That is true…

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Is it true?

Truth is something that gets bent, watered down, twisted and often is a matter of perception.  

Truth never damages a just cause and truth, it seems, is the first victim of a general election.

As far as I can tell, manifesto claims about the NHS are mostly either untrue, unachievable or unrealistic.

This is a dirty election and it’s not just me saying so.

Show me a manifesto that says; 

‘… austerity has knocked the stuffing out of the NHS.  

Depending on how the economy does, after leaving the EU, we will try and get it back on its feet, to the historic average of 4% funding increase year-on-year, do everything we can to encourage employers to turn the NHS into the career of choice, get digital basics working across the service and make sure social care is properly funded.’

… and I’ll show you someone I can vote for.

Above the cacophony and din of the election, words of truth should sound like a gun shot.  I’m yet to hear the bang.  In this election there is no truth, just interpretations.

The biggest claim about the NHS is made by Labour… their assertion that the Tory’s will, in someway, get the NHS in-hock to the US and big-pharma.  Is this true?  

The UK pharma market is small. US, China, Japan, Germany, France, Italy and probably Brazil, are ahead of us.  We are the bottom of the list, in market share, for products launched in the last 5 years.  The UK is under 3% of the EU market.

Going the other way are £11.9 billion of exports of UK manufactured drugs to more than 446 million potential patients and consumers in the EU.

In the US access to the pharma market, aside for regulations for safety, is unfettered.  

Efficacy is not a principle reason to buy, unlike here, where NICE puts a rationale behind the use of resources and asks awkward truths such as; ‘does this pill work’.  

We manage to keep the lid on prices and in consequence, because pharma is a global market, US pharma claims it’s low prices here that make for higher prices, there.

Hence Humira an injectable medication for arthritis is $1,362, on average here, $2,669 in the US and interestingly, $822 in Switzerland.

We don’t buy all our drugs from US companies but doing the sums is difficult as pharma is a global business.  However, the two biggest are GlaxoSmithKline and AstraZeneca, essentially, non-US.

Is it true pharma would be part of a US trade deal?  

If I were a US negotiator I’d give it a try.  If I were the UK government, why would I want to pay more for my drugs, in exchange for cheaper Harley Davison’s, Window’s software, Jack Daniel’s or chlorinated chicken?

Incidentally, our pre-packed salads are rinsed in chlorinated water…

Do US companies want to buy the NHS?  

Ours is a socialised medical model, anathema to the US.  We would have to repeal the NHS Act 1948 to bring in fundamental changes and the Tory manifesto specifically talks to repealing the market provisions of the Health and Social Care Act 2012… Lansley’s bonkers-ness.

Much is made of ‘Private firms handed £15bn in NHS contracts over past five years…’

Is that privatisation?  No.  It’s mainly competitive tendering for service provision and amounts to around 7% of the total NHS turnover.  

Mainly Virgin (Virgin Care pays no tax in the UK: its parent company is registered in the British Virgin Islands) and Care UK and is muddled together with postal-services, car rental and maintenance and social enterprises.  PFI is about 2% of the NHS budget.

In 2018, according to the Royal College of Surgeons one third of NHS hip replacements and one quarter of knee replacements were performed by private providers… at NHS tariff prices.

If you are one of the 4.4 million on waiting lists, I doubt you’ll care who fixes you up?

Oscar Wilde said; ‘… the truth is rarely pure and never simple.’

Well, that is true!

News and Comment from Roy Lilley

Contact Roy – please use this e-address roy.lilley@nhsmanagers.net

Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.