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Universal healthcare vs the rights of doctors and nurses

So it wasn’t George Bernard Shaw after all.

It wasn’t him in the funny story about the dinner party, I mean, the one where a man teasingly asks the woman seated next to him, “Would you sleep with me for a million pounds?” Laughing, she answers, “You bet!” “All right,” he says, “How about for five pounds?” Now she is outraged and says sharply, “What do you take me for?” He replies, “We have already established that. All we are doing now is haggling over the price.”

*

“Bristol Southmead Hospital: Racist patients could have treatment withdrawn”, reports the BBC.

North Bristol Trust (NBT) launched its Red Card to Racism campaign after staff reported an increase of abuse from patients and visitors at the city’s Southmead Hospital.

The abusive behaviour covers racist or sexist language, gestures or behaviour.

Trust chief executive Andrea Young said they wanted staff to “challenge and report it”.

Under the scheme, any patient abusing staff would be challenged and warned, leading to a “sports-style disciplinary yellow card” followed by a final red card in which treatment would be “withdrawn as soon as is safe”.

and

Ms Young said: “We’re sending a strong signal that any racism or discrimination is completely unacceptable – we want staff to challenge and report it and we want everyone to know that it will have consequences.”

Although I am not an adherent of the worship of the National Health Service that has replaced Anglicanism as the British English state religion, I can understand what people like about the NHS. Its founding principles were that its services should be comprehensive, universal and free at the point of delivery. I think the experience of other countries shows that there are many other healthcare systems that would work better overall, but it is a genuine advantage to the UK system that when a British person falls ill they do not have to even think about where and how they will get treatment, or how they will pay for it. It’s universal.

Or it used to be. Bristol Southmead Hospital has changed all that.

I could go on about how easily this policy by North Bristol NHS Trust could be abused, could lead to tragedy. A story by Jack Montgomery at Breitbart UK did just that. But in a sense all that is just haggling over details: once it is established that the NHS is no longer universal, what is the point of it?

The National Health Service was meant to be like the justice system: no one can ever lose the protection of the laws, not proven criminals, not actual racists, and certainly not some shabby old man who has been waiting in Casualty for five hours and can’t stop himself blurting out some non-PC word because he is in pain.

On the other hand, in other contexts I have argued that state systems should drop their obsession with universality. When I was a teacher I saw how one feral child in a class in a state school could ruin the education of thirty other children. For a mess of perverse reasons the policy of putting them in “sin bins” was never applied wholeheartedly, and there are some children so monstrous that even the other denizens of the reformatory should be spared their company. Not to mention the teachers, many of whom quit the profession rather than having to face one more day trying to control these thugs. Whenever it was suggested that the state should simply cease the attempt to educate such children someone would wail, “We can’t just abandon them”. “We can and we should,” I would say. “If they make themselves so unpleasant that no one wants to teach them, no one should have to.”

So don’t those arguments also apply to NHS staff members and patients who find themselves cheek by jowl with some aggressive bigot spewing out obscenities? In this case I am not talking about people who are unjustly deemed to be racists or sexists (real though I think the threat of this happening is), I am talking about truly nasty people. I said one of the best aspects of state healthcare was that it is available to all. But my own words regarding state education, also meant to be available to all, come back to haunt me: if some people make themselves so unpleasant that no one wants to cure them, surely no one should have to.

What do you think?

36 comments to Universal healthcare vs the rights of doctors and nurses

  • pete

    TV and radio adverts tell us of the benefits of a job as a teacher.

    The existence of those adverts tell us that teaching is not a good job.

  • Paul Marks

    I wonder how they would define “any racism or discrimination”.

    Most likely normal behaviour up to a few years ago.

    Call someone “Taffy” and you are an anti Welsh “racist”, call a young women “girl” and you are a “sexist”.

    Clearly sick patients in great pain should concentrate on their language and behaviour – to make sure that nothing they say or do (including body language) in any way violates the rules of the Frankfurt School of Marxism “equality and diversity” agenda.

  • Julie near Chicago

    I see. So now all persons needing medical care are first to be examined for Wrongthink.

    And people think that we who fear “Death Panels” under an American nationalized rationed-care system are overwrought!

  • Okay, fine.

    So these excluded from the NHS for holding “inappropriate views” are going to get some portion of their tax and NI refunded from that point onward, since they are paying for a service which they cannot use.

    Thought not.

    Since the definition of what constitutes “racist or sexist language, gestures or behaviour” is subjective, this just enables arbitrary punishment of people whose views you don’t like (those who voted BRExit for example).

    Just another reason why the NHS should be scrapped and replaced with something like the Swiss medical insurance based model.

  • William H. Stoddard

    I think that if you are going to deliver state services of some kind, on one hand, it’s fair to deliver them to everybody. But on the other hand, some people’s presence at the delivery site can delay its functions, drive away or harm other recipients, or disrupt the site’s functioning. It seems a fair penalty to say that if you prevent other people from being educated, you forfeit your own right to education, for example.

    This is different in principle from “you can’t get health care because you called someone an [offensive epithet of your choice].” You can’t lose the service for being unpleasant to other people. Nor for have a disapproved lifestyle (no “fat and fags” exclusions). But you can lose it for actively hindering the service’s delivery or preventing others from receiving it.

    If we must have state provision, which I would prefer to avoid entirely.

  • You can’t lose the service for being unpleasant to other people. Nor for have a disapproved lifestyle (no “fat and fags” exclusions). But you can lose it for actively hindering the service’s delivery or preventing others from receiving it.

    The unstated problem here is people refusing to be treated by a doctor of…ethnic origin and coming up with such racist hatred as “I want to be treated by a British doctor“.

    After all, their taxes paid for the buggers to be trained in the first place (unlike the foreign imports)

  • Mr Ed

    So where is the judicial reivew quashing this adumbrated policy and replacing it with a mandatory injunction to provide treatment solely on the basis of need?

    If you were to seek one, I expect that you’d find many of Her Majesty’s judges would find find a way to enshrine this bureaucrat’s right to withdraw treatment in law, on the basis of wider policy issues,msuch as the EU’s ‘Equal Treatment Directive’, pun intended.

    The Labour politician Jess Phillips did a tv documentary with Mr Rees-Mogg, I somehow came across a clip, and she said that she was raised, ‘in no uncertain terms, to hate the Tories’. Her parents, I understand, are a teacher and an NHS manager. You can see where this will end, can’t you? More NHS slaughterhouses like Mid-Staffs, but with discernment,

    Anglicsnism is the English State religion.

  • Natalie Solent (Essex)

    Mr Ed, you are of course correct about Anglicanism being the English not the British state religion. How could I have forgotten when it was this exact point that caused the word “antidisestablishmentarianism” to be?

    I will correct it on the main post.

  • Rob

    And why would someone actually have to be racist to fall foul of this? A surly nurse who takes a dislike to you lies and says you made a racist remark – who has to prove it, them or you? Who do you think the NHS is going to believe?

  • Mr Black

    Sounds entirely reasonable to me. A patient should be able to request a doctor and nurses from their own race and not have treatment forced on them by someone they object to just because they are in urgent need and have no other immediate choices. If people don’t like Pakistani doctors and Sudanese nurses, if they wouldn’t voluntarily pay for them or be treated by them, freedom of association should apply here too.

  • Rob

    And the logical extension – objecting to men in a women’s surgical ward will result in you being labelled a “transphobe” and your treatment withdrawn.

    Sounds nuts, right? Well, people are already being arrested and questioned by Plod over expressed opinions such as this. So what’s the difference?

  • Mr Ecks

    Long past time the NHS–and all other Branches of state– were cleansed of Marxian scum.

  • staghounds

    John Galt, you’re right- the desire to punish and exclude “racists” never extends to refusing to take their money.

  • Nemesis

    Refusing to treat expanding categories of patients…..I suppose that’s one way of decreasing the workload and pressures on the NHS.

  • llamas

    So your ‘right’ to health care, free at the point of delivery, is now conditioned on whether the provider decides that your opinions, expressions and mode of life are acceptable to them.

    Today, it’s racism that ‘will not be tolerated’. What ‘ism’ will “not be tolerated” tomorrow?

    So now, of course, we may confidently expect to see Muslim patients being red-carded if they decline to be treated by a Jewish doctor, or Muslim male patients who decline to be treated by a female doctor (and vice-versa)? And so on?

    Thought not. As always with primarily-political and/or -religious institutions, I suspect that the list of punishable transgressions will actually be quite limited, and rather one-sided. Britons will now have to accept that they leave even-more of their civil rights at the door of the hospital if they want to get the health-care for which they have paid.

    Secondarily, as Rob points out, a policy like this will become a catch-all that the perpetually-aggrieved and the systemic shirker will exploit to their own ends.

    As a side note – the ex-copper in me just shakes his head in bemusement. Inner-city Bristol has some rather-serious issues with actual crime – you know, where actual people get their actual stuff stolen, or are actually the victims of actual violence? This appears to be an insoluble problem for the police – but they apparently have plenty of resources to spare to send two officers to the hospital because somebody called somebody else a bad word. Apparently, hurting somebody’s feelings is now a much-more-serious matter for law enforcement than hurting somebody’s body.

    llater,

    llamas

  • Alsadius

    It seems fine to me. They won’t kick out someone who’s in the middle of having a heart attack, but if you’re non-emergent and making everyone’s life miserable, you can get booted out. Actions have consequences. This is far better than alternative systems, where people try to set things up so that actions don’t have consequences.

  • bobby b

    If you have to ration something, you might as well just deny it to the people you dislike.

    What good is power otherwise?

  • Simon Jester

    They won’t kick out someone who’s in the middle of having a heart attack

    Says who?

  • llamas

    @ Alsadius, who wrote:

    ‘Actions have consequences. This is far better than alternative systems, where people try to set things up so that actions don’t have consequences.’

    All true, as far as it goes. But, as pointed out by myself and others, what will likely be the inevitable outcome is that only some actions will have consequences, and the decisions about which actions will have consequences will be come entirely-political. As we see here.

    Theodore Dalrymple (Anthony Daniels) has written extensively about the breakdown of social order in hospitals in the UK, where all kinds of thuggery and lawless behaviour has become tolerated and excused. And yet – the action that will have consequences is – badthink, and saying bad opinions.

    When actual, physical abuse and attacks on the staff – over 20,000 physical attacks on NHS staff per year, at last report – have been stamped out by the rigorous application of consequences to actions, then it will be time and enough to deal with the silly old man in A&E muttering silly words about the colour of the nurse’s skin.

    Incidentally, I’m not the sharpest knife in the drawer, but even I am smart enough not to insult the person who’s just about to stick a needle – or worse – into me, or who has the power to make my pain and suffering go away.

    llater,

    llamas

  • llamas

    Just as an aside – I had to go for my medical for my CDL, the other day. That’s a specialist job, your GP can’t do it. I showed up at the clinic and the PA who was scheduled to do the exam walks in – she’s a Muslim woman, wearing a hijab. Which is entirely unremarkable, in the town I was in. She looks at my name on the paperwork, and then she says ‘Do you prefer to be examined by another member of staff?’

    I was perplexed. Until I figured that she read my name, and thought ‘He might be Jewish . . . . .’

    Now – was she offering me a choice? Or was she trying to give herself a choice? Or what?

    You tell me. I have no way to know. I know that my PCP is a Somali woman, blacker than coal, and I could care less when she checks me for hernias and such. So a female PA in a hijab isn’t high on my list of existential worries.

    Now – in the moment – what should I have said, or done? You tell me.

    I can tell you what I did say, which was ‘You’re licensed to do DOT medicals, yes? Then, if you’re happy, I’m happy.’ And we got on with the business at hand.

    But you can see where a situation like that is fraught with the possibility for misunderstanding or miscommunication. I hope I did right. The difference is that she gave me a choice – rightly, wrongly, for whatever reason, I don’t know. Seems like, in the NHS, you’ll have no choice, and if you complain, you’ll have no healthcare, either.

    llater,

    llamas

  • GregWA

    From what I’ve read about the atrocities committed by NHS staff, “withdrawn as soon as is safe” should mean before the patient arrives! I might be off base here since I read sensationalized sources regularly, i.e., “the news”.

  • Michael Taylor

    This is not a reason to dismantle the NHS. It is, however, a powerful reason to sack the management of Bristol Southmead Hospital. That’s all.

  • Itellyounothing

    The reason to dismantle the NHS is so that a smaller body can go out of business when rules like this are inevitably inappropriately applied.

    Plus killing tens of thousands through hunger, thirst, backwardness and Doctors love of golf. And stealing body parts.

    Though I agree universality is still a very attractive quality from a patient perspective.

  • Fred Z

    Universal medical care is another interesting human-breeding experiment, allowing genetic losers to live sufficiently longer to breed more progeny than that tough bitch mother nature would have permitted.

    I can’t help but think that evolution cannot be stopped and the result will be rivers of blood in the future.

  • Nullius in Verba

    “I can’t help but think that evolution cannot be stopped”

    Don’t you think that evolving the ability to do medicine is an evolutionary success story?

    Intelligence, language, trade, tool use, culture: some of mother nature’s greatest inventions.

  • Fraser Orr

    @Fred Z
    I can’t help but think that evolution cannot be stopped and the result will be rivers of blood in the future.

    FWIW, Richard Dawkins, probably the foremost advocate of the theory of evolution in the past 30 years, has stated many times that evolution is a fact, but that doesn’t mean it is moral good. And that evolution, the survival of the fittest, would be a dreadful way to run a society.

  • Agammamon

    No one has to cure them. Those assigned to treat them can always quit. They’re not slaves.

    But you can’t, fairly, have a system that demands universal payment into – everyone has to contribute – and then turn around and say ‘no, you can’t get what you paid for’. You first start off with the massively unpleasant people that everyone agrees we’d be better off with. You end up with anyone slightly critical of whoever is in control of the state.

    So, either the NHS is universal – and the people applying to work their know its universal – or its broken up and you return to a wholly private provisioning system.

    As you’ve pointed out, other countries manage socialized healthcare without the monolithic bloc of an NHS equivalent. Turning what you’re paying into taxes for the NHS right now into premiums for a public, ‘last-resort payer’, insurance system and an interlocking collection of private healthcare providers means that everyone (no matter how awful their behavior) still gets the money for healthcare while individual providers would be free to take on or refuse clients as they see fit without the danger that this could be politicized to maintain and increase state control.

  • Plamus

    Scenario: black patient calls black doctor n-word. Racist, or empowering reappropriation?

  • Nullius in Verba

    “So don’t those arguments also apply to NHS staff members and patients who find themselves cheek by jowl with some aggressive bigot spewing out obscenities?”

    I suspect it’s not aggressive bigots that are the issue here. The implied subtext is that this is about patients and families getting annoyed and angry at staff, becaause they or their loved one has been waiting in pain for eight hours in a crowded waiting room for treatment, and have just been told that nobody is available because it’s a Friday and all the doctors are off playing golf, and they’ll have to come back again next week. It’s a fact of life that if you wait politely and quietly you’ll go to the back of the queue, while if you loudly make a bloody nuisance of yourself they’ll get you treated just get you out of their hair. That more people are haranguing the staff is more likely a sign of worsening service, not a worsening public.

  • Itellyounothing

    Yeah, I’ve got to agree wholeheartedly with Niv on this one.

    I also think given the unrecognized but v. High quotient of minority on minority racism, the NHS will get sued for racism for excluding too many BAME patients or families because the staff will want the actual problem cases removed, not just the unapproved of white majority…..

  • Fred Z

    Nullus: Sure, technology is almost certainly an evolutionary adaptation, as is tribalism. But time is long, our experience short and whether or not either is a successful evolutionary adaptation remains to be seen. As for tribalism, the partial abandonment of it made the USA hugely successful and its resurgence seems to be destroying it.

    Fraser Orr: I prefer Heinlein to Dawkins: “Morals — all correct moral laws — derive from the instinct to survive. Moral behavior is survival behavior above the individual level.”

    At best allowing the marching morons to breed, indeed, encouraging it with generous welfare, will rapidly differentiate the species.

  • llamas (November 8, 2019 at 12:24 pm) thanks for a very interesting comment that reveals an aspect of this I would likely not otherwise have thought of. As you say, how can one tell if the woman was indulging low-level anti-semitism of the “I’ll serve a Jew but I’d rather not” kind or was showing a distinctly considerate “A Jew might fear prejudice from someone looking like me – and instead of screaming islamophobia I will considerately show I understand why they might and will tolerate the possibility”. Alas, I doubt Bristol Temple Meads administrators will have the subtlety to handle such questions.

    Fraser Orr (November 8, 2019 at 6:43 pm) Dickie D makes a big thing of evolution when it serves his agenda and (as you note) tells people not to regard it when it does not. He also complains that the media pay selective attention to his public statements. 🙂

    Nullius in Verba (November 8, 2019 at 9:56 pm), your point that this may reflect people complaining about poor service probably has content. That said, I’ve been in a Glasgow A&E on a weekend. As it chanced, in my most recent memory the most noticeable drunk, shouting but happily in no state to assault staff, or even stand up, was of non-caucasian ethnic origin. But I feel sure they get drunks of the traditional kind, as incapable of doing anything but speak (or rather yell) as the others, who doubtless sometimes add traditional insults to woke ones in the occasional cacophony.

    Lastly, I remark that the NHS has employed large numbers of non-white people (both Brits and visitors learning medicine) for a very long time. If Bristol temple Meads is demanding such a policy now, whatever changed (if anything other than the wokeness of administrators did) cannot be that some patients are only now having routine experience of staff not the same ethnicity as themselves.

  • Trofim

    I worked 30+ years as a psychiatric nurse. In my final years I worked in a 24/7 crisis team in Birmingham. At the outset the manager said we would be adopting a policy of “cultural sensitivity”, which meant, in essence, that a patient should as far as possible be allocated a staff member of a similar cultural background, speaking same language, and could request such a clinician if they wished. We all knew, of course, but would not have dared to say it, that this policy was intended for BAME patients, and no white British person could given the same privilege because it would be racism. Even the non-white members of the team seemed uneasy about it. In fact I don’t remember it ever being invoked formally – pure common sense dictated that sometimes such and such a member of staff, or interpreter, would be helpful.

  • Peter Melia

    What is “BAME”?

  • What is “BAME”?

    Black, Asian (Indian subcontinent really), Minority and Ethnic.

    Basically enables SJW virtue signalling.

  • TDK

    What do we do with patients suffering from Tourette’s syndrome?

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