Healthcare:can the (healthcare) society be saved from collapse?

Posted: May 12, 2012 in Health, National Health Service, Uncategorized
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A friend introduced me to the thoughts of Jared Diamond, during a conversation at work, in particularly to a  lecture he presented titled “Why societies collapse“.

In his lecture he presented an interesting analogy describing contributory factors associated with the collapse of societies; an analogy relating society, to bacteria in a Petri dish.

As bacteria grows within the confined space of a Petri dish there comes a point where there is a balance between “resources” within the Petri dish (nutrition) and “resource consumption”.

Diamond suggests, to prevent collapse within an evolving society, a balance between resources and their consumption; as much as a balance between economic outlay and economic potential to prevent collapse.

“Mismatch between available resources and resource consumption” will bring imbalance due to continuing growth of bacteria. As society expands beyond the available resources and systems of economy available, as with the bacteria, society collapses.

Taking Diamonds bacteria analogy to macroscopic level in everyday life, brought me to the state of the health service in the United Kingdom (UK). Taking this to microscopic level (that is hospital level) one can begin to appreciate why hospitals are failing.

It is clear that boundaries have been reached when the “Petri dish” represents the confines of the hospital. Attributable to an ageing, expanding, population available resources are not keeping up with consumption nor is the required economic outlay to maintain the service provision being met by the economic potential available. Simply there are not enough people contributing enough to the pot.

Resources in this instance means service provision within the hospital.

Accident and Emergency departments failing to meet the four-hour targets set by Government, where-by “no-one should wait more than four hours in accident and emergency from arrival to admission, transfer or discharge“. Or the increase in waiting times for operations due to the availability of level two and three facilities and ward beds.

In order to address the collapse of this micro-society one has to look at resources and resource consumption in tandem with economic outlay and economic potential.

What can be done to delay, if not prevent the collapse of this society?

As the Government of the day used public funding to save the banks from collapse, the health service is employing private companies. And whether this is liked or not, there is little that can be done about it.

Some hospitals are having to utilise facilities at private hospitals because they do not have the resources available within their “Petri dish”. We are already seeing private companies investing in health services. Richard Branson’s “Virgin Care” investing in community health services: Circle Partnerships investing in “Hinchingbrooke Hospital“, are providing the economic outlay.  This investment is bringing back an equilibrium to resource availability against resource consumption.

Whether one agrees with the thought that these companies have entered the market to make a “quick buck” or not; the question do we want healthcare or not, needs to be asked. There will never be enough people contributing to the pot, so we will all have to pay more in the long run no matter how healthcare is provided.

  1. So we need to put more funding into the NHS vs using Private healthcare resources. Private healthcare companies can only argue that they can provide a better healthcare service for less money, while making a profit at the same time. I believe that the only way they can do this is by operating in the same way that all companies operating in a capitalist society i.e. the investors happy to see a profit irrespective of at what cost.

    If a company is producing widgets and widget X is cheaper to produce than widget Y plus widget X has a higher profit margin than widget Y, which of the two widgets do you think the company are going to maximise their resources on? The same works for healthcare. I have MS, do you think the Private healthcare company wants to maximise their resources on me or a 25-year-old with no known health issues apart from a sprained ankle?

    The profit motive drives everything in Private healthcare, do you think investors would invest their money in private hospitals that run at a loss? I can’t buy private health insurance because I have an existing condition, that says it all.

    Our NHS needs funding by the taxpayer. If people have jobs they pay taxes, the more people who have jobs more taxes are paid. If the problem is that society people are living longerwhether or not we look at some sort of insurance payments for healthcare, it is just another form of taxation. Taxation isn’t a dirty word, it’s a way of providing good quality services for people irrespective of their ability to pay. It’s called being a member of society, which we all remember Margaret Thatcher said no longer existed (in her dreams).

    For arguments sake let’s get read of the NHS. We could replace it with state-of-the-art Private hospitals, providing the latest medical science has to offer. This could all be paid for through private health insurance. What could possibly be wrong with that?

    I refer you to the banking system.

    • rickjo1 says:

      Hi Gary

      Your response makes perfect sense, except with what has happened in the banking sector recently.

      Hospitals are already having to divert massive amounts of funds away from healthcare to enable them to meet their commitments to the Private Funding Initiatives (PFI), which have enabled them to expand. This is a discussion for another day as to whether PFI is a value for money exercise.

      There is a point to consider, which is with the closure of smaller hospitals: have surviving hospitals become so stretched that they can no longer cope, have they become too big to fail? The answer could very well be yes. Evidence of this is the purchasing of private healthcare (PHC) services to augment their stretched services: PHC has enabled the “Petri dish” to expand, delaying/ preventing the collapse of the “society”.

      At the moment, PHC provides a service which can cope when everything goes well. If you are unfortunate to experience a complication during or post surgery the public sector picks up the mess; dodgy breast implants as an example.

      I think it inevitable that we will have a two tier healthcare system (private/ public) and we are not far off already. What we are doing is trying to hold on to the principles of the NHS, which even from inception was doomed to fail.

      Foundation Trust Hospitals are having to make a profit from somewhere to survive. They are becoming lean in practice and we can see the effect that this is having on healthcare; it is reflecting exactly the points you raise in the second paragraph. Whilst not as strong an example as you present with your circumstances, hospitals are already discriminating in the provision of services in order to save money.

      The NHS is a socialist ideal trying to survive in a capitalist world. In South Africa, the Government has tried to introduce an NHS style healthcare system which has failed because there are insufficient means to raise the money to support it.

      Just a thought on taxation. If you work, you contribute to private healthcare insurance: the Government introduces a taxation policy whereby the capital raised through taxing private healthcare providers is ring-fenced to support the public healthcare system.

  2. Should mention that I have to use speech recognition software because I can’t use a keyboard, therefore some of what I write may not quite make sense because of spelling/grammar etc. Anything else that doesn’t make sense is due to lack of intelligence on my part.

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