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Another proud moment for socialised medicine

It seems there is a shortage of certain drugs in Britain’s National Health Service.

Joe Fortescue from Alfreton, Derbyshire wants the government to provide more diamorphine, which has been in short supply since 2004. He said his 49-year-old ex-wife from Nottingham was screaming in pain in the days before her death because it was not available.

Horrendous. We are not talking about sophisticated and costly cutting edge drugs here, just a strong painkiller. As someone personally currently gobbling none-too-effective codeine painkillers every four hours after a close encounter with the NHS yesterday, dare I say I ‘feel the pain’ of those relying on the NHS in their time of need.

Perhaps the ex-husband of the hapless woman who died in agony for want of the correct drugs should have just scored some himself, available to anyone driving slowly with their windows open in the crappier parts of most large British towns and cities. Diamorphine is essentially just heroin after all and needless to say the ‘free market’ in heroin has no difficulty supplying public demand. Only the state could be inept enough to be unable to find heroin for a dying woman.

Truly the state is not your friend.

36 comments to Another proud moment for socialised medicine

  • Fraser

    Meanwhile we’re spending cash trying to convince Afghan farmers to stop growing opium.

    Gotta love joined-up government.

  • Yes Fraser, I was thinking the same thing. Pretty bizarre really when you think about it.

  • RAB

    Me too folks. In fact I heard a bloke on radio 5 just the other day the very thing about a shortage of painkillers.
    There was supposed to be an international agreement to buy up the crop, but as usual….

  • permanent expat

    As I so often say here: What’s new!
    Just yet another cause for shame….as if The Septic Isle isn’t already submerged in it.
    I’ve commented, at length & with fury in other strings, on the plight of Afghan opium farmers & our incredibly stupid attitude in that time-warped graveyard of empire-builders…….no NHS diamorphine? What a miserable, callow, unfeeling bunch of wankers…..my heartfelt anger & sympathy with Mr. Fortesque.
    So what’s new?
    Helmand Province: If you want the epitome of mendacity: “The commanders on the spot are getting everything they have asked for.” You don’t have to be a rocket-scientist to know that that’s utter crap.
    So what’s new?
    The Natwest Three: They may well be bad boys but are nevertheless innocent unless proved otherwise but we are prepared to deliver them to a ‘foreign power’ under a law designed to combat terrorism……on grounds of suspicion. We used to have our own justice here until fairly recently.
    It all gives me such a sense of pride.
    So what’s new?
    Answer: Nothing! It’s business as usual in the Untied Kingdom.

  • Diamorphine is heroin. They are the same drug, period. The people in the story just keep saying “diamorphine” because they want to avoid the emotional consequences of saying “heroin”.

    This “shortage” is more likely to be political than practical, I fear. The people who fight and administer the “war on drugs” do not like it when drugs that have been outlawed and demonised are able to be used for legitimate medical purposes as well, either because they think it blurs the distinction between “drugs of addiction” (bad) and drugs of medical use (good), or because they think that drugs provided for medical purposes will end up in the hands of addicts (they probably will, but this is surely a small price for being able to avert genuine suffering). Hence such things as the endless arguments and posturing about the medical use of cannabis in the US (a much milder drug than heroin/diamorphine).

    Britain is quite unusual in allowing heroin for medical purposes at all. Most countries do not, and those that do are constantly bullied by the Americans (from who most of the drug war idiocy ultimately comes) to stop it. There is therefore no (legal) international market for the drug, and countries that increase or start domestic production are likely to suffer from various kinds of international sanction, which may be what is happening here.

    Basically, though, this is one of the most outrageous consequences of the war on drugs. People suffer from extreme pain. Drugs do exist that can make the pain go away. Patients are not allowed to use them. It is utterly obscene.

  • I am in full agreement with you Perry. When I had a nasty ear infection, I was in absolute agony. Getting effective painkillers from my GP was like getting blood from a stone. Obviously this pales in comparison the Fortescue’s dreadul story. Of course, it’s not just the NHS that it the problem: It is also the sawbones’ state-recognised guild. I should legally be able to consult whoever I want about my ailments, or no one at all, and then buy whatever drug I want from whoever I want. Fuck prescriptions.

  • The war on drugs and government interference also puts pressure on physicians to underprescribe necessary pain meds, even when abundantly available on the market.

    Since moving to coal country, I have learned to see the connection between flipping the light switch on and a miner’s back breaking down. Our lifestyle depends on the health breakdown of otherwise very strong men.

    Because coal mining is the overwhelmingly dominant industry in this area, there is a statistically much higher need for and use of pain meds. However, high rates of painkiller prescription sends up a red flag to the government and gets physicians unwanted attention…sometimes being suspected of being a scrip factory catering to addicts. Even physicians whose specialty is PAIN management!

    The government is stupid. Their meddling is leaving people in pain. It’s cruel.

  • Noel Cooper

    This “shortage” is more likely to be political than practical

    Absolutely, one of the tragedies of this particular case is that making heroin from morphine (readily available) is a doddle, within the capabilities of any undergraduate chemist. The manufacturing supply problem is entirely due to state regulation.

    As an aside Perry, if your codeine is not working too well, bear in mind you may be a slow metabolizer

  • John K

    A truly disgusting story.

    I have a feeling that the baleful influence of Dr Shipman may also be at work here. Since he murdered over 300 patients by injecting them with diamorphine (which as has been pointed out is just pharmaceutically pure skag) doctors have been rather circumspect in their use of the drug. No-one wants to be red flagged by the health nomenklatura for investigation as a possible Shipman wannabe. Of course, this may mean a few unfortunates die in agony, but shit happens. Remember people, the NHS is the envy of the world. They envy it so much that not one other nation has ever tried to reproduce it. The NHS, so good they tried it once.

  • Alex

    There is infact a world wide shortage, about two thirds below what is required!

  • john turnbull

    not an isolated incident, alas. i’ve just returned to the us following my father’s death from stomach-cancer last sunday – not quite as bad a story as joe fortescue’s because we were able – just – to get the diamorphine we needed for him, but it was very close-run, out of 10 or 12 pharmacies in the area only 2 had it and, at that, his prescription took all they had, so someone else was probably unlucky. the nurses did talk about the problem of fallout from the shipman affair, making it clear it’s more of a “cya” problem than anything else.

  • John Ellis

    Perry,

    Do I understand your “close encounter” with the NHS to mean you actually allowed yourself to be treated by that organisation?

    Not very ideologically pure of you, was it? Can’t complain about all those taxes you pay now, though…

    😉

  • If the state gave me the option of opting out so I could take that money they extort from me and acquire private insurance instead, then you would be right. But that is not the case. You have a lot of nerve telling me that although I am compelled to pay for it regardless, I cannot then try to recover some value from my stolen money. In short, fuck you.

  • Richard Easbey

    Perry:

    John Ellis will never understand the idea of “opting out” of the NHS. Freedom is an utterly foreign concept to worshippers of the state.

  • Sue Wingrove

    I can’t comment on Joe Fortescue’s case since I don’t know the details. but I can say I have been proud to rely on the NHS in my hour of need which has involved several trips to hospital in the last few months – and I have heen hugely impressed with the treatment and professional care that I have received. And my GP advised me correctly that I could not get better care privately even if I cared to go for it.
    I am also proud to say that as I am about the only person I know who doesn’t practise tax avoidance, I can hold my head up high and know that I contributed to the care that I received. Sadly, all the people I know who avoid taxation are always the first to moan when a ‘free public service’ does not come up to their expectations (this is not a reference to Mr Fortescue, I hasten to add) yet do they not stop to think what a great NHS we would have if they too paid their taxes? They will be happy enough to get in an NHS ambulance if they have an accident, I expect.

  • John Ellis

    Perry,

    Whoops, touched a nerve there, perhaps? The urbane mask slips…

    Of course you can use the NHS, just don’t then whinge about paying the taxes. (I mean as a matter of principle – EVERYONE whinges about taxes in some way…) And maybe you would acknowledge that for some things, a National Provider makes sense. There is room for a hundred BUPA-type organisations, but if they all ran their own ambulance services, it would be rather like the days of the Victorian Fire Brigades.

    Concerning the “fuck you”…rather unworthy of you. Or is civilised debate (or even teasing) only OK if everyone agrees with you?

    Richard…what are you talking about? I tease Perry for using the NHS (which he hates as a matter of principle) and suddenly I am a state-worshipper? Bit of a logical leap there, old son.

  • I’m very happy for you Sue, but please answer the moral case (or even the utilitarian case) for compelling people to pay for the NHS if they do NOT want to contribute but would rather make their own arrangements. Also you act as if if the state does not provide these things, they will be be provided at all. Unlike a military, which cannot be provided for privately, medical care certainly can.

    I was in a car smash during a visit to the USA and the ambulance which picked my wife and I up was not provided by any NHS and it was all covered by travel insurance.

  • I have no real complaint about the medical professionals who work for the NHS, as the care I have personally received has generally been adequate. My complaint is with the system within which these people operate and the contraints it perforce places on the people who have to use it.

  • Paul Marks

    I note that John Ellis has not replied to the point made to him – namely why is it not consistant to complain about the goverment stealing money (the N.H.S. is not funded by “contributions” that is what free beds were funded by before the N.H.S. was created, when the government stole a vast network of hospitals many of which it has since shut down – especially the small community based hospitals) and then use the government service.

    For example, someone who studied the government’s intereventions in transport over the last century or so might well come to conclusion that Britain would have been better off if the railways had not been regulated into the ground (the regulations go back to the 19th century, but only really got out of control with the Liberal party government of 1906) and if the government had not built a vast network of “free” roads.

    Does this mean that people should not use the roads that they have been forced to pay for?

    What John Ellis wrote made no sense.

    As for “teasing” it is a standard sign of a coward that they try and escape blame for making false statements by saying “it was just humour”.

    Also decent people do not mock others when they are in pain (as Perry said he was).

    But then Mr Ellis clearly does not know much about decency.

    Overall “fuck you” was the correct response.

  • permanent expat

    Ooops!…………..some nasty wounding in the playground. Hope Matron is standing by!
    Ooops!………..not only standing by but herself flailing about a tad.

  • I must confess that the whole painkillers thing is making me a tad irritable.

  • permanent expat

    Now look what you’ve all done!

  • Johnathan

    The illogicality of the drugs laws in this country get worse. I second what Michael Jennings said.

    John Ellis: Perry or anyone else here had the option of opting out of the NHS by getting tax relief on private health care, no doubt he and many others would take advantage of it.

  • permanent expat

    Johnathan: So get them changed, FFS.

  • Of course you can use the NHS, just don’t then whinge about paying the taxes.

    Please actually think. You have that 180 degrees wrong. I am FORCED TO PAY MONEY FOR THE NHS AGAINST MY WILL and not using the NHS will not get me a refund of the money taken from me against my will. I can make alternative arrangement if I can instead spend that money as I want, rather than the state wants, and provide for my own medical care, but I cannot do that because I cannot afford to both pay the NHS and purchase private insurance.
    As a commenter wrote earlier, there are things that can only be provided collectively, such as defence, but clearly that is not the case with medical services.

    Concerning the “fuck you”…rather unworthy of you. Or is civilised debate (or even teasing) only OK if everyone agrees with you?

    Because I find it insulting that you think I can be coerced by the state but I cannot complain about that because I dare to try and recover some of that money by taking some of the services that I am FORCED to pay for against my will. I do not find that funny at all.

  • BladeDoc

    I’m not sure why the availability of diamorphine is a big deal. Morphine, hydromorphone, oxycontin, fentanyl, su-fentanyl, and al-fentanyl are all commercially available and equi-analgesic if you use the right (i.e. big enough) dose. Although I’ve never heard of a pain-killer shortage in this country (US), if my pharmacist told me they were out of one of them I’d just switch the patient to another. Is that not possible in the UK?

  • John Ellis

    Playing with you guys is getting increasingly less fun.

    Perry,

    We have had this “debate” many times. My position is, if you don’t like the NHS in principle, fine. You don’t need to use it. If you want to be less finely principled, in order to “get some use out of the money extorted from you by the state” and eke out your Trust Fund a bit, fine too, but whinging about the quality of care you then receive seems a tad churlish. You, unlike many others, can afford better (IF private IS better, always – as we know, in the UK it often is not, clinically speaking).

    When you extend the argument to imply that private industry can solve all healthcare provision ills, I disagree with you, but neither I (nor, I suspect, most of you) are experts. so we can only generalise from first principles. The underlying first principle for me is that some form of limited re-distributive taxation is a social good. Most of the people here don’t. OK.

    I am no Statist or knee-jerk NHS groupie, though. Of the last three times I have been in hospital (over the last 10 years), I have gone private each time. The first was a freebie from my employer. The next two times were my choice, and directly my funds.

    I don’t begrudge others access to an NHS partly paid for by my taxes, though. Sometimes it seems to me, the richer people are, the more selfish they become. (Or maybe, it’s the other way around).

    But when I get anglosaxon abuse for a gentle dig at what might seem to some as “sleeping with the enemy”, I would rather go play elsewhere.

    So I will. I hope the painkillers prove increasingly inadequate. Churl.

  • And I note you do not actually answer the points I made. Moreover you know nothing about the state of my finances so just to repeat myself… fuck off.

  • Charles Pooter is bang on.

    Privatising medicine is fine, if you have a reasonably low barrier to entry into the market. Without it, you don’t have a good market delivering value.

    Look what happened when the optician market was opened (opticians have to do some regulation, but it’s not too onerous). More players came in, Prices came down, service went up, more technology came into play.

    The medical market will not be a real market unless it can effectively grow, and with 7+ years to qualify, it keeps lots of people out.

    Doctors are mechanics for the body. And most aren’t at a level of being the sort of mechanics that work at Williams F1. They’re more like the people at your local garage. Anything gets a bit difficult, and you’re off to a specialist.

    But car mechanics don’t earn 6 figure salaries, because there’s no barrier to entry. You set up a garage, and if you’re good, people will come back. If there’s a shortage, people will move into the profession.

    My own treatment with an ear problem that lasted 9 months was appalling. The doctors had less “customer care” than I’d expect from Tesco, and the ENT (that I was referred to and paid for) misdiagnosed the root of the ear problem. Thankfully, a non-medical union massage therapist worked it out in a scientific manner, and helped to resolve the problem swiftly.

  • Nick Deer

    Yes you “churl”, how dare you object to having your pockets emptied by other people!

    How so many Brits delude themselves they have a proper healthcare system is a wonder.

  • John,

    Government doesn’t run supermarkets just because some people are incapable of working and need help. Instead, it gives people money and they go and buy food from one of a number of supermarkets.

    This is a more efficient model, and one that has seen greater choice, lower prices and better customer service. Supermarkets are constantly looking for how to satisfy their customers.

    Unlike the NHS. They have your money. So, if you don’t like it, you can pay to go private. Except for many people they can’t, because the NHS has starved them of money that they might have been able to use to go private.

    And because it has customers for no reason than monopoly, and not because they’ve earnt you as a customer, they have no incentive to improve.

    Also, the lack of a free choice prevents people from making comparisons of services between multiple providers. So people assume that the NHS is great, because they are told so lots of times, with no idea of how much better it could be. People had no idea how cheap flights could really be done until the EU broke the cosy cartel on flights by national carriers, and new entrants came along and showed just how much cheaper they could be.

    It’s not about helping the rich. The rich can afford private health, or to travel abroad. It’s about providing more to consumers. That’s what markets do. The only people who suffer from markets are the established monopoly producers who have a cosy existence. For they will have to start working harder to keep themselves in a job.

  • Johnathan Pearce

    I think it is time that John Ellis joined the lists of those who take their comments somewhere else. Telling someone that he hopes the impact of painkillers wears off is beyond the pale.

    Your argument is totally the wrong way round. As Perry said and as you refuse to acknowledge, he, like the rest of us, is forced to pay for the NHS, so he might as well take advantage of its services. For what it is worth, I would do the same, although I might supplement my care with some additional private care on top, as I have done in the past when I needed urgent care.

    Surprising, isn’t it, how venomous and emotional champions of socialised medicine get when their holy cow, the NHS, is even criticised in the most indirect way? We are not dealing with rational thought here, but a religion, a fact that former Chancellor Nigel Lawson noted many years ago.

  • Tim Almond,

    Thanks for the adding to my comment. Yes, the problem of the medical monopoly predates the NHS.

    The Doctors have organised themselves into a state-recognised guild that artificially restricts supply of medical services and therefore raises prices. They have also constantly lobbied, successfully, to regulate and criminalize alternative providers. The drug companies are also guily parties in this unholy nexus (e.g. their recent attempts to regulate the vitamin market, via the EU — just the latest example).

    In the late 19th Century, the friendly societies managed to lower prices by buying medical services for their members as consortiums (i.e. they balanced out the collective power of the medical union). I believe it was Lloyd George who first fucked-up this postive development with state interference. Ever since then, I would argue, that Doctors and drug companies have both been the amongst the most successful politcial interest groups of the 20th Century. In a sense the NHS can be seen as a Socialist attempt to balance the power of the Doctors, but the NHS is state-controlled and open to lobbying power, so the attempt has been a total failure.

  • speedwell

    Just one more reason why I’m not taking a job transfer to the UK to work at a job I want very much with a boss I think the world of. It’s just not worth it to have to live over there.

  • Paul Marks

    Mr Ellis says “if you do not approve of the N.H.S. you are not forced to use it”.

    Others say “but we are forced to pay for it”.

    And Mr Ellis says “if you do not approve of the N.H.S you are not forced to use it”.

    He is just repeating himself – using words that are not relevant to the replies made.

    Mr Ellis admits that he has had this “debate” before – where he just keeps repeating something that has no connection to the replies he is getting.

    Either Mr Ellis is not reading the replies he is getting, or he does not understand them.

    Or he is a troll.

  • Paul,

    Ellis is so much of a troll, he probably has his own bridge…