Healthy people are expensive

Anyone follows politics in even the most cursory manner (or, indeed, reads the letters page of the Metro) will, I assume, be thoroughly pissed off with self-righteous fucknuts bollocksing on about how drinkers, smokers and obese people should be taxed to buggery because they cost our brilliant NHS buckets of cash.

For many years, those of us who indulge ourselves in our pleasures have pointed out that we pay a fuck-load of tax for the pleasure of doing so—not just in the ludicrously high National Insurance payments, but also duty on the fags and booze. We pay far more in tax, in fact, than the cost to the NHS.

"Nonsense!" cry the prodnose temperance loons.

Well, now a nice little report has come out which points out that "healthy" people really do cost, as Timmy reports.

The question is, are the costs of treating the illnesses and deaths brought on by those three indulgences higher or lower than the costs of treating those who live healthily but still inevitably die? We could argue it either way: Alzheimer’s costs more to manage than lung cancer costs, the cracked hips of age related osteoporosis perhaps more or less than fried livers from excessive bourbon. What we need to do is actually go and tot up the figures. Fortunately, that has been done:

Obesity is a major cause of morbidity and mortality and is associated with high medical expenditures. It has been suggested that obesity prevention could result in cost savings. The objective of this study was to estimate the annual and lifetime medical costs attributable to obesity, to compare those to similar costs attributable to smoking, and to discuss the implications for prevention.
….
Although effective obesity prevention leads to a decrease in costs of obesity-related diseases, this decrease is offset by cost increases due to diseases unrelated to obesity in life-years gained. Obesity prevention may be an important and cost-effective way of improving public health, but it is not a cure for increasing health expenditures.

The actual numbers for lifetime from 20 years old medical costs were:

The lifetime costs were in Euros:

Healthy: 281,000

Obese: 250,000

Smokers: 220,000

There are excellent arguments in favour of taxing in order to reduce the occurrence of smoking, excessive boozing and obesity. We humans are subject to hyperbolic discounting, not taking full account of long distant future costs for current pleasures, sometimes those running the public health system really do know more than us, there are externalities associated with these behaviours (late night drunks, passive smoking and the visual pollution of someone 300 lbs overweight perhaps). But the argument we cannot use is that these behaviours increase the costs of health care.

The reason we cannot use this argument is that it simply isn’t true.

So all you health fascists can stick that in your pipe and I'll smoke it.

Destroy the medical profession

As regular readers will know, your humble Devil is no fan of the medical profession: sentences such as , and "when will these fucking medical types shut their fucking cakeholes and get on with their job of patching people up?" might have led viewers to conclusion that I think that doctors are a total bunch of fuckers who should be beaten to death with their own stethoscopes.

And said viewers would be correct. But it's nice to see my view validated by Sam Bowman at the Adam Smith Institute.

"People of the same trade seldom meet together, even for merriment and diversion, but the conversation ends in a conspiracy against the public"—Adam Smith

As usual, Adam Smith was right. Today I can think of no trade about which the above is more true than the medical profession. I don’t just mean doctors’ use of occupational licensure laws to keep their prices artificially inflated. Politically active groups of doctors are possibly the greatest single threat to personal freedom that there is in the UK today. Their motivation isn't necessarily their wallets, but their egos. Bullies like to use the state to push people around so they feel powerful.

As I outlined in my commentary on Working Class Patients And The Medial Establishment: Self-help in Britain from the mid-nineteeth century to 1948, David Green states very clearly that the medical profession are actually motivated by both "their wallets" and "their egos".

The organised medical profession had long resented the dominance of the medical consumer, and particularly resented working-class control of medical "gentlemen". The BMA were equally anxious to obtain more pay and, above all, higher status for doctors.

As regular readers will know, the combination of the BMA and the private insurance companies led directly to the destruction of the Friendly Societies—social corporations that provided primary care and unemployment benefits for the working classes—through the lobbying of MPs involved in the 1911 National Insurance Act. [Emphasis mine.]

The essence of working-class social insurance was democratic self-organisation: amendments to the Bill obtained by the BMA and the Combine [the private insurers' trade association] undermined it. Doctors' pay had been kept within limits that ordinary maual workers could afford: under pressure, the government doubled doctors' incomes and financed this transfer of wealth from insured workers to the medical profession by means of a regressive poll tax, flat-rate National Insurance Contributions.

I have said it many times, and I shall say it again—doctors are not your friends and the medical profession couldn't give two shits for anything other than big, fat pay-cheques. And, as I said back in June 2010, ...

...whilst the doctors continue to run our medical services, and continue to bribe, bully and poison our rulers—and whilst our rulers still have the power to force us to obey these bastards—we will never be free...

They medical profession are a bunch of thugs, driven by self-importance, conceit and greed, whose only motivation for existence is to bleed you dry and then present you—or someone near to you—a massive bill. But, they are also suffer from an almost incredible arrogance in that they believe their every prognostication to be gospel, every utterance to be truth and every opinion to be law. They are cunts of the very first water.

So, since we have now established this principle, let us see what has driven the ASI's Sam Bowman to attack the bastards on this occasion.

There’s a sad example of this in today’s call in the Lancet, a medical journal that is often used as a political mouthpiece by campaigning doctors, for the government to introduce a “fat tax” to curb obesity.

Of course, the proposal is utterly specious. It's pretty dubious whether the "obesity epidemic" claims are true or not. And which diet plan should be implemented? Is it bacon, sugar, bread or something else that makes us fat? Will political parties of this fat tax utopian future be divided between the Low-Carb Party and the Low-Fat Party? And what if fat people's early mortality rates mean that they actually save the government money in pension and care home bills?

The doctors err even by their own logic. As Will Wilkinson has pointed out, if fat taxers thought things through, they would favour a tax on fat people themselves, not on the food they eat. Taxing food punishes people who exercise so that they can enjoy Big Macs, but not people who are so lazy that they balloon out while eating a balanced diet.

Of course, to the average doctor—who has coddled and protected, in importance and financially, by the state for a century—corporations must automatically be evil (otherwise they wouldn't actually sell things, right? They'd do it out of charidee); not only that, but the Ordinary People, the hoi polloi, are too stupid and bovine to make their own choices.

Of course, this should be no business of the doctors': their job should be to shut the fuck up and do their job of patching people up (and charging a suitable fee, of course). And in a free society, that is precisely what would happen.

However, we do not live in a free society: we live in a Welfare State*. And in the Welfare State (and particularly this one), the health service is administered by the state and the doctors are the gate-keepers. It is the hoi polloi, who pay for this health service, of course, but—since we are given no choice about it—we are (as I have said many times) in hock to the state.

The state is the provider of a service: the National Health Service in this case. Because the state provides and "pays" (through taxes, of course) for this service, it has the power to dictate to the population.

Obesity costs money over and above a "normal" person's treatment. Even if the obese person has private medical insurance, they cannot opt out of the NHS because they are forced to contribute to the NHS through their NICs. And, in fact, because of various laws—an ambulance can only take you to a state A&E;, all GPs are employed by the state—no one can opt out of the state-provided system entirely.

In this way, everyone is in debt to the state. And as long as everyone is in debt to the state, the state, fundamentally, has the right to tell the population how to behave. And this debt can never actually be discharged: you are in debt to—and thus subject to the whim of—the state from the moment that you are born until the moment that you die.

And, remember, there is no actual contract to sign (or not sign) so the government can—and does—keep on shifting the terms of this agreement as and when it likes. It's a little like Lando Calrissian's bargain with Darth Vader in The Empire Strikes Back: "This deal just gets worse..."

As such, no one in this country owns their own body; no one in this country owns their own life. Everyone is effectively in hock to the state because you can never, ever opt out of state provision.

Once again, it seems that Sam Bowman agrees with me on this...

The justification for pushing people around like this is the NHS. Shouldn’t people have to pay for their own illnesses? Well, yes – that’s how personal responsibility works. But having an NHS removes the personal responsibility, and artificial attempts to inject it into the system are doubly illiberal and wrong.

The government (and the electorate, for that matter) forces people to be in the NHS. You have no choice in the matter, and you can’t opt out of it. Jamie Whyte put it well: "first the do-gooders conjure up the external costs by insisting that no one should have to pay for his own medical care, then they tell us that they must interfere with behavior that damages our health because it imposes costs on others." This is perverse and illiberal.

Yes, and the doctors—and their spiritual buddies, the politicians—love it: this way, they can all feel important, and all line their pockets.

The tax would only affect the poor—rich people's spending habits wouldn't be dented. How easy it must be for doctors to pontificate about the need for a fat tax, knowing that such a tax would hardly affect them at all.

Indeed, what with doctors having to take on the treatment of all of these extra obese people, surely it must be time for another contract "negotiation"**—trebles all round!

This creepy, controlling paternalism has plenty of fans in politics on both sides of the partisan divide. Doctors are the politicians' enablers, lending the weight of their “expertise” to the nanny instinct of the political class in exchange for the feeling of being important.

Which is precisely the same relationship that the government has with Fake Charities—many of which are also run by doctors and their creepy little acolytes.

No amount of expertise – medical or otherwise – should give somebody the right to interfere with another adult’s choices. Nor should democracy be used as an excuse to violate the sovereignty of the individual. If fat people are costing the NHS money, that's a mark against having an NHS, not against having fat people.

Quite. And all of this relates to the conclusion of my June 2010 post linked to above...

Most of you will have seen—in the newspapers and, in particular, on blogs written by members of the medical profession—claims that doctors should be allowed to run the NHS, because they know what they are doing. Of course they do: they want to run your lives and giving the medicos control of the NHS would give them the ultimate tool to do so. That would ensure a much "higher status for doctors" and the edict would be simple—obey us or be left to die.

If you doubt this, just take a long at some of the news stories around, especially as regards the medical profession's urgings to deny healthcare to smokers, drinkers and fat people. True, the BMA tend to side with Fake Charities more than the insurance companies these days, but the process is the same; government-funded "medical advisers"—no less effective or poisonous than Grima Wormtongue—whisper into politicians' rights ears, whilst government-funded "charities" bolster the message from the left.

Our New Coalition Overlords™ promised to take on the vested interests but, narrow-minded as they are, they seem to mean only the bankers and other huge commercial interests whose establishment status flows from the rules and regulations imposed by government.

But no mention has been made of those other vested interests: those—like the medical profession—whose power, privilege and money is propped up by the government and funded by the blood of taxpayers. There are so many of them that a stupid person might find it difficult to know where to start.

But, actually, it is really very simple: if we want decent welfare for all, affordable medical care and freedom, we need to return to "democratic self-organisation". And if we wish to do that, we have to smash and utterly destroy the organised medical profession, and grind it into the dust.

We need to return these arrogant doctors, and their associated scum (a category in which I include politicians), to beings servants of the consumer, not the masters. But whilst the doctors continue to run our medical services, and continue to bribe, bully and poison our rulers—and whilst our rulers still have the power to force us to obey these bastards—we will never be free, and we will never have a proper, functioning society.

To paraphrase P J O'Rourke, when the legislators can decide what can be bought and sold, the first thing for sale are the legislators. And the medical profession bought them a hundred years ago.

Destroy the power of the BMA and the medical profession and we can begin to struggle towards freedom. Leave them in place—poisoning public debate and raping the freedom of ordinary people in order to gain money and prestige—and we will always be slaves.

All of the above continues to be true—nothing has changed. So every time that you see a doctor warning of some dire consequence of anyone's lifestyle, don't condemn their victims—that is the precise reaction that these fuckers want from you, the better to divide and conquer.

Imagine, instead, how much you would like these bastards to stop hectoring you and bossing you about—and think, therefore, about how best to damage and destroy the entire medical profession. Think about how best to humble the arrogant, dictatorial doctors who urge the government to ban and tax your pleasures, how to put the lazy, hoity-toity nurses who starve their patients to death back into their proper place and, most important of all, how to blast apart all of their evil bloody trade unions.

And try not to laugh too much whilst you do so...

* Not for much longer, of course, because the Welfare State is utterly bankrupt across the world.

** Where the doctors tell the politicians how much cash they want and how little actual doctoring they want to do, and the politicians agree. After all, it's not their money, eh?

The shorter NHS reform debate

Now, I know that the whole NHS reform debate is pretty complicated and no one quite knows what's going on—so, your humble Devil has decided to provide a handy cut-out-and-keep guide to the whole issue...

All doctors (most especially GPs and GP bloggers): "The reason that the NHS is crap is because it is run by managers, not medical staff who know best about their patients' treatment."

All doctors (most especially GPs and GP bloggers) on the news that medical staff are to get the ultimate say on how the NHS is run: "We didn't mean us!"

Meanwhile, as 0.12% of the RCN membership passing a vote of no confidence in the Health Secretary is reported as 99% of nurses pass a no confidence vote in Lansley, your humble Devil reports that 99% of nurses starve their patients to death.

Hey! Don't thank me—I'm here to help...

It's long past time that IE6 died

Over the last few years, your humble Devil has been working for a small web software company in Surrey. I was hired as a second-string website designer and—mainly due to the fact that I just won't shut up when I see things that need sorting out—I have swiftly moved through various jobs within the company: from second-strong designer, to Project Manager, to Head of Marketing*.

My current role, and the one that I hope to stay in, is as Product Manager. Despite the fact that I have seen the company triple in size over my three years with them, it is still a small company and, as such, I do rather more than a Product Manager in a large company would do. I put together the product roadmap, write software specifications, design the workflows, user experience (UX) and user interfaces (UI) for the products, as well as coding a good deal of the actual UIs too.

It's busy but immense fun and, usually, incredibly satisfying.

However, we are a web software company and, as such, there are a few things that are massively annoying: these can generally be defined as Internet Explorer 6, Internet Explorer 7 and Internet Explorer 8 (I am reserving judgement on IE9, since it looks to be half-way decent), and their prevalence amongst our customer base.

Of all of these, Internet Explorer 6 is the worst: its support for CSS and Javascript is pitiful and its debugging tools non-existent. What that means is that not only does it not work "properly" but it won't even give you a clue as to why. Released in 2001, IE6 for Windows had worse CSS support than (the now defunct) 5.2 for the Mac: as a browser it is slow, archaic and out-dated.

Unfortunately, for various technical reasons—mainly to do with the tight integration with Windows that led to accusations of monopoly abuse, as well as providing massive security flaws—many large organisations still use IE6 and are having a hard time weaning themselves off it.

But the simple fact is that IE6 not only prevents people like me from writing better web software: it is a massive security risk. As one writer at ZDNet put it... [Emphasis mine.]

Any IT professional who is still allowing IE6 to be used in a corporate setting is guilty of malpractice. Think that judgment is too harsh? Ask the security experts at Google, Adobe, and dozens of other large corporations that are cleaning up the mess from a wave of targeted attacks that allowed source code and confidential data to fall into the hands of well-organized intruders. The entry point? According to Microsoft, it’s IE6...

This would be worrying enough: after all, there are plenty of corporations which are still using IE6—but at least you don't have to give them your sensitive information.

But, as I know from personal experience, one of the areas most resistant to upgrades is the NHS—and they do have plenty of your most personal details on file. Yes, they are behind the N3 network (which brings a whole new set of challenges to those of us working with them) but it only needs one entry point to compromise the entire system.

Many NHS organisations believe that they are supposed to be using IE6; many of them believe that the Spine applications that they need to access will not work on anything other than IE6. This is not only untrue, but these organisations are ignoring a very clear Directive—issued over a year ago by the Department of Health—to cease using IE6 and to upgrade to IE7 as a minimum.

The Department of Health has told trusts using Windows 2000 or XP to move to version 7 of Microsoft's browser.

In a technology bulletin published by the department's informatics directorate on 29 January 2010, it advised NHS trusts using Microsoft Internet Explorer 6 on either Windows 2000 or Windows XP to move to version 7 of the browser.

"We've advised NHS trusts to upgrade to IE7 as early as possible," said a spokesperson. The guidance said that IE7 works with the department's Spine applications, and provides additional security.

The notice also recommended that organisations that continue to use IE6 should apply a security update patch from Microsoft to all affected computers, or if this is not possible apply mitigation methods suggested by the vendor.

Microsoft reported a significant security problem with IE6 on 14 January which could compromise a computer's operating system, although the browser was already known to be less secure than newer versions. The new vulnerability could act as an entry point for hackers to a network, allowing sensitive information to be stolen, according to the DoH bulletin.

Some weeks ago, I raised this issue with a number of NHS organisations, and asked—given the sensitive nature of the data that they hold—why they are still using this browser. Most have said they will look into it, and that is the last that I have heard of the matter.

It is hardly surprising that government organisations—not known for their ability to keep our data safe—are still using this out-dated and flawed browser. It is bordering on the criminal that they continue to use IE6.

Now, Microsoft themselves have set up a new website—IE6 Countdown—which seeks to encourage the death of this shitty piece of software. Naturally, M$ do not put it in quite those terms—they seek to push the benefits of upgrading to the latest version of IE rather than pointing out that IE6 is crap—but the message is the same: don't use IE6, especially for security-critical systems.

Perhaps, with IE6's own manufacturers seeking to kill it, those who risk the integrity of our data every single day might pay some attention.

And then we can take some small steps towards a better web experience too...

* At the moment, we are desperately looking for friendly, enthusiastic people to fill two roles: that of a web designer/front-end developer and that of first-line tech support. Please drop me a line if you would like more details...

Criticising the NHS is not treason

(Mr and Mrs Kitchen are away)

You know there's an election looming when the Tories and Labour start battling for the dubious honour of being the "party of the NHS". The deification of this creaking, bloated and massively over-rated money pit has always mystified me. But its reputation as an untouchable and glorious institution is set in stone and, for better or worse, it's here to stay. As the hysteria over Dan Hannan's comments shows, no debate can be had about socialised healthcare in this country beyond the spastic yelp of how we should pay nurses more money and refuse treatment to people we don't like. 

The most pathetic attack on Hannan came from Andy Burnham, whose resemblance to a ventriloquist's dummy in mascara gets more uncanny with every passing day. 

"I would almost feel... it is unpatriotic because he is talking in foreign media and not representing, in my view, the views of the vast majority of British people and actually, I think giving an unfair impression of the National Health Service himself, a British representative on foreign media."

He said Mr Hannan's words were an "insult" to the 1.4m NHS workers and "he should not be voicing those views in the foreign media in my view".

Come off it, Burnham. It's a little thing we call free speech. Patriotism doesn't come into it. Do the words 'scoundrel' and 'last refuge' mean anything to you, unctuous little turd that you are? 

When dickheads like Burnham resort to appealing to national pride, you know the argument's been lost. You may recall the equally hopeless Tom Harris using the same tactic earlier in the year when Hannan tore into our thieving, half-blind bastard of a Prime Minister:

What was truly repugnant about his speech was the total absence of any sense of patriotism...

Gordon Brown isn’t just Labour’s prime minister; he’s Britain’s prime minister, and for any UK politician to launch such a disgraceful, personal attack on his country’s leader — in a foreign country — is nothing short of disgraceful. 

Or, to put it another way: "We all know the NHS is shit and that Gordon Brown's a cunt, but let's not tell the rest of the world, eh?". Well, fuck that. Hannan was right then and he's right now. 

Liberal Conspiracy, frothing at the mouth at Hannan's attack on the "largest, most respected, and most valued of British institutions", has also been swept away with a sense of burning patriotism:

Watching Daniel Hannan speaking as a supposed representative for Britain on Fox News, bleating about how our country has been rendered feral and crippled by the NHS is enough to raise a sudden, unexpected swell of patriotism normally reserved for the success of a British icon on the global stage or spectacular sporting defeats.

It's all very touching. Perhaps now would be a good time to start a war. But instead of resorting to knee-jerk patriotism and sending nauseating messages via fucking Twitter, how about looking at what Hannan actually said? (His two main interviews can be seen here and here). 

1. The UK has "bad survival rates".

From The Telegraph:

Cancer survival rates in Britain are among the lowest in Europe, according to the most comprehensive analysis of the issue yet produced.

Survival rates are based on the number of patients who are alive five years after diagnosis and researchers found that, for women, England was the fifth worst in a league of 22 countries. Scotland came bottom. Cancer experts blamed late diagnosis and long waiting lists.

Whereas the USA has the best cancer survival rates:

American women have a 63 percent chance of living at least five years after a cancer diagnosis, compared to 56 percent for European women. 

American men have a five-year survival rate of 66 percent — compared to only 47 percent for European men.

I think we have to chalk this up as one for Hannan.

2. "People who have conditions that they try to buy drugs for independently are told that their whole treatment will be stopped."

From The Guardian:

The husband of a woman who died of cancer but was denied free NHS treatment because the couple chose to pay privately from their savings for a drug to prolong her life yesterday urged the government to change its guidelines.

Linda O'Boyle, 64, who had bowel cancer, is believed to be the first person to die after fighting for the right for top-up NHS treatment alongside privately purchased cancer medicine - so-called co-payment. Six other patients are launching a legal action to allow NHS patients to top up their care with private drugs.

Dr Crippen has other examples of this disgusting policy, even if he does think that Hannan is a prick. 

Two nil, Hannan.

3. "We have 1.4 million people employed by the NHS. It is the third biggest employer in the world."

From The Times:

NHS is world's biggest employer after Indian rail and Chinese Army

And from the Daily Mail:

Between 1999 and 2005, the number of NHS staff increased from 1.1million to 1.4million, up 24 per cent. Growth was fastest amongst senior managers - up 62 per cent over that period, with the number of doctors increasing by 30 per cent and nurses by 23 per cent.

Or, to put it another way, there is an NHS employee for every 43 people. And with a budget of £90 billion, it costs each British citizen £1,500 a year to keep the thing going. That works out at about £70,000 in a working life.

In exchange for this eye-watering sum of money, you will be told how to live and may be refused surgery if the powers at be don't like your lifestyle - even if all you did was break your ankle. And don't expect a refund.

Smoker refused operation on broken ankle

A smoker is facing years of pain after an NHS hospital refused to set his broken ankle unless he gives up cigarettes.

John Nuttall, 57, needs the operation to fix the ankle he broke in three places two years ago and which was not healed by a plaster cast.

Mr Nuttall, from Newlyn, west Cornwall, said: "I have begged them to operate but they won't. I have tried my hardest to give up smoking but I can't.

"I want to warn other smokers. We have paid our National Insurance stamps all our lives and now we are being shut out of the NHS."

Three nil Hannon.

4. "Most of those 1.4 million people are administrators"

From the Taxpayers Alliance:

In September there were 408,200 qualified nurses in the NHS; 25,700 midwives; 34,010 GPs; 34,900 consultants; and 49,200 other hospital doctors. There were also 1,450 school nurses; and 39,900 managers.

The total of employees above comes to 593,360 - less than half of the 1.4 million total. What do the rest do? Some will be administrators, but some will be cleaners, caterers or any number of other things. There are, unquestionably, a fuck load of administrators working in the NHS, but to say that "most" of the 1.4 million are administrators is an exaggeration. 

3-1

5. There are "huge waiting lists".

From the BBC:

CURRENT WAITING TIMES IN ENGLAND AND SCOTLAND

8 months for cataract surgery

11 months for a hip replacement

12 months for a knee replacement

5 months to repair a slipped disc

5 months for a hernia repair

These figures come from the BBC's report of 27 May 2004. If you look at this interview with Hannan, you will see the same figures on the screen. Notice, however, that Fox News have changed the date to 27 May 2009. Proof if proof were needed that Fox News isn't always the most reliable news source.

Have things changed much since 2004? It's hard to say. According to the National Center for Policy Analysis:

Americans spend less time waiting for care than patients in Canada and the U.K  

Canadian and British patients wait about twice as long - sometimes more than a year - to see a specialist, to have elective surgery like hip replacements or to get radiation treatment for cancer. All told, 827,429 people are waiting for some type of procedure in Canada. In England, nearly 1.8 million people are waiting for a hospital admission or outpatient treatment.

Reliable statistics on US waiting times are hard to find. As for the UK having huge waiting times, it depends on what you call 'huge'. The average waiting time for inpatients is just over two months, and just over a month for outpatients, according to the NHS. There's no doubt that waiting lists have come down under Labour, even though it took a doubling in NHS spending to do it.

According to the ludicrous Andy Burnham, there are no waiting lists at all:

“We have no waiting lists now in the NHS and people have full choice of NHS hospitals.”

Burnham's a gobshite and Hannan is basically correct. 4-1.

6. "I could tell you horror stories about elderly people left starving in wards."

From The Telegraph:

Patients left to starve on NHS wards

The number of NHS patients suffering from malnourishment as they leave hospital has nearly doubled, new figures show. Around 140,000 patients were discharged after being inadequately fed on NHS wards last year, statistics obtained by the Conservatives reveal...

Michael Summers of the Patients' Association said: "Families tell us that when visiting elderly relatives in hospital in particular they noticed how malnourished they are.

"Nurses are so rushed off their feet that it is no surprise that patients end up malnourished. We have heard stories of elderly people who haven't had a meal all day because they have just been overlooked. The food is just taken away when the patient hasn't been able to eat any of it.

"It is a scandal in the 21st century - it ought never to happen."

5-1.

7. "We have far fewer GPs per head of population than you have in North America"

Statistics vary enormously for this. Take your pick out of this lot. All but one agree that the USA has more doctors per head than the UK, but to say that we have "far fewer" is an exaggeration.

Hannan finishes 5-2 up by my reckoning. One or two exaggerations but nothing that warrants treating him like a child-molesting war criminal. 

Let's take a deep breath. A fairly obscure Conservative politician with a voice like Richard Madeley has pointed out some draw-backs in our health system. He's not John the Baptist, but he's not Lord Haw Haw either. 

Have a good weekend.

Five myths about alcohol

(nb. I am not the Devil's Kitchen)

No. 1 - We are drinking more than ever and 1 in 4 people are drinking at hazardous levels

This claim has been made regularly since May of this year, based on data from the Office of National Statistics. The Telegraph's report was entirely typical: 

One in four drink too much, official figures show.

Ten million people in England – one in four adults – are putting their health at risk by drinking too much, official figures have shown.

'Too much' is more than 21 units a week for men and 14 units for women. The highly questionable nature of these 'daily limits' has been discussed by my gracious host before; he has also recently touched on the changing way in which these units are counted, all of which reinforce the myth that there is a mounting epidemic of binge-drinking.

Since 2007, the Office of National Statistics has assumed larger glasses are being used and stronger alcohol is being consumed. They now assume that a glass of wine contains 2 units, rather than 1, as it did before. With beer, what used be counted as 1 unit is now counted as 1.5, what used to be 1.5 units is now assumed to be 2 units and what used to be 2.3 units (a large can) is now counted as 3 units.

As you might expect, this has made a dramatic difference to the statistics. The graph below shows the percentage of men and women drinking more than their 21/14 unit weekly 'limit' under the old system*:

Nothing to see here, is there? A downward trend since 2000 is evident for both sexes.

But this is how the same statistics look using the new system:

Wa-hay! Booze Britain! Exactly the same data but very different results.

So which is the correct estimate? The ONS is, in my view, a basically honest institution and it seems fair to estimate 2 units are in the average glass of wine. It is less fair to assume stronger beer at a time when two of the biggest selling lagers - Stella and Becks - have introduced weaker brands. 

But wherever the truth may lie, the fact remains that even if the ONS had changed its system 10 years ago, the overall trend would remain downwards. 

That consumption has actually been falling recently - albeit slightly - is confirmed by figures for pure alcohol consumption. These show that per capita consumption peaked in 2004 and has since dropped off: 

Litres of alcohol per person aged over 14 (PDF)

2002: 11.13

2003: 11.34

2004: 11.59

2005: 11.4

2006: 11.0

2007: 11.2

This data is significant because per capita consumption effectively measures the amount of ethanol consumed by a person, which is what the system of units is supposed to do. But while units have to be clumsily estimated, the per capita system measures what has actually been bought and therefore, one has to assume, been drunk.

According to the Institute of Alcohol Studies - no friends of the booze - total alcohol sales have fallen by 13% since 2001/02**. According to the ONS, the number of teetotallers has risen from 9.5% to 14% since 1992. And pubs are closing at the rate of 53 a week. And per capita consumption of pure alcohol currently stands at 11.2 litres, much less than Luxembourg (15.6 litres) and, indeed, less than 14 other European countries. That's your ‘Booze Britain’ for you.

*These figures are shown in table 2.5 of Statistics on Alcohol, England 2009

** Page 8 of Drinking in Great Britain (PDF)

No.2 - Alcohol is cheaper than it was 20 years ago

This forms the cornerstone of efforts to introduce a minimum price for alcoholic drinks by, amongst others, Fatboy Donaldson:

In his report, Sir Liam noted that over the preceding 20 years, the country’s disposable income had risen faster than alcohol taxation, and alcohol had become ever more affordable.

It is true that alcohol has become more affordable. Everything has become more affordable as a result of rising prosperity. Most people would consider this to be a good thing. But relative to other products alcohol has become less affordable.

When inflation is factored in, British households' disposable income increased from 100 to 208.8 between 1980 and 2008. In other words, people can afford to buy more than twice as much as they could in 1980. 

In the same period the affordability of alcohol - thanks to above-inflation tax rises - has only risen from 100 to 175. To imply that alcohol is actually "cheaper" is disingenuous in the extreme.

In fact, as the Office of National Statistics concludes, it is plain wrong:

Between 1980 and 2008, the price of alcohol increased by 283.3%. After considering inflation (at 21.3%), alcohol prices increased by 19.3% over the period.

In real terms, as well as in monetary terms, alcohol is more expensive that it was 20 years ago.

No. 3 - There is a worsening epidemic of underage drinking

Here's The Telegraph again:

Teenage drinking epidemic 'causing misery'

Britain needs to wake up to the epidemic of binge-drinking among teenagers and the misery it is causing thousands of families, one of the country's most senior policemen has warned.

He criticised the drinks industry for targeting the young and exporting its "negative costs on to the streets, hospitals and into the criminal justice system".

But only last week the Trading Standards Institute reported:

A survey of 13,000 young people by the Trading Standards Institute found the number of teenagers who drank weekly fell from 50% in 2005 to 38% this year.

Which backs up what they said in 2007:

Fewer teenagers are drinking regularly - partly because it is becoming harder for youngsters to get hold of alcohol, a Trading Standards survey suggests.

And this is supported by figures from the Office of National Statistics (May 2009):

One in five pupils (20%) [11-15 years] had drunk alcohol in the last seven days, a proportion which has declined from 26% in 2001.

Furthermore:

The proportion of pupils who have never drunk alcohol has risen since 2003, from 39% to 46% in 2007.

Underage drinking - at whatever level - is clearly an issue for parents and the police, and yet, Trading Standards exhibited the same attitude of buck-passing as the copper above:

Trading Standards North West, which carried out the poll, said it intended to write to the firms behind these drinks to "seek clarification of the plans for action to reduce their appeal to young people".

That's right. It's "the firms". Not the police, not the parents, not the shopkeepers and not - heaven forfend - Trading Standards. It's down to the manufacturers to stop people buying their products illegally.

No. 4 - Alcohol-related hospital admissions have risen by 69%

Responsible journalists usually follow this little nugget of information with an important proviso:

The number of people admitted to hospital in England with alcohol-related problems has risen by 69 per cent in five years, to 863,000 in 2007-08, although changes to data collection — which now include secondary diagnoses, such as alcohol-related injuries — have contributed to the surge in cases.

These "changes to data collection" do more than merely "contribute" to the "surge in cases" -they are the overwhelming explanation. The redefinition is sweeping and appears to include anybody who turns up in hospital with a trace of alcohol in their blood, as the ONS explains:

“These figures use a new methodology reflecting a substantial change in the way the impact of alcohol on hospital admissions is calculated. The new calculation includes a proportion of the admissions for reasons that are not always related to alcohol, but can be in some instances (such as accidental injury).”

This covers a multitude of sins. As a helpful commentator recently pointed out, alcohol can be linked to virtually any disease, usually very tenuously. Sure enough, the largest proportion of "alcohol-related" admissions involve people with geriatric diseases:

Overall, the number of alcohol-related admissions increased with age in 2007/08, rising from 49,300 admissions among 16 to 24 year olds to 195,300 admissions of people aged 75 and over.

Only a quarter of the 863,000 admissions are directly attributable to alcohol. Not that any of this was deemed worthy of mention by, for example, The Daily Mail:

Alcohol-related admissions to hospitals in England have soared by more than 50 per cent over the last five years, latest figures revealed last night.

Startling data from the Department of Health showed there were 863,257 drink-related admissions in 2007-08, up sharply from 569,418 in 2003-04 - the year Labour's reforms ushered in round-the-clock drinking.

No. 5 - Lager is cheaper than water

This doozy is a favourite of pretend charity Alcohol Concern and has been repeated many times, particularly by the The Daily Mail:

Drunk for £1: Anger as leading supermarkets sell lager for 22p a can

Supermarkets are selling beer at a cheaper price than water, fuelling concern over their role in Britain's binge-drinking crisis.

Despite repeated public health warnings, Tesco, Sainsbury's and Asda now offer lager at just 22p a can - less per litre than their own brand-mineral water and cola, and cheap enough to allow someone to get drunk for just £1.

Let's ignore for a moment the obvious point that someone wanting to buy water is hardly likely to buy lager on an impulse instead. Let's even ignore the fact that water comes out of the tap for 0.02p per glass.

Instead, let's look at Tesco's own brand lager. Here it is.

It costs 91p for a 4-pack, or 5.2p per 100ml.

And here's Tesco's own brand mineral water. 

It costs 13p, or 0.7p per 100ml.

So please can we put this one to bed now?

Eagle-eyed readers will have spotted something about the own-brand lager - it is piss-weak (2% ABV). Frankly, you might as well drink the water. 4 cans of this stuff equates to about a can and a half of Stella. Hardly enough to get "drunk for £1", although that didn't stop the Mail from printing a hilarious account of someone pretending to do just that.

Away from media hysteria and the medical lobby's hyperbole, the facts are plain: we are drinking less than we did 100 years ago, more than we did 50 years ago and less than we did 5 years ago. We are middle-weights in the European drinking league and the fact that we have a lot of knob-heads causing problems in our towns and cities at the weekend is because there a lot of knob-heads in the UK. The reasons for that is a whole other story, but it has nothing to do with advertising, happy hours or the price of lager. 

It is doubtful that even the British Medical Association really believes that charging 50p a unit or banning Guiness adverts will make the slightest difference to rates of consumption, but that is not really the objective. The objective is to officially identify drinking as 'bad' in the same way that smoking is 'bad'. From that starting point, all else follows.

Will we ever trust doctors again?

Ian Gilmore: His guitar playing on Shine on You Crazy Diamond was sublime but these days he's a proper cunt.

(nb. I am not DK)

The Lancet has decided to dedicate a whole issue to pushing the fuck-me-I-never-saw-that-coming anti-booze crusade that all us paranoid libertarians said would inevitably follow the war on tabs as a result of the slippery slope that apparently doesn't fucking exist.

Parading it to the blinkered morons of the Fourth Estate is ubiquitous arsehole Ian Gilmore, who makes the connection between smoking and drinking explicit:

"We need an international framework convention for alcohol control, similar to that on tobacco, as soon as possible, to put into practice the evidence-based measures needed to reduce alcohol-related harm.

"These include increasing the price of alcohol, reducing its availability and banning advertising, and the action needs to start now."

Translation:

"We've been fucking smokers up the arse for a number of years now and, frankly, we're in the mood for some fresh meat. Obviously we'll be using the same bullshit statistics to soften the British pleblic up for a good roasting. 

"But before we begin, I'd just like to thank all the docile pricks who pathed the way by supporting the smoking ban just because it meant they wouldn't have to wash their clothes or hair anymore. 

"Believe me, you dirty, smelly, gullible set of twats, a trip to the washing machine is going to seem like a fucking birthday party by the time we've finished with you."

Step One is a 50p per unit 'minimum price' on alcohol. In an attempt to whore this policy to the public, Gilmore came up with a 'fact' which, even by the standards of puritanical, lying, fake charity, quack bastard, burn-in-hell fuck-nuggets like him, is an egregious travesty. Not that the fucking Telegraph bothered to question it:

Minimum alcohol price 'could halve hospital admissions for drinking'

Prof Gilmore, the president of the Royal College of Physicians, said the move could reduce the numbers admitted for alcohol problems by around 100,000.

In 2007, just over 207,000 people were taken into hospital because of the effects of drinking.

Really? Upon what research is this based, Gilmore, you say-anything, do-anything, prohibitionist fucking little worm? Are you prepared to stand by this prediction if we introduce this piece-of-shit law and hospital admissions don't fall by half? Can we expect you to do the decent thing, ie. resign, stick an orange in your mouth and kill yourself? Or will you and your band of hateful motherfuckers simply demand a higher 'minimum price' and yet more vindictive bullshit?

The hopeless bastard reveals what a nonsense this is as he tries to suck up to middle England:

Writing in The Lancet, however, Prof Gilmore says that the price hike would cost the average person only 23p more per week.

Only 23p? So it'll be so small that no one notices and yet big enough to save 100,000 lives? Give me three bottles of your snake-oil, Dr Gilmore. Fuck it, let's make it 46p and eliminate alcohol-related admissions altogether.

Lying, evil little shyster. That's all he is.

If that little statistic sounds like bollocks—and by Christ, it is—it is entirely in keeping with The Lancet's special edition, of which the highlight is this study:

One in 25 deaths across the world are linked to alcohol consumption, Canadian experts have suggested.

And if 1 in 25 deaths seems a bit high, wait till you hear about the supposed rate in Europe:

Europe had the highest proportion of deaths related to alcohol, with 1 in 10 deaths directly attributable.

10% of all deaths? Let's do a quick bag-of-an-envelope calculation, shall we?

According to the ONS, there were 509,090 deaths in England and Wales in 2008 and there were 6,541 deaths related to alcohol in England. That last figure doesn't include Wales so let's be generous and add a further 500 deaths for the sheep-worriers.

Which gives us a total number of about 7,000, or 1.38% of all deaths.

Of course, that doesn't give us the percentage for the whole of Europe, but seeing as we're supposedly some of the worst drinkers in Europe (another fucking lie), that should be considered a conservative estimate. Still nowhere near 10% though, is it? It's not even close to the 1 in 25—or 4%—claimed for the whole world, and for that global total you need to factor in a billion muslims who don't drink at all, plus God knows how many people who haven't got a pot to piss in, let alone a pub to get pissed in.

So the only conclusion can be that, yet again, we're being lied to on a massive scale. And what does the prick who conducted the study have to say for himself?

"The big message is treat alcohol like tobacco..."

Yeah, alright, we get it...

... not as a substance that is relatively benign except for those bad alcoholics. That is not true."

And that, too, is a bare-faced lie. Being a tee-totaller is not good for you and moderate drinking is very certainly 'benign', as has been shown many times, for example:

Women who drank alcohol on at least one day a week had a lower risk of coronary heart disease than women who drank alcohol on less than one day a week...

For men an inverse association was found between drinking frequency and risk of coronary heart disease across the entire range of drinking frequencies. The lowest risk was observed among men who drank daily (0.59, 0.48 to 0.71) compared with men who drank alcohol on less than one day a week.

They lie and lie and lie. Do these fuckers really think that a few bullshit anti-drinking laws are worth dragging their profession into the gutter? One day these quack bastards will tell the truth about something important. Will anyone believe them?

UPDATE (by DK): Professor Ian Gilmore is, of course, not just "president of the Royal College of Physicians", oh no. He is also the Chair of the Alcohol Health Alliance which is, of course, a fake charity of some magnitude.

Now, a quick search of fakecharities.org for "Alcohol Health Alliance" throws up such definitely fake charities as Sustain, the Institute for Alcohol Studies and the Alliance House Foundation (formerly the UK Alliance for the Suppression of the Traffic in All Intoxicating Liquors); all of these organisations are heavily funded by the state which means, of course, that the Alcohol Health Alliance is also heavily funded by the state.

As such, Professor Ian Gilmore is a mouthpiece for the government and should probably have his tongue ripped from his lying head before being hanged by his testicles in a tank full of ravenous piranas. The cunt.

It is worth pointing out that nowhere in the Telegraph article is this information pointed out.

Now me—I'd say that taking the word of a man who is the Chair of an organisation, the members of which include the formerly-named "UK Alliance for the Suppression of the Traffic in All Intoxicating Liquors", without mentioning this little nugget of information—or massive fucking conflict of interest—is the act of a deeply stupid, tit-head, biased cub reporter.

I would view said nugget as something that a professional journalist might like to mention to his readers. You know—for balance, and that kind of thing. Not, apparently, in the increasingly bizarre and amateurish world of the fucking Daily fucking Telegraph.

Professor Ian Gilmore really is a fucking cunt of the very first water who first featured on The Kitchen in December 2007. Needless to say, he has made a couple of appearances since then.

And I fully expect him to become a regular hate figure in the future too.

Down the memory hole

(nb. I am not the Devil's Kitchen)

Regular readers will be aware that the ruthless swine at the Department of Health have been caught with their trousers down trying to rig the public consultation that led our beloved government to ban tobacco displays in shops.

You may recall that the views of 25,000 members of the Tobacco Retailers Alliance were ignored when the DoH published the results of its half-arsed consultation in December. The organisation was not even listed as a respondent, leading some cynics to suggest that this might be due in no small measure to the fact that every man-jack of them opposed the idea.

Now, via Taking Liberties, comes the news that the DoH has quietly issued a new version of the consultation document with the Tobacco Retailers Alliance added to the list of 'consultation respondents'. And they are not the only ones. The list of respondents has expanded from 7 pages to 10. No fewer than 80 organisations have miraculously appeared out of nowhere and are now part of the consultation.

In relation to the key question of tobacco display bans, the new version states:

Question 8: Do you believe that there should be further controls on the display of tobacco products in retail environments? If so, what is you preferred option?

We are particularly interested in hearing from small retailers and in receiving
information on the potential cost impact of further restrictions on display. What impact would further controls on the display of tobacco have on your business, and what might the cost be of implementing such changes?

Responses: 95,488

Around 84 per cent of respondents to this question favour stricter controls, with the vast majority of these preferring option three: requiring retailers to remove tobacco products from display.

The old version - the one that convinced the government to bring in this law - is no longer available. It doesn't exist. In time it will never have existed. But by a stroke of good luck, I happen to still have the original PDF. And in answer to the same question the old version states:

Responses: 95,488

Around 84 per cent of respondents to this question favour stricter controls, with the vast majority of these preferring option three: requiring retailers to remove tobacco products from display.

So no change at all then. Exactly the same number of responses and exactly the same outcome. In fact, despite the belated acknowledgement of these 80 'stakeholders', not a single word in the main text of the consultation document has been altered. Not one word.

And yet we know that one of these groups - the Tobacco Retailers Alliance - includes 25,000 respondents and that they are most definitely not in favour of "requiring retailers to remove tobacco products from display". Whether or not the 95,488 responses cited above includes the 80 groups overlooked in the original document, these 25,000 no votes alone would make it impossible for there to be an 84% majority in favour.

And that is just one organisation. Amongst the other respondents who were mysteriously absent from the original document are Gallagher Tobacco and The Free Society. It's fair to guess that they were opposed to this law and would have said so.

Most of the other new arrivals are regional PCTs and councils who can be relied on to toe the DoH line. Whether they actually submitted responses to the consultation we do not know. Other additions are just odd. What, for example, did Brobot Petroleum and the US Chamber of Commerce have to say about the proposal? God knows but there they are, large as life, in the list of respondents.

This has all the hallmarks of a clumsy cover-up. The farce of this "public" consultation has spread far beyond the blogosphere and the new version appeared on the DoH website just four days after The Telegraph became the first national newspaper to cover the story.

It looks very much as if someone at the Ministry of Truth Department of Health has hastily amended the list of respondents without bothering to include their responses or counts their votes. To have done otherwise would have demolished the "overwhelming support" that this measure was reported to have enjoyed.

By padding out the list with various PCTs and borough councils, the DoH may be planning to claim - if pressed - that there was some sort of administrative cock-up by an office junior and that the Tobacco Retailers Alliance was not singled out for special treatment. But adding so many new groups just seems like overkill. It would mean that a quarter of respondents were missed off the original document due to an "oversight". Surely even a government department cannot be so inept?

Whatever the truth - and it's nothing the Freedom of Information Act shouldn't be able to resolve - the smell of bullshit around this affair is now overpowering.

What you didn't read this week

(nb. I am not the Devil's Kitchen)

One the best things about the smoking ban is that you no longer have to step over dead bodies to get to the bar. We all remember, don't we, the familiar sight of nonsmokers clutching at their chest as that lethal secondhand smoke triggered one cardiac arrest after another. On any visit to the pub you were certain to witness at least one heart attack. The life expectancy for barmaids was three weeks. Thank God those days are over.

Naturally, once the smoking ban came in, there was a massive drop in the number of people being admitted to hospital for with heart attacks. How could it be otherwise?

That, at least, was the story just over a year ago when the Beeb and virtually every newspaper in Britain reported that Scotland had seen a large fall in heart attacks since March 2006 (when the ban started) and so - post hoc ergo propter hoc - it was the ban wot done it. The Guardian's report - Smoking ban brings big cut in heart attacks in Scotland, study finds - was typical of the media's willingness to believe in this delightful little fairy-tale:

"The number of people being taken to hospital with heart attacks in Scotland has fallen significantly since the smoking ban was introduced, the most detailed study into the impact of the measure has revealed.

Researchers found a 17% drop in the number of people admitted for heart attacks in the year since the ban came into force."

Inevitably, one the hatchet-faced gurners from Action on Smoking and Health piped up to make the implied connection with passive smoking explicit:

"We knew from epidemiological statistics there was a risk from secondhand smoke to cardiovascular health but not how much of a risk until now."

This was an understatement. If the study was true then it meant that before the ban a whopping 17% of all heart attacks were caused by passive smoking in public places. Even in the swivel-eyed fantasy world of anti-smoking nutjobs, surely this sounded a tad high? But it was good enough for The Daily Mail who leapt at the chance of doing a spurious extrapolation:

"If the pattern is repeated throughout the UK, there would be almost 40,000 fewer heart attacks a year."

That's right. Before the ban, there were 40,000 heart attacks from secondhand smoke in the workplace. Hence that a pile of corpses down The King's Head.

What the ASH spokeswomen didn't mention was that the 17% figure was not based on hospital admission data but on the same sort of "epidemiological statistics" that had propped up all the rest of the passive smoking horseshit. Some friendly researchers had picked a sample of patients in a selection of hospitals over a limited time-frame and had crunched the numbers in a rather unusual way. And the researchers happened to be members of anti-smoking groups. And the study hadn't even been published. In fact, if the Scottish government hadn't gone to the trouble of issuing a press release, no one would ever have heard about it.

When the study was finally published in July this year it got another flurry of international press attention. By this time, the belief that heart attacks had fallen by 17% had become established fact and was being cited in a bid for world domination:

"The findings of a major study into the smoking ban in Scotland supports calls for a worldwide ban of the practice in public places, health officials said today."

The research, which was first revealed last year, found a 17% fall in hospital admissions for heart attacks in Scotland in the first year of the ban."

But the smell of bullshit lingered over the story and this week the truth finally emerged.

You see, we don't need to pay partisan researchers to estimate how many people get admitted to hospital for heart attacks because the hospitals count and diagnose all the patients themselves. These figures are then compiled and published by professional statisticians. It takes them a while to do it, but that's because they want to get it right. They don't just want to pull numbers out of their arses to provide lazy journalists with fanciful stories.

And when these professional statisticians have collated the information properly, they publish it online for all to see, showing the recent trend and the long-term trend.

They finally got round to doing this on Wednesday and everything that was reported last year was exposed as a shabby load of old bollocks. Yes, admissions for acute coronary syndrome had fallen after the ban but they had been falling for years as this graph shows:


The figure was nowhere near 17%. It was 7.2%. And, above all, the rate went up for the first time in a decade the following year - by 7.8%. In other words, there were more heart attacks in smoke-free Scotland last year than there were before the ban.

So not quite the glorious success story that you might have been led to believe.

Funnily enough, the Scottish government hasn't got round to sending out a press release to spread this bit of news yet. You heard it here first. And probably last.


H/T: Freedom2Choose

Fringe benefits

This is just unbelievable and, at the same time, so utterly predictable.

Medical teams could be rewarded with bonuses for successful operations under a plan being considered by the UK's largest hospital trust.

What the fuck? These people are to be rewarded for doing their job properly?

Medical teams are already rewarded for successful operations: it's a really novel sort of reward called "a salary". It's a reward similar to what most of the rest of us get; the difference is that if we in the private sector aren't "successful" then we get something called "the sack".

Of course, this is not a government initiative: it is a unilateral move by Imperial College Healthcare Trust, and therein, I think, lies the motivation. A motivation not entirely dissimilar to a little bit of American history.

With the 2nd world war raging in the 1940's, labor was in short supply, and the government imposed wage controls. To deal with this situation, employers begun to offer health insurance as a fringe benefit to attract more workers.

Indeed. And in the NHS, we effectively have wage controls, through the (insanity that is the) National Pay Deal.

And so Imperial College Healthcare Trust is attempting to attract the best labour through finge benefits, just as US employers did with healthcare insurance. Ironically, in this case, the fringe benefits are being offered to the healthcare workers themselves.

I still wonder where they think that the money is going to come from though; are they going to pay everyone for every operation undertaken? And will these bonuses count towards the employees' final pension payout? And what fringe benefits will Imperial offer once every other trust starts doing the same thing?

It's time to remove the NHS providers from state control. Oh, and forcing PCTs to split into Commissioning and Provider arms (as they are having to do) is not going to do the trick...

Out Of Sight, Out Of Mind

Author's Note: The author of this post is not "The Devil's Kitchen"

Via Letters From A Tory, MPs are complaining, through a cross-party committee, that they face discrimination and stigma if they make mental health problems known.

At least they will be able to get help. Meanwhile, those who aren't paid over sixty grand a year are stuck with the NHS. And thanks to chronic waste, mismanagement and general neglect, NHS mental health services are nothing short of a disgrace.

On reading the blog of Calum Carr*, one would hope that his experience in trying to obtain help for his mentally ill wife, only to meet with abuse, evasiveness from medics and politicians, and Byzantine bureaucracy, is unique. However, I seriously doubt that it is.

Dr Crippen described provision for the mentally ill in this country as "appalling" and psychiatric services in his area as "dreadful", with "unqualified amateurs who think psychiatry is a game". For their part, psychiatrists, as reported by the Times, report that:

The doctors say that patients with serious problems are often referred to psychologists and social workers rather than clinicians and do not receive the medical therapies they need.

So, no, Mr & Mrs Carr's predicament is far from unusual.

In hospital, the situation for the mentally ill isn't much better. A report by Dinesh Bhugra, the incoming president of the Royal College of Psychiatrists, paints a damning picture of mental health-care in the NHS in 2008. In-patient acute psychiatric care is described by Bhugra as:

So poor...that he would not use them himself - nor allow a member of his family to do so.

Some wards are "frightening and dangerous places", perhaps not surprisingly when it is "standard practice for many wards to be run at up to 120% occupancy".

Mental health is chronically under-resourced and mismanaged. Why? Because mental health is a low priority. It isn't 'sexy' - It doesn't make for great press-releases or grab headlines; and it is difficult. Treatment of a patient with a complex mental disorder requires more than giving them the right drug so they'll get better. When a so-called health service is run for the benefit of politicians and managerialists rather than patients, it is inevitable that unglamorous areas such as this will become neglected. It's no surprise that, after 60 years, mental health in the NHS so often lives down to its oft-repeated description as a 'Cinderella service'.

MPs: If you really give a shit about people suffering from mental illness - and I don't mean 'stress' as a result of somebody finding out about your latest expenses scam or affair with your secretary - how about actually doing something to sort out the absolute fucking national disgrace that is NHS mental health care neglect.
You may suffer embarrassment as a result of mental health problems being highlighted by the media or otherwise becoming public knowledge...but it'll be cold day in hell before any MP ends up on the mental health scrapheap that people like Mrs Carr are consigned to by the fucked up system that you have left to rot.


* The bloggers' campaign is at Mental Health 4 All.

The NHS: the politicians think it's fucked...

The NHS: we know it's fucked, the politicians know that it's fucked, and at least I'm honest about it...

... they just won't tell you that, apparently. The IEA have just published a new book—Sixty Years On: Who Cares For The NHS?—written by Dr. Helen Evans of Nurses for Reform. I haven't read it yet, but the IEA's Prohibitions book is thoroughly excellent, so I imagine that this one will be pretty good too.

Significantly, the study lays bare for the first time the private views of a large number of the country’s most senior health politicians, policy advisers, academics, journalists and professionals.

Containing a series of devastating blows to the NHS as it prepares to celebrate its 60th anniversary, the research shows that when speaking off the record a substantial majority of Britain’s health elite no longer believe in nationalised healthcare.

Yeah, you can bet that almost every one of our bastard politicos has private health insurance (and charges it to expenses too, I'll wager).

While the NHS is itself now charged with being ‘inequitable’, ‘two tier’, ‘rationed’ and ‘costly’, a majority also believe it is too ‘monopolistic’ and want to see a much greater role for private funding arrangements—which could include personal health savings accounts.

Looking at private funding arrangements versus the state, an overwhelming majority of respondents surveyed (65%) believe that because people’s healthcare is unpredictable, some of its costs will increasingly have to be covered by private sources: ‘government arrangements such as taxation cannot do it all’.

As it happens, I know Dr Evans vaguely; her husband is Dr Tim Evans of the Libertarian Alliance (thoroughly sound chap); anyway, having dropped her an email, Dr Evans (who is, would you believe, a libertarian nurse: who would'a thunk it), was kind enough to give me a (no doubt, stock) quote:

“As people’s expectations increasingly outpace what the state can deliver, and as nationalised healthcare loses the battle for hearts and minds, behind the scenes our opinion formers are starting to seriously consider market alternatives.

With NHS dentistry collapsing before our eyes, ever more voters having private medical insurance, private health cash plans, or simply self funding for private surgery, the political class is under pressure to think anew. Already, in many of their minds, the NHS is dead. They won’t go on the record and say as much, but that is privately what they think.”

Anyway, you can download the text for free [PDF], so why not do so. As a leader of a party which consistently and honestly answers that, yes, we would abolish the NHS, I am going to have a squint at it over the next couple of weeks: I might get an idea or two...

It will, at least, be a stick to beat the politicians with; especially as the Tories had the temerity to send me an email not only encouraging me to "wish the NHS a happy 60^th birthday", but also to read their Health green paper.

David Cameron has launched a Green Paper which sets out how a Conservative Government will create a health service that is "truly the envy of the world."

Oh, great! Yet another bit of buggering about with the NHS, yet another reorganisation and yet another set of fucking targets.

When will these cunts learn that the biggest problem in the NHS is the fact that the government keep buggering about with it? It's like the NHS is a particularly itchy, pus-filled spot on the face of the body politic and they just can't resist scratching it. But they never make it better: it just discharges a whole load of putrid chyme, swells some more and hurts until it gets scratched again.

Tosspots, the lot of 'em...

Break out more party poppers for the Wonder of the WorldTM

Your humble Devil has expressed outrage and disgust at the NHS co-payments policy before, when examining the case of Colette Mills.

Now we can chalk up another victory for the bureaucrats of NHS, as they help to make another dying woman's last months as painful and distressing as possible.

A woman dying of cancer was denied free National Health Service treatment in her final months because she had paid privately for a drug to try to prolong her life.

Linda O’Boyle was told that as she had paid for private treatment she was banned from free NHS care.

She is believed to have been the first patient to die after fighting for the right to top up NHS treatment with a privately purchased cancer medicine that the health service refused to provide.

Oh, very well done, you bunch of fucking shits.

This weekend Brian, O’Boyle’s husband, said he was appalled by the way she was treated. He recalled his wife as a woman with an infectious laugh who had given a lifetime of service to the NHS as an assistant occupational therapist. The couple, who had three sons and four grandchildren, lived in Billericay, Essex.

After she developed bowel cancer and began having chemotherapy, doctors told her she should boost her chances of fighting the disease by adding another drug, cetuximab. It is not routinely funded by the NHS.

When she decided to use her savings to pay for it, Southend University Hospital NHS Foundation Trust withdrew her free treatment, including the chemotherapy drug she was receiving.

The trust said yesterday: “A patient can choose whether to continue with the treatment available under the NHS or opt to go privately for a different treatment regime. It is explained to the patient that they can either have their treatment under the NHS or privately, but not both in parallel.”

Why the fuck not? This woman has spent her entire working life paying National Insurance which, I might remind you, is supposed to pay for medical treatment (amongst other things). It isn't your money to withhold, you cunts; it is her money that the government was supposed to invest in an insurance fund.

Of course, the government has never, ever done that: as I have pointed out before, National Insurance is a scam, it is a Ponzi scheme.

As for Employer's National Insurance... well... LPUK health policy is still under review, although you can find our outlined aims here, but I, personally, would favour the abolition of NICs anyway. Any health payments certainly wouldn't be going to the state in any case; NI is just a Ponzi scheme (as is the public sector pension arrangement). Does this sound at all familiar?

Ponzi was bringing in cash at a fantastic rate, but the simplest financial analysis would have shown that the operation was running at a large loss. As long as money kept flowing in, existing investors could be paid with the new money, but colossal liabilities were accumulating.

As with NI, the money was not actually invested: it was simply used as income and the liabilities were paid out of that income. The Ponzi scheme was a massive fraud, and so is NI. As with tax—or, as I prefer to call it, extortion with menaces—if it wasn't the state doing it, the whole scheme would be illegal.

It is time to do away with this centralised healthcare and it is time to do away with National Insurance Contributions. Let people make their contributions to private healthcare schemes (you can regulate them, as per Switzerland. Seriously, if one single commenter whinges about the evil American insurance, I'll go fucking apeshit), and private unemployment insurance and private pension schemes.

At least they know that their money will actually be invested and that they will be able to access their funds and pay for the treatment that they fucking want. Even if her insurance company would not fund the drug that Linda O'Boyle wanted, at least they wouldn't make her pay for all of her treatment.

Seriously, I hope that the fucks who continue to take these decisions get really depressed and then go home and hang themselves.

But never mind: Labour's on the way out, eh? Surely the Tories will right this wrong?

David Cameron, the Conservative leader, said in a statement that it was “tempting” to allow patients to pay for extra cancer treatments that were not funded by the NHS.

The party has been reluctant to express an opinion on the issue, fearing that it could be portrayed as favouring middle-class patients who can afford to buy themselves extra treatment.

Oh. That'll be a "no", then.

Look, you fucks; you aren't creating a two-tier NHS or favouring the middle classes: you are simply allowing those who decide that they would like to have a chance at a few more months of life to top up the NHS treatment that they have already paid for throughout their working lives.

It isn't your money, you bastards: it is our money.

And because the National Insurance scheme is so obviously a scam, you have to force us to hand it over to you using state-sanctioned violence. And then you don't even have the decency to invest it as was promised: in fact, no government has ever invested it, as was promised. The National Insurance fund is a lie: it never existed.

National Insurance: the greatest Ponzi scheme ever and quite probably the most prolific scam ever perpetrated.

The bureaucrats of the NHS: amongst the most evil people on earth. May their wombs rot and their balls moulder within their disintegrating, disease-riddled bodies, the foetid ichor of their rapidly liquidising organs causing them exquisite agonies whilst the stench of decay warns all around them of their depravity as the decay of their bodies mirrors the pus-soaked interstitices of their moral-free minds.

Fuck them all. With a rusty nail-encrusted stick.

UPDATE: you really should go and read this post by Prodicus. Here is the preamble...

The following letter was leaked to our Fuck Me You're Joking Oh My God You're Not Are You correspondent.

Dear Customer,

It has come to my attention that you have broken our rules by purchasing medicine from a supplier who is not me. Your treatment is therefore cancelled with immediate effect.

What you should do now.

You should fuck off and die.

Thank you for using the National Health Service, and may I take this opportunity to wish you the best of luck with the rest of your... oh.

Yours sincerely,

Her Majesty's Secretary of State for Health

It just gets better...

UPDATE 2: Unity looks into the whole thing a little more carefully and specifically the efficacy of the drugs involved. His take is definitely worth reading, although it doesn't really alter my opinion on co-payments. As John Redwood points out, we all use co-payment all the time.

The government’s visceral hatred of co-payment for health is as absurd as it is dangerous. Practically everyone who uses the NHS practises co-payment. The very system Labour set up more than half a century ago soon required co-payment in the form of prescription charges. It always allowed private sector pharmacies to offer over the counter drugs to people for self treatment, or for treatment under the advice of the pharmacist.