Surgeon Defends Britain's National Health Service
STEVE INSKEEP, host:
The defenders of Britain's system include Lord Ara Darzi. He is a prominent surgeon who just finished his stint as a minister in Britain's Department of Health. He admits British health care is imperfect. Still, he says, it's a fairly straightforward system.
Dr. LORD ARA DARZI (British Government Advisor, Britain's National Health Service): Every patient, or a member of public in England, are registered with a primary care physician. You go and see your general practitioner. Your general practitioner will refer you on and the cost of that referral and the payment of that hospital is made by this local insurer, which we call primary care trust. The payment is made by a single payer.
INSKEEP: Single payer, the government, end of story.
Dr. DARZI: Yeah.
INSKEEP: There had been some reforms in the National Health Service in recent years, and that makes me wonder what it is that went wrong that needed reforming.
Dr. DARZI: Well, the National Health Service has not just come through a reform. It's come through a complete transformation over the last eight years. We did have patients on waiting lists for their operations for a long period of time. We certainly did have shortages of doctors or nurses. And the expenditure in health, back in the year 2000 was 37 billion pounds, roughly $70 billion.
Dr. DARZI: The expenditure now is 110 billion pounds. That's near enough $200 billion. The NHS in itself has grown by about a third, employing new doctors, new nurses, new hospitals. So, a lot has changed and a lot of the stories that I certainly heard over the last couple of weeks, which is being debated, are the stories of the past.
INSKEEP: So, you got to the year 2000 and found that the government-run system had just not kept up with the needs of the British public. The spending was not sufficient, the number of doctors available were not sufficient, and the wait for particular kinds of treatment was just out of control. That's what was happening and that's what you tried to fix, fundamentally.
Lord DARZI: That's correct. You know, the NHS, the last decade is a different NHS from the NHS the decade before.
INSKEEP: Well, let me get to a specific example that's been cited this month here in the United States. Senator Charles Grassley, a Republican who is deeply involved in health care negotiations, raised concerns about moving the United States anywhere near what Britain has because of an example of a fellow senator of his. Let's listen:
Senator CHARLES GRASSLEY (Republican, Iowa): I've been told that the brain tumor that Senator Kennedy has, because he's 77 years old, would not be treated the way it's treated in the United States. In other words, they say, well, he doesn't have long to live, even if he'd live another four or five years. They'd say, well, we've got to spend the money on people that have more, can contribute more to the economy.
INSKEEP: Okay. Does the British system make that kind of distinction? Here's an older fellow, you've got this treatment that you could give him but it wouldn't add massively to his life expectancy, so we'll deny that. Do you do that?
Lord DARZI: Well, I'm sorry to say that's the most ludicrous thing I've heard. I've heard that written down but I've never heard it in real speech. And the answer to that is absolutely no.
INSKEEP: So, Grassley's comment is based on nothing, so far as you can say?
Lord DARZI: Absolutely - not just false, these are lies which have been used to set fear against reform.
INSKEEP: Ted Kennedy goes to Britain, he's a British citizen, he's going to get full treatment and that treatment is going to be fully paid for. Is that what you're saying?
Lord DARZI: Absolutely, irrespective of the tumor type as well.
INSKEEP: Let me play another clip, if I might. This comes from an ad that's been running nationwide in the United States, an ad campaign produced by a conservative political action group called The Club for Growth. And they show on the screen, an image of an old man who is mourning in a hospital bed.
(Soundbite of ad)
Unidentified Man: Twenty-two thousand, seven hundred fifty dollars: in England, government health officials decided that's how much six months of life is worth. Under their socialized system, if a medical treatment costs more, you're out of luck. That's wrong for America.
INSKEEP: That's an ad from the Club for Growth. And just to be clear: is there a meter by the bed, in effect, in Britain, and if health care gets too expensive for an individual, you cut him off?
Lord DARZI: Absolutely not. Again, it's the most ludicrous thing I've heard. And I'm just giving an example: the life expectancy in the U.K. is actually longer than it is in the U.S.
INSKEEP: But if somebody gets into a particularly difficult medical situation and treatment is particularly expensive, do you ever get to a circumstance where you say, we're just not going to pay for that treatment anymore?
Lord DARZI: Absolutely not. I'm not standing up here and saying we have the best health care system that you should copy. That's not the intentions of me getting on the radio to you. It's - I'm making clear that what you're hearing is not just false and distasteful, it's just far what I expected, someone in these senior political roles, to be disseminating fear against the system.
INSKEEP: Lord Darzi, thanks very much.
Lord DARZI: My pleasure.
INSKEEP: Lord Ara Darzi is a former minister in Britain's Department of Health and a surgeon at St. Mary's Hospital in London.
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