Members of the public and politicians all twittered their support for the NHS when it was criticised by American Republicans this summer, but a group of consultants has taken a more direct approach.
An open letter - signed by over 100 doctors - has been sent to democratic Senator John Kerry in the US seeking to correct misconceptions about the NHS. It was sent to Senator Kerry because he had called for the lies about healthcare to be refuted.
As part of the current healthcare debate over ‘Obamacare’ in the US, Republicans have accused the NHS of being Orwellian, Marxist, and presiding over ‘death panels’ that decide which patients should live. The debate was fuelled by Conservative MEP Daniel Hannan who, when interviewed on US television, described the NHS as “a 60-year mistake”.
The letter strives to set the record straight. It starts by emphasising that NHS patients are given choices about their care. It explains, for example, that termination of a pregnancy is a personal decision if approved by two doctors. ‘No board or organisation of any kind makes any decision about termination for fetal abnormality.’
On the treatment of older people the letter says: ‘Elderly people can get counselling and advice to help them determine their requirements for their future care, but only if they wish it.’
And describing primary care it states: ‘Patients are normally registered with a family doctor practice of their choice. A patient is able to see a doctor immediately for urgent care in general practice although seeing his or her own family doctor for non-urgent care may require waiting a few days. If the patient requires referral for specialist opinion or treatment, they can choose whichever hospital they prefer.’
Chuck Grassley, the most senior republican on the Senate finance committee, was the most provocative of the US critics. He said that then ailing democratic colleague, Edward Kennedy, would have been left to die untreated from a brain tumour in the UK on the grounds that he would be considered too old.
The letter tackles this claim head on: ‘There is no cut-off age for health care in the NHS. Senator Kennedy, like anyone else of that age, or older, and with health problems such as his, would have been treated by the NHS with the same high levels of care as someone younger…Many hospitals now offer “hospital to home” programs for palliative and end of life care to enable very ill people to remain at home.’
It also says: ‘There is no “death panel” in the UK NHS or anywhere else in the UK health care sector.’
American papers also claimed that Stephen Hawking wouldn’t survive if his care was managed by the NHS - an accusation he was quick to refute.
The letter says: ‘Professor Stephen Hawking of Cambridge University, recently awarded the Presidential Medal of Freedom by President Obama, is disabled and has always been under the care of the NHS. Professor Hawking is an outspoken admirer of NHS care. Like thousands of others who are disabled, he is entitled to free medical care and medicine, and he can get adaptions, equipment and home care to allow him to live at home.’
And the issue of rationing was addressed. ‘No one is denied medicine if they need it. All children up to the age of 16, pregnant women and adults over the age of 60, unemployed people, patients with cancer and many with chronic conditions, don’t pay for their medication from the NHS.
‘88% of medicines are dispensed without charge. For the minority who pay there is a standard charge of $11 dollars per prescription, regardless of the real cost of the drug. Some parts of the UK have abolished prescription charges altogether.’
There is also criticism of the US health care system, particularly about the standards of care for those with pre-existing conditions. ‘In the US, people with pre-existing health problems are rarely covered by private insurance companies for those problems. Many do not change jobs for fear of losing cover for such conditions from their new insurers.
‘The NHS is literally a life saver for those with pre-existing health problems - they are not denied care. It is vitally important that the NHS, and any government financed health plan anywhere, undertakes the care of such people.’
A brief description of the NHS and its origins is included and points are made about patient satisfaction and relative costs. ‘The NHS is funded by taxes and provides universal coverage while costing 8% of UK GDP. The US system currently costs 16% of GDP but leaves 45 million without insurance and a further 25 million under insured.
‘Survey after survey shows that British patients express a high degree of satisfaction with the care they personally receive from the NHS. On average, British users of the NHS live longer and have a lower infant mortality rate than the US,’ it says.
The letter was signed by senior figures from the medical profession including Sir George Alberti, past president of the Royal College of Physicians and dean of Newcastle School of Medicine, Professor Andrew Boulton, professor of medicine at the University of Manchester, Professor Mark Gabbay, professor of general practice at the University of Liverpool, Professor Eileen O’Keefe, professor of public health at London Metropolitan University, and Sir Alexander Macara, chairman of the National Heart Forum.
Co-author of the letter Dr Jacky Davis, consultant radiologist and co-chair of the NHS Consultants Association, said: “The US healthcare system makes trillions of dollars in profits every year, some of which finds its way into the pockets of politicians and lobbyists. The new proposals threaten these profits and their recipients.
“In addition, the American right sees this issue as a way to bring President Obama down, so it is not surprising that this toxic mix of vested interests has organised a campaign of misinformation on the subject, including outright lies about the NHS. This letter is an effort to refute the lies. We cannot tell Americans how to reorganise their healthcare but we can at least help them have a debate based on facts rather than lies, distortions and selective use of statistics.”
The letter has also been sent to a number of American politicians, newspapers and the AARP.
Read another consultant’s blog on the issue.
Read the full letter as it has been presented in the US.
Tags: US healthcare
