Free at the point of Delivery

Photo by Olga Kononenko on Unsplash

Hospitals are not hotels.

That much should be obvious. They don’t provide personal services tailored to your every whim and fancy. Nor do they provide concierge doctors who will order an MRI for the headache you have as a result of a heavy night down the pub or golf club. They will provide lubrication for instruments that might need insertion to explore your deeper recesses prior to surgery but that is as much luxury as you are going to get. 

In the NHS, the key thing to remember is that it is ‘free at the point of delivery’. Which means you can leave your credit cards and wallet at home and there is no need to negotiate with an insurance company while watching the exsanguination of your visceral organs on the hard shoulder of the M25 after a road traffic ‘event’. 

Mind, there are those who think that is precisely what you should be doing to reduce the cost to the Treasury. The other thing you can do is die early. Take up smoking and stuff highly processed salt and sugary foods at each and every opportunity until your type two diabetes is so bad your foot falls off and your heart explodes in sorrow. That way you can save cash that would otherwise be spent on the extra years over the age of 70 that your miserable bony carcass survives. 

Free at the point of delivery. Fancy that. Of course you have paid already but you have just not paid anywhere near what a simple procedure might set you back if you lived in a third world country, with a piss poor service, like the United States. There, if you so much as pick up the phone to discuss a lump in your trousers, you can kiss your mortgage goodbye. A chap in Chicago had to sell his aircraft carrier to pay for a hernia repair.

Insurance is bloody expensive and they like to exclude as many conditions as possible. If you have had one heart attack in New York the insurance covers the first defibrillator shock, then they charge per shock thereafter at a rate of $1000 a pop. While you crash ashen faced, eyes rolling and involuntarily pissing yourself, each ‘stand back’ you hear is another bill. You might as well just die. Which, happily for them, most poor Americans do. Especially the black ones. Black Lives Matter. Only if they can pay their medical bills. 

This side of the ocean, things are a little different even if there are some who’d like it not to be. Chest pain? Then the very last of your worries is the final bill. And yet, there’s no pleasing some people. 

As waited my turn for the cardiologist and his team to investigate my own pain in an NHS hospital, I had the utter joy to overhear a chap in the next bed down but one. 

“You wouldn’t run a bloody business like this”, harrumphed the git with an over inflated sense of his own importance. A sense that arose, no doubt, as a result of constant ego massaging in childhood as “mummy’s little trooper”. It is a shame the “little trooper” grew up to be a “big twat” whose judgment on health matters is as poor as the pissed up tourist’s order for yet another large Drambuie in a Bangkok brothel staffed entirely by lady boys with unlimited access to oversized butt plugs. The Git sat half slumped on the hospital bed, his face as black as a miner’s arsehole only less picturesque, while his demeanour was nowhere near as sweet. This was due to being told that his cardiac investigative procedure would be later than planned due to some poor sod having the temerity to have an actual heart attack and therefore being in more need of the medical team’s attentions. It is the case that ‘emergencies’ such as one’s life ebbing away with every minute of the ticking clock, take precedent over the ‘urgent’ or the merely ‘planned’ surgical procedures. The NHS is many things, but it takes ‘triage’ quite seriously. 

This means that your ingrowing toenail, chronic dandruff and a perineal wart take second place to actual profuse bleeding from lax orifices. They also take second place to a heart attack that would stop a bull in full charge at the lady bits of cow. Priority is a word Git understands alright, except in his personal world he is his own priority; the sun revolves around him, the universe unfolds at his command, swallows migrate when he allows it. His self centredness probably means he’d give himself his own blowjob if it did not mean he had to make an effort without ‘staff’ to tickle both his ego and scrotum at the same time. 

He probably does run a business, taking sweets from the mouths of cherubim in order to sell them on to diabetics as ‘organic low fat vitamins’. He may organise beggar crippling, to keep the town’s streets free from injured ex servicemen trying to eke out a cold miserable existence living rough, or he may be engaged in selling bottled sunshine to the blind. It has not occurred to him that the NHS is now a collection of independent organisations who are required to contract out services, engaging in competitive tendering, while seeking private providers who have an imperative to generate profits. It used to be a Marxist inspired centrally run Stalinist institution (according to the Daily Mail) providing free at the point of delivery, universal and comprehensive health services. Now it is dealing with increasing demand, rising technological and medical costs and chronic underfunding. Oh, and throw in a pandemic.

Perhaps we should treat cardiac surgery like we treat holidays in the Costa del Sol. Advertise a variety of ‘products’ to suit a range of budgets and tastes, including ‘no frills’ right on up to deluxe premium gold packages.

‘No frills’ means incisions undertaken by a medical student working her fifth 12 hour shift in a row. There would be no analgesia except a pre sucked aspirin, and the procedure would be done in a candle lit shed beside the Starbucks at a roundabout on the A30. The medical student would have only dyspepsia and a deep longing for sleep as accompaniment. The deluxe package includes a personal team headed by an actual cardiologist, access to unlimited chocolate biscuits and a gram of top quality Colombian cocaine in case things get tricky during the procedure.

If I were Health Minister, gits would be filtered out to automatically receive the no frills package while still being charged for Deluxe. 

Some people.