We are developing the social individualist meta-context for the future. From the very serious to the extremely frivolous... lets see what is on the mind of the Samizdata people.

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Samizdata quote of the day – murderous nurse edition

“What strikes you when reading about any number of NHS scandals since then isn’t so much the systemic failures, it’s the instances of individual cruelty to patients. Bereaved parents repeatedly told the Ockenden report about a lack of compassion from staff and some even said they were told they were responsible for their own child’s death. All of this amounts to a sense that the health services continually privileges the institution over the needs of patients at the most vulnerable times of their lives. When you consider how utterly inhumane that is, it becomes easier to understand how the NHS could contain a monster like Letby.” (See here for details on the Ockenden saga.)

– Alys Denby, Editor, CapX, in a weekly letter to subscribers of that platform. Denby writes about Lucy Letby, a nurse convicted last week of murdering a number of babies in a NHS hospital.

Monsters can flourish in certain institutions, and it strikes me that those that are treated as near-sacred institutions provide cover for them. The NHS needs to be nuked from high orbit for various reasons, and these scandals surely add to the list.

29 comments to Samizdata quote of the day – murderous nurse edition

  • djm




    Less than 3 years ago, the instruction from on high was to “clap & bang those pots 4 R NHS”

    So what you’re saying is

    we haven’t always been at war with Oceania ?

  • bobby b

    U.S. healthcare is expensive partly because of the culture of overkill for safety’s sake (which, yes, means safety from lawsuits.) Three tests where one might do, three opinions where one might do, three days in hospital where one outpatient visit might do. (Those “mights” do a lot of heavy lifting.)

    Your system is far cheaper. But there are always tradeoffs.

  • Steven R

    Doctors and nurses who kill are found in private hospitals, VA hospitals, public hospitals, university hospitals, nursing homes, and in-home nursing. It’s been going on since we’ve had doctors and nurses. It isn’t because of socialized medicine; it’s because people like her are simply broken. Unless the author of this article can find a NHS policy that states “…and our nurses can simply decide who lives and who dies on their own…” he’s off the mark on this one.

  • Fraser Orr

    My experience of the NHS is that the patients are considered rather an inconvenience. Like many large government institutions it is run for the benefit of the institution instead of the “customers”. Schools, for example, are like that too. Which isn’t to say that there aren’t great doctors, nurses or teachers, just that the culture of the place, the incentives, the manner of thinking is that patients are an inconvenience and a cost rather than the whole point of its existence. There is a great Yes Minister episode about this called “The Compassionate Society“.

    In fairness it has to be said that when a child dies in an American hospital the doctors and nurses are really very compassionate. They also hand you a bill for quarter of a million dollars. So it cuts both ways. (The American healthcare system is a perfect combination — it takes the worst aspects of a central government system and the worst aspects of a corporatist run healthcare system and combines them together to give us the worst of both worlds. Of course there is lots of money swilling about, so they do have to spend it on something — which is why most new medical discoveries and devices originate in the US, and why our medical billing subsidizes the billing of all the other healthcare systems the world over.)

  • Fred Z

    @Steven R: We do numbers here, we are not socialist innumerates.

    How many doctors and nurses who kill are found in private hospitals, vs. VA hospitals, vs. public hospitals, vs. university hospitals, vs. nursing homes, vs. in-home nursing?

    Knowing what I know about the civil servants who staff public hospitals here in Alberta Canada I’m going with public hospitals as the big winners in the murder league.

    Anyone got any actual stats?

  • Steven R

    Just a few years back there was a nurse who killed at least seven patients with insulin at the VA Hospital in Clarksburg, WV. That’s local to me and right off the top of my head.

    I used to have a job that had me sit in on some of the QA and Mortality and Morbidity meetings at a major university hospital. They took patient deaths very seriously.

    I did find three interesting pages:

    Then we have the doctors who kill their patients:

    I think gross statistics would be difficult to find since deaths are expected in hospitals and nursing homes, especially with the elderly involved, and many nurses and aides change jobs frequently, and hospitals and governments seem to be particularly close-lipped about the whole thing.

  • Johnathan Pearce

    Steven R, as you know, 90 per cent of healthcare in the UK is delivered via the National Health Service, and run, with some adjustments, on the same central planning model that it had in the late 1940s when it was created by a socialist government. Despite all the failings and problems of recent years, the NHS still seems to garner respectful comments from most of the UK public.

    The NHS has become ever more bureaucratic, and filled with the same arse-covering types that flourish in many large organisations if freed from the need to deliver great service or go out of business.

    Large (private) groups do at least have some form of competition. Take the cases of Anheuser-Busch, Gillette, Silicon Valley Bank, and others, where for various reasons, either because of contemporary political and social obsessions, or just plain incompetence, the firms have suffered massive falls in share values or be taken over in a shotgun wedding (as in the case of SVB).

    Senior people in failed organisations that have to make a profit or die typically are fired. With the NHS, whole layers of management appear to have presided over a series of murders and I haven’t as yet read of any of those in charge being shown the door. (Of course, that may happen, if Members of Parliament and others raise a sufficiently potent stink.) It is also typically easier in the UK to sue a private firm than a public sector body, although this is not a binary matter.

    In the UK, if you want healthcare, the choices unless you are quite well off are limited outside the NHS. For many procedures, the NHS dominates, and that includes care of very young children. Monopolies of any kind are bad. The NHS is a monopoly, benefiting – hopefully not much longer – from a protective cloak of moral cant.

  • NickM

    Saying anything bad about the NHS in the UK is akin to apostasy in the Islamic Republic of Iran. Oh, you won’t get killed but you will be seen as evil.

    When an institution becomes almost the soul of the nation then it becomes immune from any criticism – any criticism, even constructive, then this sort of thing happens. Compare with the Catholic Church in Ireland or the BBC with Jimmy Saville…

  • Peter MacFarlane

    “Like many large government institutions it is run for the benefit of the institution instead of the “customers”.”

    Remember the hackneyed old internet adage: “If you’re not paying, you’re not the customer”.

    In the British NHS, the customer is not the patient, it’s the government bureaucrats who administer the system.

    I find this explains quite a lot.

  • Michael Taylor

    People employed in badly-managed service-oriented companies come to resent and even hate their clients/customers, particularly if demanding, since they interrupt their other tasks (loafing, gossiping, complaining).

  • Jacob

    U.S. healthcare is expensive partly because…
    US healthcare is expensive because people are rich and wish to spend a lot of their money on health (whether it helps or not).
    Us health care providers are rich too.

  • Paul Marks.

    There has been terrible behaviour, the murder of these poor babies is just awful. It reminds me of the “lockdown” period where cancer screening was cancelled because it was “non urgent” (many people are now dying of cancer, because their cancer was not caught early on) but abortions were considered “urgent medical care” and carried on.

    As for systems – Covid sadly showed that the Corporate State medicine system of the United States has its own terrible problems, and not just its vast cost. Most doctors did not follow Early Treatment (which could have saved so many lives) because the bureaucracy and the corporate bodies (which are joined at the hip) actively discouraged it – instead people were often left till they were very ill and then put on “vents” (which were often misused), like Britain the United States had a very high Covid death rate (much higher than most, although not all, “less advanced” countries) – then there was the pushing of the toxic injections which was actually more extreme in the United States than in the United Kingdom.

    We must not make the mistake of thinking that the Corporate State medical system in the United States has anything to do with a free market.

  • John

    Here in the UK close association with the severest of scandals, such when 81 requests for a public enquiry into the high rates of deaths and unacceptable care standards at a hospital within the Mid Staffordshire NHS Foundation Trust were (allegedly) rejected by two successive Health Secretaries, is no barrier to an ongoing successful political career.

  • Paul Marks.

    John (and indeed everyone) – the relationship between a healer and their patient should be sacred, neither the government or corporate bodies should get in the way.

    This means that neither the British or American system is good, although not as bad as Canada where a patient paying a doctor directly is, I am told, actually illegal – and the government and corporate media seem to spend a lot of time encouraging people to die. First it was people who were terminally ill, then people who were chronically ill (that is not the same thing at all as terminal illness – I am chronically ill), now there is a lot of talk of encouraging people to die if their lives fall below a certain standard, essentially death-for-being-poor.

    There is something deeply wrong in Canada – even by our standards.

  • tfourier

    Having dealt with both the NHS and the US medical system I’ll take the US system for all its faults any day.

    In the NHS like all socialized medical systems you the patient are just a cost. In the US system you the patent are a source of revenue. So if the NHS kills you especially if you an old person who uses 5x/10x the medical resources of a younger person that’s a net gain for the NHS. In the US system if you die they have just lost a very lucrative customer.

    So guess which system goes to great lengths to make sure you live?

    Every horror story I’ve heard about the US involves some obscene medical bills. Which is cleared up sooner or later.

    Every horror story I’ve heard about the NHS involves someone dying.

    The same goes for other socialized systems. The socialized Italian medical system killed my 3 year nephew. He would be still alive today if he had been treated in a country with a mixed heath insurance financed system. Like France or Germany for example.

    One of the simplest stupidity tests in the UK is someone talking about the “free” NHS. As if the 150 billion quid p.a that it costs is magically conjured out of thin air. Its not free. Its actually very expensive. But the NHS as an organization is cheap and nasty and provides mostly very shoddy healthcare. Which is why I believe the majority of doctors have BUPA.

  • Martin

    Every horror story I’ve heard about the US involves some obscene medical bills. Which is cleared up sooner or later

    Not quite. The American healthcare industry’s role in exacerbating the opiod crisis is awful.

  • bobby b

    Re: the horrible horrible US healthcare system:

    I’m in my mid-60’s. I know a lot of people. Some are rich. Some are poor. Most are in-between.

    I have never known anyone who has died (or even become more sick) because they couldn’t afford health care. Between insurance, government programs, laws that mandate treatment when needed, and lots and lots of docs, everyone gets treated.

    I have never known anyone who has been financially ruined because of healthcare expense. First, most people have some form of coverage, whether it be paid insurance, government programs, etc. Second, most debts arising from healthcare are NOT in the mutiple-hundreds-of-thousands of dollars. Third, there’s really no point in hospitals legally pursuing debtors, taking homes and incomes – you don’t work lawsuits against broke people. There’s no point.

    I have never heard of anyone waiting months for treatments, tests, consults, or help. I can get a doc appointment tomorrow if I feel the need for one. I can get that primary-care doc to send me on to a specialist within a week or so.

    This all has the feel of the old Russian story where they’d take pictures in the poorest of the poor sections of New York City and then claim to their own people that “this is what America is like.” There are always going to a few bad stories in a system that encompasses 340,000,000 people. But I cannot fathom how educated people could compare what we have in the US healthcare system with socialized medicine where you wait and wait and wait, and then are only allowed cheap solutions.

    Go to any near-border-town in our North, and count the number of Canadian license plates in the med centers’ parking lots. They’re not driving down here for the cute nurses.

  • tfourier

    @bobby b

    Completely correct.

    I have dealt with the US system for decades in all its forms, serious illness, prior conditions, ER’s etc and the amount of out right lies told about it by Americans for purely political reasons (it leads back to Organized Labor) and the compete and total BS I’ve heard from Brits and Europeans because of what they have seen on the telly or read in the Guardian. Brainwashed does nt even start to describe just how clueless Brits especially are about the US system.

    Its actually surreal. I will give concrete examples of the total lies about the US system and Brits will flat out treat you like you are lying. I tell them that the best hospital in San Francisco is the free public hospital. SF Gen. Which only treats those with no health insurance or those transferred to it’s ER because it has the best ER in the city. Last time I was in there was to make sure a guy who lived in a Homeless Shelter got checked in. He was in a bad way. Prior injury.

    But you tell this to Brits they straight up disbelieve you because of the lies they have been fed by the UK media. You tell them, look it up. Its on the SF Gen website. Hell, here is there main desk tel number. Ring them and ask how much treatment costs. Nothing. Zero.

    The US system can be shark pool for the unwary. Or straight up stupid. But no different than someone who goes to a car dealer without do research an getting charged $3K for what was a repair $15 job. And so on. If you do a little research the US is fantastic, good value for money (once the Gov are out of the loop) and the best system in the world. I also really like dealing with US doctors and medical staff. A huge difference from the dismissive, patronizing and outright hostile UK ones. Its fun dealing with UK doctors after having dealt with US one for years. They soon get the message that you are not a typical NHS sheep patient who is supine and passive.

  • Subotai Bahadur

    bobby b
    August 21, 2023 at 9:14 pm

    I second your post, with the caveat that I am even older than you. I have a daughter who went to college for a term in Britain [required for her degree]. This is back around 2000. She had a diabetic crisis, and had to be hospitalized. Just in passing before she went I had to get a rather expensive medical insurance policy to cover her in Britain, and still had to pay the NHS. From the moment of entering the hospital, nothing worked from glucometers to IV machines. I have a series of war stories from her day and a half there. I will note that I am a retired Peace Officer, and I have spent a lot of time in hospital ER’s including for a while Denver General Hospital which is a major urban trauma ER. I know my way around hospitals.

    She ended up being placed in a bed on an open ward [large room with a dozen or so beds down each side] in a geriatric male unit due to crowding. That was not the problem. What was the problem was that in the middle of the night she saw a team of medical staff go to a patient a couple of beds down and administer what could be called an involuntary euthanasia. She said he tried to fight, but was unable to and they removed his body the next morning. She checked out AMA the next morning as soon as she could. No way in hell are me and mine going to ever go into an NHS facility.

    For Canada: A friend of mine was a pharmacist here in town. She SCUBA dove for fun, and would go up to Vancouver Island to do so. A crew member on the boat she would always use was named Carl. Carl had a mild case of Crohn’s Disease. All the Canadian system would give him was over the counter meds. My friend invited Carl down here and took him to an American doctor [I have to note that there was something between them and they eventually got married]. There is an non-narcotic drug here that is safe, relatively inexpensive, available and effective, in Carl’s case. The Canadian system would not order it because it cost more than OTC. That is one of the reasons Carl moved down here. And eventually after they were married became a Nurse Practitioner.

    Carl and his family were from Port Hardy at the northern tip of Vancouver Island. Carl’s mother needed an MRI. The nearest medical MRI was in Winnepeg, Manitoba over 1000 miles away and with over a year wait list. Interestingly enough, veterinary clinics [not controlled by the Stste] had MRI’s for pets in every major city. They brought Carl’s mom down here.

    Me here in the US and an MRI about the same time in the small mountain town I live in. I had repeatedly hurt my right knee while “fighting felons” over the years. I got tired of the pain and stiffness. I called my GP doctor Monday morning and he referred me to an Ortho specialist whose office called me back Monday afternoon and said they needed an MRI. At that time, we did NOT have an MRI in our small town hospital. However, the hospital contracted with a private company that had an MRI in a flatbed trailer that made the rounds of small mountain town hospitals. They made an appointment for the MRI Wednesday morning. I had an appointment with the Orthopod Thursday explaining what he could do. I had my surgery Friday morning.

    Tell me which system works better for the patient.

    Subotai Bahadur

  • Paul Marks.

    American health care is, largely, “socialised” – much of the spending comes, one way or another, from various layers of government, the corporate bodies are joined-at-the-hip with government, and the health “system” is saturated with regulations. It has been a gradual process of Collectivisation starting with doctor licensing (State by State) from the Progressive era onwards, then the FDA, then health insurance via employers (due to tax law and war time wage controls), then Medicare and Medicaid, then SCHIP, then Obamacare, and finally Covid.

    The idea that it presents some sort of pro liberty alternative to the NHS is utterly absurd. All nations are committed to ever more Collectivism – in health care and much else. This is the will of the international “educated” establishment.

  • Stonyground

    “It reminds me of the “lockdown” period where cancer screening was cancelled because it was “non urgent”.

    Diabetes monitoring stopped too. I’m pretty good at keeping mine under control by doing lots of exercise. It used to be distance running and triathlons. About the time of the lockdowns one of my knees started troubling me so that I could no longer run and could only do short cycle rides. Of course the swimming pools were closed. I’m back on top of it now but I suspect that less fit diabetics will have had considerable problems.

  • bobby b

    “The idea that it presents some sort of pro liberty alternative to the NHS is utterly absurd.”

    Paul, I’m not claiming that our health-care system is a libertarian’s dream.

    I’m claiming that it works. We get medical attention when we need it. We largely can afford it. It still contains sufficient free-market competition such that providers are concerned with making us – the people who choose where to go – happy.

    Not perfect. But it certainly sounds better than many other systems discussed here.

  • bobby b

    August 22, 2023 at 5:54 pm

    “I’m back on top of it now but I suspect that less fit diabetics will have had considerable problems.”

    Curious if you’ve tried a ketogenic diet specifically for the diabetes. I ask because I know some diabetics who swear the lack of glucose in ketosis has evened out the swinging cycles of their blood levels.

  • Jacob

    The trick (or solution) seems to be this: you have basically a state run system financed through taxes. This is politically unavoidable. Besides it you have a parallel, basically private, assembly of medical services. These are financed mainly through insurance, and partly through direct payments by patients. The private system complements the public one. Together, they provide whatever service there is – meaning something that is more or less OK.
    The ugliest problems exist in countries like Canada who try to suppress the private system for ideological reasons, claiming it undermines the public one.
    Medical services will never be perfect, since demand is infinite, and in the end – the problem is unsolvable – people die anyway.

  • Ben David

    I am an American ex-pat living in Israel.
    Israel started out socialist and has introduced privatisation and free market reforms (which is the main reason that the chattering classes disdain Benjamin Netanyahu).

    Socialized health care was awful. The NHS stories exactly match what I have heard from Israeli old timers. There were several HMO-type organizations to give the illusion of choice. In addition, there were tiers of access according to one’s ‘protekzia’.

    We now have a hybrid system. The government underwrites a basket of basic services. The HMOs offer various for-pay coverage plans on top of that. Doctors can choose how they want to structure their practices and affiliations with the HMOs and hospitals. Consumers can choose a doctor affiliated with the HMO or go for private consultation.

    New technologies like ultrasound or laser eye surgery typically are introduced via private entrepreneurs, then the invisible hand of the market does its work – they are included first in deluxe coverage plans, then eventually become part of the basket of basic services.

    This system works very well.
    A basic level of healthcare is always available, unlike the US where a historical quirk ties government funding to employment.

    Also, the courts here have kept the lid on litigation.

  • Paul Marks.

    bobby b – you know your own situation vastly better than I do, if you say that American health care is affordable for you, then I (of course) accept your word, you are an honourable man.

    I remember you correcting me during Covid – I was denouncing American doctors for not using certain medications as Early Treatment, and you pointed out that a relative of yours had been given precisely those treatments by American doctors – that put me in my place, and rightly so.

  • Paul Marks.


    The NHS keeps pestering me about diabetes – even though repeated blood tests show it is one disease that I do NOT have.

    I have some serious illnesses – but the NHS is not very interested in the illnesses I do have.

    I am baffled by it all.

  • Jim

    “Despite all the failings and problems of recent years, the NHS still seems to garner respectful comments from most of the UK public.”

    I don’t think it does. I think most people have had either a personal or one person removed disaster experience (up to and including preventable death) with NHS ‘care’. Even opinion polls are suggesting now that for the first time over 50% of the public are dissatisfied with the NHS (https://www.kingsfund.org.uk/publications/public-satisfaction-nhs-and-social-care-2022).
    The reason so many people think that public support for the NHS is rock solid is because the media and politicians constantly tell us it is. The illusion of public support for the NHS is a carefully constructed Potemkin Village – it exists to protect the NHS and its 1.5m employees and the political class responsible for creating the monster it has become. Those vested interests are desperate to ensure that there never is a public debate over how healthcare could be provided differently, so they do their utmost to create an illusion – that the public love the NHS and anyone who suggests doing healthcare differently is an evil degenerate who wants to kill your Granny.

    Whereas we all know if anyone or anything is going to kill Granny, it’ll be the ‘angels’ of the sainted NHS. One day this disconnect between the illusion and the actual views of the public will suddenly be revealed, in a Brexit-y type way. I’m not sure whether the political class will be shocked or not, whether they have come to believe their own propaganda or not. I do know they’ll react in a similar manner and do everything they can to prevent any change whatsoever.