A few months ago I waxed lyrical about the British National Health Service, or NHS, which brought my friend back from the edge of eternal darkness. I myself have felt well-inclined towards the NHS for thirty-odd years, but in recent weeks I feel as if I am becoming part of a Monty Python spoof.
First, let us look at the current World Health Organization figures on swine flu, also known as H1N1. As of early August the good news is that Madagascar and Greenland are swine flu-free. The bad news is that the United Kingdom is suffering more cases than most other European countries. Why is this? There appears to be no clinical explanation for this at present, although I could tell readers stories to make their hair stand on end about hygiene in British eating establishments or the latest tales of men urinating in theater aisles during performances.
So this brings me to the government’s pandemic flu strategy. In the popular Evening Standard newspaper’s August 3 edition, there is a full two-page spread advising the public on how to deal with symptoms. We are told we must designate a “flu buddy” — oops, in England this is called a “flu friend.” We are instructed to initiate a complicated string of processes once ill. (Have you, dear reader, ever had really bad flu? Ever felt as if you will die and can barely stagger to the bathroom, only to fall over from fever, the shakes, and delirium?)
This ludicrous ad, which I calculate must have cost the NHS about $400,000, (a tabloid quarter page averages £80,000) tells flu sufferers to stay away from the doctors’ offices and call a helpline. You are then put through a series of questions about your condition, temperature, medical history, current health issues, and symptoms. You will be asked for your address and postcode. If you are not unconscious by the time this is over, you are then — wait for it — given an “authorization number.” Incidentally, the person “assessing” your qualification for a “flu authorization number” is one of two thousand folks recently picked from a motley queue of the unemployed who, from what we television-watchers could establish from the interviews given, are largely medically unqualified call center staff.
Sky News reported on June 23: “Many have jumped at the chance of at least three weeks’ work at £6.60 an hour — without even having to undergo an interview. The advertisement looking for recruits was posted on various websites calling for people to take on a customer service role assisting a medical institution. … Requirements include being fluent in English and some experience of dealing with customers in retail, catering, or office work.” On the Sky blog worried medical professionals, including one intensive care nurse, complained, “They may have been trained in retail or catering, they may be high-caliber lawyers who cannot get work, but surely this does not qualify anyone appropriately to assess over the phone whether someone is ill enough to be passed over to a medical professional.”
So let’s get back to the Evening Standard advertisement. It tells the sick person to write down the authorization number, which must then be communicated to your “designated flu friend.” What happens if the buddy has fallen ill? The purpose of the unique number is to give that person a course of anti-viral drugs for you from a “designated” (there’s that word again) collection center. The advertisement does not say if this person, who will have had to drive or take public transport to the collection center, will then have to pay the requisite £7.20 ($13.50) per prescription. When the buddy gets to the distribution center, he or she must then produce ID and ID for the patient.
Then the buddy gets the drugs and takes them to the patient. See the rub? If the whole point of the scheme for the sick person not to come into contact with a doctor’s office is to prevent spread of the illness, how is the buddy going to get the pills to the gravely ill patient? Okay, the buddy might have keys and will simply open the door and dump the wee bag on the welcome mat and flee for his or her life. But the sick person might languish in bed and even die before being able to stagger to the welcome mat.
What I find so ludicrous about this grand scheme is that it fails to take into account a true pandemic situation as that of December 1999, when several friends and I were so ill we could not stand up and indeed my colleague Jim Baird, a strapping fifty-nine-year-old, succumbed after two days of illness. Thousands died and people were being sent to France as there were not enough places for patients or the dead. So, if people start dropping like flies, who will get the Tamiflu or Relenza for their friends?
My solution is a costly but simple one, and I suggested this at the last meeting I attended of my central London health care panel: the NHS should deliver a box of Tamiflu to every household in the UK. If it was possible for the NHS to deliver a “swine flu leaflet” to every house, would it not be an idea to do the same with anti-viral? If it was possible for British Gas to deliver energy-efficient bulbs to millions of households in Britain, might this not be an option for medication? We are told the symptoms come on rapidly and people are dying. If one had the pills on hand by one’s bedside table and a bottle of water, might this not save lives?
Having just seen an advertisement for a consultant to the NHS at a rate of pay of £700 a day (that is $1,300), it seems the health service has its priorities skewed. I hope the United States has a better way of dealing with a pandemic and that this article will be instructive on the way not to go.