Ministry of Missing the Point?

Buses? What all that about then?

I've already blogged about the 'cancer co-payment' scandal. Jayann's objected in the comment's section that this terrible policy is no different than paying for a knee op. But it is different, because if you chose not to have a private knee op, you will still get an NHS one eventually. Furthermore, Dr Rant recently paid for an MRI scan of his knee during his NHS treatment so he could get back to his patients faster. No one suggested that I would have to then have a private op because I'd had a private MRI scan, and neither should they have. So the idea that you can draw a parallel is total bollocks.

No, I agree with DK in one of his best medical posts ever when he says:

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.

However, Crippen then pointed us in the direction of this post by the excellent Ministry of Truth. MoT spends a very long post suggesting first that the main story should not be people who want to co-pay being denied treatment, but the peddlers who sell the stuff.

Now, no fan of quacks and peddlers of false hopes is Dr Rant. However, that was not the main point of this story at all. And compared with the magnet-sellers, I'd take my chances that £17k on a drug that has a reasonable chance of buying me an extra 150 days of life. That's not snake oil. Snake oil is when you pay £17k for a drug that has no chance of helping you at all. There was some hint that the treatment being 'denied' was in fact combination treatment that would not have been given without the private drug, but this was unclear, only mentioned in passing. I would have liked to have heard more about that.

There is more, but not about the bit I thought was interesting. Instead MoT went on to have a go at Doctors For Reform. I was around when DfR were formed. I wasn't actually involved in setting it up, and I don't know the people involved in setting it up personally, but I remember their early flyers.

The fact that the people setting this up are largely entrepreneurs who have private as well as NHS business interests is hardly sinister. It is to be expected. Who else has the time and money to do this kind of good work? It is hardly sinister that they come from a range of politically active backgrounds either (unless you think that not having a New Labour parliamentary candidate in your group makes you automatically suspect).

MoT also mis-represents DfR's stance on the NHS. It is hardly a surprise that Doctors for Reform are a group of doctors who want the NHS to be reformed. You hardly need to by V for Vendetta with a google-map to work that out from their title. However, the reform they are aiming for is a European-style mandatory insurance system, not a US-style insurance system that MoT suggests they are looking for. I know, because they told me. To link DfR to US health insurance is a strawman fallacy. MoT should have dug deeper and looked at the DfR website:

What is social insurance?

Social insurance is the type of health system used in countries such as France, Germany and Switzerland. The systems differ but all have the same key characteristics. All citizens receive health insurance in return for contributions usually made from salaries or, in the case of the worst off (in some countries) from taxation. Insurance cover is guaranteed and everyone pays a fair price. Standards of healthcare in these countries are higher than in Britain.

“Social health insurance systems tend to be associated with high levels of satisfaction in the population. The sources of this satisfaction are interesting, including a combination of solidarity and transparency. To some extent, social health insurance may make every patient a private patient” (Funding health care: options for Europe, LSE authors, European Observatory on Healthcare Systems, Open University Press).

Personally, I think the NHS does not need that kind of reform. It simply needs to be cut free from the management and DoH dross that paralyses and corrupts it, but I can see where DfR are coming from. The Swiss system in particular has a lot to recommend it (and is not bankrupt and paralyzed by repeated strikes the way the French, and to a lesser extent, the German systems are). [At least two members of the Dr Rant team have given donations to DfR because they believe that such a social insurance system is the best way forward - Ed.]

Perhaps I am wrong, but I think MoT has well and truly missed the point. Now, Dr Rant gets things wrong from time to time, exaggerates, swears a lot. But when you call yourself 'Dr Rant', you kind of imply that is what you are going to get. When you call yourself 'Ministry of Truth' you don't give yourself much leeway. You need to get it right.

I'm disappointed.