are totally opposed.

Courtesy of @bengoldacre

The same exercise could certainly be carried out in the departments of Education, Defence, Treasury etc. etc.

The mob's got nothing on Lansley

The Health Secretary has cracked the problem of NHS funding: his face. 

The Conservative cabinet minister's face appears on bedside entertainment systems on a continuous loop saying that their care "really matters to me" and asking them to thank NHS staff.

If they want to turn him off, they have to register under a system which sees patients charged more than £5 a day to access TV, email and phone services.

he insisted he was delivering "a useful message" and pointed out that patients had the choice of watching something more interesting – if they registered

I can only applaud. £5 per day to avoid his smirking contempt is a bargain, despite it being extortionate. It comes to £1825 per year, a mere £1679.50 more expensive than the licence fee and £1393 cheaper than the basic Sky package. 


Still, when someone's weakened through illness, that's the best time to mug them. It horrifies me that hospitals are now seen as retail opportunities for a captive audience. I read recently that a hospital down south has a Marks and Spencer Food outlet. That really highlights the north/south divide: my local infirmary has a Greggs bakery, retailing bacon sandwiches, pasties and other assorted unhealthy products to the cardiac patients, morbidly obese and others. Local phone calls cost patients more than calling Australia from home: and it's old people on reduced incomes who spend most time in hospital. So much for joined-up health…


Sadly, the monitors don't play this Andrew Lansley song:





PS. I'm only joking about these charges making money for the NHS: it all goes to private companies like Hospedia.

Earth to Nadine Dorries

If you're not familiar with Nadine Dorries, she's an abrasive Tory MP with an unhealthy interest in teenage girls' uteruses (uteri?) and a fine line in abusing colleagues and constituents, inventing statistics and generally making things up.

But now isn't the time to get into all that. Instead, this is just a quick corrective. In the course of her many hectoring and untrue statements on the BBC's Question Time this week, she announced that the government's intention is to get NHS safety up to the level of the private sector.

Now, I'm from a family which has both worked for and benefited hugely from the NHS. I've seen the best and the very worst of it. But I'm not having this kind of nonsense from a reactionary blow in. Two facts:

1. The NHS was founded because the private sector failed completely. The poor were treated only by charities, in extremes. There was simply no health care: ongoing treatment, vaccinations and so on. Hospitals were often filthy, unsafe and underfunded. Dorries' so-admirable private sector specialised in the kinds of back-street abortions which killed mothers and ruined lives.

2. If something goes wrong in a private hospital, you don't get some kind of 4-star care. They call an ambulance like everybody else, and you join the queue at your NHS A+E ward. That's the secret of profitable private health: they only do easy, quick things that make a lot of money. Anything complicated, like emergency medicine or chronic conditions - off to the state with you.

Now the NHS is being privatised, it's Forward To The Past. I look forward to my children contracting retro diseases like rickets and consumption.

Meanwhile, watch David Cameron talking about the NHS as 'a business'.

Back Street's Back

Thanks to the unelected political donors, washed-up ex-backbenchers and celebrity stunt appointees in the House of Lords, the NHS as a legal entity has now been abolished.

The government - Tories who promised 'no top-down reorganisations' and the Lib Dems who… well, it doesn't matter what they said, does it - has turned the National Health Service from an aspiration into a brand, under cover of which the profitable bits will be sold to corporations and the grotty bits (mental health, geriatrics) will moulder away and die.

Doctors will be forced to contract out to cherry-picking companies: some doctors will take the cheapskate options because they get to keep the change, others will make cosy deals with private providers. Either way, the interest of the patient will be less important than now.

Meanwhile, the public good is to be abolished. Like education, the Conservatives see health as a private good, rather than a public one. In reality, your health is important to me. If you're free of contagious disease, so am I. If you quit the cigarettes or start wearing your seatbelt, less of my tax will be spent on reinflating your blackened lungs or scraping your remaining brains back into your skull.

The NHS died today for many reasons, many of them obscure and legalistic. But here's one: the  Secretary of State for Health is no longer legally required to maintain a National Health Service. There are two immediate effects. Firstly, local health bodies can decide for themselves what the health priorities are. This may have some positive effects, but I can just as easily see some localities deciding that sexual health, or vaccinations aren't important. Diseases associated with poverty will be ignored, while the sexy ailments which make the front page of the Daily Mail will get priority funding. It's a return to the back streets, especially if your local authority decides that sexual health and terminations are morally unacceptable.

Secondly, if the 'NHS' fails in future, there's no democratic way to get answers, or to make heads roll. You'll pay for it, but your MP won't be able to ask the Secretary of State for Health to answer your questions. 'It's not my responsibility', he'll say. It's up to your local provider - and good luck with that, as they'll probably be exempt from Freedom of Information requests (just like the 'free schools' that we're now paying for).

I liked the NHS. My parents are doctors and many of my friends and family have been nurses or - more often - patients. It's been underfunded, kicked and abused. Some areas of provision are shockingly bad. But I've always understood that they're ultimately working for, and answerable to, us.

No longer.

The Day They Signed the Death Warrant For The NHS

It's not my headline. It's not the Guardian's. It's not in the Morning Star or the Socialist Worker. 


It's in the Daily Telegraph. And it goes on to say this, amongst other things.

This means that in these areas, the NHS will no longer exist. Sure, the logo will still be there, but the NHS will no longer be national, any more than British Telecom is.

There is no doubt that this signals the first wave of privatising the NHS. Yet MPs of all persuasions continue to be deluded.   

The White Paper is a docile, fluffy, patient-focused document, with much talk of choice and empowerment. This is in stark contrast to the Bill, which almost exclusively focuses on opening up the NHS to private providers. The Bill is written in dense legal terminology, making any detailed analysis time-consuming and difficult.

But anyone who does study it will find little more than a road map for destroying the NHS, turning it into a cash cow for the corporate sector. The focus is on transforming public sector provision into an entirely market-led system, throwing open every service to private providers.

Previous pieces of legislation that existed to ensure the NHS remained in public ownership are weakened or removed entirely in the Bill. Even the role of Secretary of State is altered so that he is no longer responsible for the NHS. There are 15 clauses (ss125-131, 168-175) that will allow private companies to buy and asset-strip NHS facilities. Clause s12 specifically enables the privatisation of high-security psychiatric services.

Does that sound as if the NHS, or the interests of patients, are being protected?

If the Daily Telegraph - the Tories' most loyal friend, and not known for its sympathy towards the public services - think that the NHS is being killed, then it's a) right and b) deeply worrying. 


The author even suggests that MPs are too lazy to read the Bill, and that the Prime Minister and Health Secretary are deliberately lying to us:

The health secretary and the Prime Minister assure us the NHS will not be privatised when the legislation they are pushing through explicitly suggests otherwise.

The Bill enters the report stage and third reading on September 6 and 7. At the end of this, MPs will be voting on the future of your NHS. Is it safe in their hands?

I think a reprieve may be too late. 

Coins in, policy out

I sometimes write to my Member of Parliament. The previous one - Rob Marris - was a New Labour clone, but he was an honest and hardworking man who always replied personally. We disagreed on a lot of things, but I respected him and was sad when he narrowly lost the election. 


My current MP is self-absorbed multimillionaire property speculator Paul Uppal. One of my friends wrote to him detailing her concerns about the government's assault on the National Health Service. 


Amazingly, she got a reply:

Thank you for contacting me regarding the Government's Health and Social Care Bill.

Last year, the Government set out the changes it wants to see in the NHS. We also set out why the NHS needs to change: first, because Ministers want to protect and improve the NHS so that it can be even better in the future; and second, because – with the pressures of an ageing and increasing population, new technologies and rising costs – the NHS simply has to adapt and improve.

The changes the Government want to see are simple ones. First, where patients have greater choice and control over how and where to be treated. Second, where the NHS is left free from political interference to focus on what really matters – whether patients get the best possible care. Third, where doctors and nurses are driving improvements in patient care, and supported by high-quality management.
The Health and Social Care Bill sets out how, in legislative terms, we will meet these aims. The Government recognises, however, that there are some concerns. Many of these concerns are genuine, but many are based on myth. Doctors and nurses are asking about what these plans will mean for them. Patients and carers want to see how these changes will improve services for them. We hear those concerns.
So, now that the Health and Social Care Bill has successfully completed its Committee stage in the Commons, the Government is going to take the opportunity of a natural break in the legislative process to pause, listen, reflect and improve our plans. This is a genuine listening exercise. Where there are good suggestions to improve the legislation and the implementation of these plans, changes will be made.
I welcome your interest in these essential reforms. Indeed, the Government is encouraging everyone to help improve its plans, so that the NHS is protected for future generations as a high-quality and comprehensive health service – free at the point of use and based on need, not ability to pay.

I do believe the Government’s listening exercise is genuine. Ministers are taking the opportunity of the natural break in the legislative process to pause, listen, reflect on and improve their plans for NHS modernisation. Where there are good suggestions to improve the legislation and its implementation of the plans, changes will be made.

Some concerns about these plans are based on myth, such as the belief that we are not trialling the changes. However, some are genuine. This lobby group is raising concerns about cherry-picking, about involving the full range of experts in commissioning decisions, about competition on price, and about democratic accountability. It has always been the Government’s aim that cherry-picking should not be permitted, that commissioning should involve the full range of experts, that competition should be based on quality, and that the NHS is made more democratically accountable. These are all areas where we have already strengthened our plans, and hope to improve them still further.

I would strongly encourage you to contribute to the consultation which you can do online at healthandcare.dh.gov.uk. I would be very interested to receive a copy of your submission.

Thank you again for taking the time to write to me.

Paul Uppal MP

Now, she and I are both academics. We spend a lot of time reading students' written work, and we can smell plagiarists from a mile off. We know when a sentence is nicked from somewhere, and Uppal's response stunk like a dead fish with halitosis. Putting his signature in a different font is a classic schoolboy error. 


So - like I do with cheating lying students, I got onto what my dad calls The Google. Well, you could have knocked me down with a feather when I found this letter to an MP and his reply:

Thank you for contacting me regarding the Government’s Health and Social Care Bill.

Last year, the Government set out the changes it wants to see in the NHS. We also set out why the NHS needs to change: first, because Ministers want to protect and improve the NHS so that it can be even better in the future; and second, because – with the pressures of an ageing and increasing population, new technologies and rising costs – the NHS simply has to adapt and improve.

The changes the Government wants to see are simple ones. Firstly, where patients have greater choice and control over how and where to be treated. Secondly, where the NHS is left free from political interference to focus on what really matters – whether patients get the best possible care. Thirdly, where doctors and nurses are driving improvements in patient care, and supported by high-quality management.

The Health and Social Care Bill sets out how, in legislative terms, we will meet these aims. The Government recognises, however, that there are some concerns. Many of these concerns are genuine, but many are based on myth. Doctors and nurses are asking about what these plans will mean for them. Patients and carers want to see how these changes will improve services for them. We hear those concerns.

So, now that the Health and Social Care Bill has successfully completed its Committee stage in the Commons, the Government is going to take the opportunity of a natural break in the legislative process to pause, listen, reflect and improve our plans. This is a genuine listening exercise. Where there are good suggestions to improve the legislation and the implementation of these plans, changes will be made.

Thank you again for taking the time to contact me.

Yours sincerely

The Rt Hon Hugo Swire MP

Member of Parliament for East Devon‘

Now this isn't the time to do a deconstruction of the multiple lies and distortions in this dishonest speak-your-weight garbage, or to critique both MPs' refusal to address the specific points raised by their correspondents. It's the time to excoriate these lazy bastards and this cynical, arrogant government for the way they treat us. 


So much for the idea that Parliament is the place where fearlessly single-minded representatives examine every proposal for flaws and speak truth to power…


Marks for original thought: 0
Marks for blatant contempt for your constituents: 10.


(In the interests of balance: Labour did it too. They all view citizens as carping, moronic whingers getting in the way of governance).


Can I ask you all to write to your Tory MPs and see how many send the same letter out? According to this site, Nigel Mills MP, Steve Baker MP, Damian Collins MP, Nick Boles MP, Andrew Selous MP, while the Lib Dems send out a similar stock response which almost but doesn't quite end with 'not the face!'. 


I love the Internet. Before that, they might have got away with this kind of behaviour. Now we can all compare and contrast in seconds. 

Sir Paul Beresford MP, liar

This is what Tory MP Beresford says

Sir Paul Beresford, a Conservative (and a dentist) says GPs are strongly in favour of the reforms.

Lansley accepts this.

This is what the Royal College of General Practioners say, guided by the responses and votes of their members:

More than half of GPs responding to a snapshot survey carried out by the RCGP are concerned that the proposed health reforms will not lead to improvements in care for patients.

Over 50% disagreed that the proposed model of GP commissioning would create a patient-led NHS. More than 70% of respondents said they disagreed- or strongly-disagreed that the concept of ‘Any Willing Provider’ would either achieve a patient-led NHS, or improve healthcare outcomes. 

More proof that the Tories are liars on this here.

Doctors in Distress

Well, a partial victory for everybody except the Tories and their Lib Dem homunculi: a temporary suspension of the Health Bill and a massive amount of embarrassment for the government.

Andrew Lansley, the health secretary, has confirmed that the government will temporarily shelve the health bill. In a statement to the Commons, he said ministers would use the break "to pause, to listen and to engage with all those who want the NHS to succeed". There will be changes to the bill, he said. But he provided no detail as to what these amendments might be. Asked how long the new consultation period would last, he said "during the recess and beyond". At least one Labour MP urged Lansley to resign and at times Lansley appeared severely rattled. Labour's John Healey said Lansley was no longer in charge of health policy. David Cameron would decide what happened next, Healey suggested.

This is what the NHS should be, from the hilarious Doctor In The House series:



Unfortunately, the series rapidly declined as the makers struggled to cope with the advent of the jet age and the swinging 60s…

Back In The Box, Healthcare Issue

This is classic, top quality shenanigans. Sarah Wollaston is a Tory MP who was a doctor and is distinctly unimpressed by her party's insane plan to sell the NHS to their mates.

Obviously, you don't want independent thinkers around when the Select Committee on Health starts looking at the small print.

So you dispatch the most junior government minister in existence to her constituency on debate day so that she has to be there to welcome him and pose for photos rather than ask pointed questions and appear on TV interviews making awkward points.

The only trouble is that Dr Wollaston has to welcome a junior minister to her Devon constituency today and tomorrow.

Yes, it's Richard Benyon. On a two-day ministerial visit to the green pastures of south Devon. And no doubt her party colleagues impressed on Dr Wollaston how discourteous it would be for her to not be in Totnes when Mr Benyon was there.

Even if, as parliamentary under-secretary at Defra, he is one of the most junior members in the entire government.

His visit will make it a lot harder for Dr Wollaston to do TV interviews.

It was arranged at the last minute, I understand, and had been postponed from an early date.

Voilà: silence.

Another fine story unearthed by the odd Michael Crick. Brilliant shenanigans: it entirely privileges partisan politics over the good of the sick. This from the party that called for an end to spin and for 'new politics'.

Meanwhile, the cat's out of the bag, thanks to Tory Minister Greg Barker, in case there was any doubt that their attack on public services was more than nasty-minded ideological obsession:

We are making cuts that Margaret Thatcher in the 1980s could only have dreamt of.

NHS - safe in their hands

The Tories have publisher their plan to destroy reorganise the NHS (the thing they promised not to do, during the election). The document is several hundred pages long, double the length of the document which founded the National Health Service.

Here's one way to work out what their priorities are: turn the document into a Wordle - a graphic representation in which the size of the words reflect how many times they're used. I can't reproduce Tom Moberley's excellent work in a readable version, but you can see it here. What's shocking is that terms relating to administration, commissioning and outsourcing far outweigh those related to care. As far as I can see, 'patient' doesn't turn up at all. If you suspected that the whole plan is simply to dismantle and privatise one of the jewels of British life - from a party without any mandate to enact such dramatic legislation - this proves it.

Love your NHS

It's ramshackle and unwieldy, but it's the best and fairest healthcare system in the world - and the Tory / Lib Dem government is ripping it to shreds to feed to the corporations which have done such a marvellous job in America and elsewhere. 

The NHS is the only health system in the industrialised world where wealth does not determine access to care – providing the most widely accessible treatments at low cost among rich nations, a key study has found.

The survey, by US health thinktank the Commonwealth Fund, showed that while one-third of American adults "went without recommended care, did not see a doctor when sick, or failed to fill prescriptions because of costs", this figure was only 6% in the UK and 5% in Holland.

In all countries except Britain, wealth largely determined access to health, with patients with incomes below the national average more likely to report trouble with medical bills and problems with getting care because of cost.

The NHS was also extremely cost-effective, with spending on health per person almost the lowest in the survey. A person in the UK paid $1,500 less than a person in Switzerland, $600 less than a German and less than half the $7,538 paid by every American for healthcare.

Pass this on, and defend the NHS. 

Thrills, spills and laziness

Despite having a conference paper to present in three days' time, I've done no work. I have an excuse - my 97 years-old grandmother was rushed to hospital. At this stage, apparently, even the minimal excitement of working out what might be in an egg-shaped foil wrapper is a little too much. 

She'll be fine. I've been convinced for years that she's immortal. It won't be too long before her other super-powers manifest themselves. Huge respect is due to the First Responders (rural paramedics) who turned up in 4 minutes, and the main ambulance, which arrived from the city in 10-12. The First Responders are volunteers who need cash - I'm sending them some. Do the same in your area.

I've met a lot of ambulance crew recently, and I'm friends with one. They're always cool, calm, funny, horrifyingly funny and reassuring. Also (American readers please note), it's all part of Britain's general taxation. There's no bill and no worry.

Meanwhile, the above graphics illustrate the life-cycle of the average postgrad/postdoctoral academic. They're from PhDcomics.com.

Airbrushed airhead

The Tories are running a Big Brother style poster campaign: airbrushed photos of Call Me Dave Cameron with silly vague statements next to his porky face (they seem to have moved his spare cheeks to his monumental forehead).

Needless to say, people are 'editing' them. I shall fetch the paint-pot as soon as one goes up near me.

Daily Mail vs. the NHS: who will win?

Depressingly, it's probably that journalistic harlot the Daily Mail, but in the meantime, here's a constructive and considered response to Richard Littlejohn's inane, ideologically-dictated hatred of the NHS. An NHS worker makes the medical and social case for a state health service rather than the expensive and unequal medical treatment afforded to those who a) have insurance and b) somehow don't get trapped by said insurance's loopholes in the USA.

Remember: over here, whatever is wrong with you, you turn up at a surgery or hospital, get treated, then go home. At no point do you have to produce a credit card or prove that you have insurance.

I know the NHS is tired in places, and that this government's preference for the health of the private sector outweighs its concern for the health of the citizens, but it's a magnificent principle. The health of one affects the health of all, and a fair, efficient service is best provided through the collective will of the people embodied in the state.

Take that, Republican'ts

It's early days, but the College Republicans' attempt to collect 'horror stories' about the NHS with which to scare Americans has backfired badly - all the entries so far are positive!

I particularly like this 'horror story':

I went to the Doctor's last month for a, well, downstairs problem. I was given an appointment for that day at 11.30. I got there with plenty of time to spare, but wasn't seen until 11.45. I was livid.

Do add your own honest accounts of NHS care.

Save a few American lives

The US healthcare debate is still being distorted by malign ideologically-motivated forces, aided by the vested interests of the insurance industry, leaving 46 million Americans (20% of the population) uninsured and many others not covered for serious industry. Old people, let's remember, organise coach trips to Canada and Mexico to buy their prescription drugs, whereas here, they're free for pensioners and only £6 for everybody else, whatever the real cost.

The College National Republican Committee is openly asking for 'Your Health Care Horror Stories' via email or on their blog. How about filling it with our actual experiences, or adding your story here, a joint effort between British political site 38 Degrees and US magazine Mother Jones? I know the NHS has its limitations, but it's essentially brilliant - I know several people whose lives have been saved, and others who have received brilliant treatment (I'm looking at you, Zoot Horn). I've made a polite, measured start on the CNRC blog.

This is really starting to grind my gears

Courtesy of the Guardian's Diary.

US Investor's Business Daily:

"The controlling of medical costs in countries such as Britain through rationing, and the health consequences thereof, are legendary. The stories of people dying on a waiting list or being denied altogether read like a horror script … People such as scientist Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."

Stephen Hawking after treatment at Addenbrooke's NHS hospital:

"I wouldn't be here today if it were not for the NHS… I have received a large amount of high-quality treatment without which I would not have survived."

Motor Neurone Disease life expectancy: 2-5 years after diagnosis.

Stephen Hawking's diagnosis: 1963 (aged 21). Age now: 67.

So, Investor's Business Daily, you're a lying sack of shit.

Arma virumque cano

We whinge and protest about the NHS a lot - and it certainly gets things wrong - but virtually everyone outside the New Labour bubble and Tory Central Office thinks that a tax-funded, not-for-profit, state-run health service is the only way to provide high quality care fairly to everyone.

It's different in the US. Obama wants to introduce insurance cover so that the 46 MILLION Americans who aren't covered can access healthcare. He isn't (unfortunately) proposing a national health service which would treat everybody - the proposal is to retain private hospitals and reform the insurance system which funds them.

So from this side of the pond, this looks like a slightly kinder version of the capitalist model which has served the US so well (ho ho ho). To many Americans, however, this is communism. Death threats are being made, supporters of healthcare are being beaten up, and now anti-healthcare activists are calling on meeting attendees to bring their guns. What a grown-up way to respond to a weak proposal from a massively endorsed president.

Update:

This is all getting very nasty. American conservatives are spreading lies about the NHS to scare Americans, such as the claim that people over 59 don't get cardiac care, and that Ted Kennedy's brain tumour wouldn't be treated here because he's 77 (well done, Senator Chuck Grassley). Add to this Sarah Palin's description of Obama as 'evil' and her claim that her Down's Syndrome child would face a 'death panel' and we have the makings of a lynch mob. And yes, I'm well aware that that term is racially aligned. There's a nasty undercurrent swirling around Obama which runs 'socialist'-'UnAmerican'-'not born in the US' (untrue)-Muslim (untrue, and who cares anyway)-black-shouldn't be President.

Speak up for the NHS. As Neal points out in the comments, the UK spends less, but spends it better and more fairly. Lots of American pensioners take coach trips to Canada to buy their prescription drugs - pensioners here don't pay a penny (until the Tories get in again) and so don't have to go over to France, Ireland or wherever.