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As the world gets taken over more and more by multi-national companies and right-wing policies I think the NHS is a dead man walking today.
Should Cameron and his 'there is a profit in this somewhere' lot get in at the next election the demise will come sooner than even I expected, I believe.
The Left view of society caring for all ideology has finally been beaten by the right. Of course there is a price for everything in Toryworld!!

What, you seriously think that social democracy, let alone its social institutions can survive for anything like 60 years under the greed and brutality of the capitalist system.

Many of the Darzi review's ideas for specialist care are excellent but they are being misused by Trusts in order to cut non-specialist services such as those for women and children.

This is the case for us locally where many services at Epsom hospital are under threst.

When approached, the government have just said this is up to local bodies but the reality is that these are politically supported /validated local cost cutting exercises which are taking away vital non specialist services.

The proposal to change the NHS so that there are super surgeries is a great idea on the face of it.Having expertise available and different opening hours, will be convenient for some and save the NHS money. However there are many people who live in small villages that at present have problems getting to the next village to the doctor's surgery, how these patients will cope when they have to travel even further does not seem to have been taken into account. Many people have cars but the price of fuel is affecting the rural communities much more than urban ones.The rural bus services are often less than two buses a day( in some areas it is just market day once a week), and many already have to wait for several hours for the return bus, if they are lucky enough to have one.
Elderly people and those with young children the chronically sick ( and we are talking about the NHS here) will have problems using the buses , with these lack of services.
The carbon footprint of longer journeys to super centres has not been taken into account either as far as I can see.

If the UK does not keep an NHS(at one time said to be the envy of the world!) then those of us who have worked in it/for it for all our working lives have wasted our time and our dedication. Similarly those of us who from a point of view of principle do not seek or use private medical services will have wasted our effort in that respect, and the country will be the poorer in its care for citizens of all backgrounds and in all circumstances.
The NHS is one of Britain's great achievements.
Please let us all work to keep it and develop it further.
Merrymag

The NHS is world class resource. Unfortunately NHS Trusts are often run by people who do not realise that they are there to serve the public, they often make decisions that are designed to cover the organisation rather than in the public interest. I have campaigned one NHS Trust in Lancashire to examine fully a culture of patient abuse at one of its units. They did , eventually, complete an " independant" inquiry that only covered a fraction of the time scale involved and did not ask anyone outside of the Trust any questions, It did however find that the unit was comparable with the Rowen Unit infamous for its role in the Rowen Report! A daming claim for any report to make. Unfortunately there are still members of the team that ran that unit on either suspension with full pay or long term sickness, which is costing tens of thousands of pounds a year, but of course is allowing the Trust not to complete further investigations that would be embarressing if they were know! It seems the Trust management would rather spend thousands of pounds of public money keeping potentially dangerous staff out of circulation that face the public interest. The Trust in Question has not published the Fenton Report either or will not release any further information regarding the further investigations that they are claiming to be doing. It is such a shame that our health service keeps so much from us!

Thankyou missmadscientist for clarifying what this debate is all about - money!

If I lived in a village and my docter was miles away in another village, or God forbid, in a town or city's supersurgery then I would die of neglect!

I forgot. I bang on almost everyday about the fact that the population (thats all races in case it is misunderstood) is increasing at an alarming rate, partially because of a great NHS.

If the population does increase by 50% within a few short decades then issues like "Will dementia overburden the NHS" will be very much symptoms of the decline.

Its NOT an NHS problem its a wider social, and dare I say it, a global issue.

When I was in for a heart bypass I think I was very impressed. I am not a great patient and the food was UNBELIEVABLY bad. It is a PFI hospital so for me its disguised and inefficient accounting.

I must say I think the management in these places don't have great reputations though.

At age 76 I've experienced good and not-so-
good health care, both before and since NHS.

The concept of 'free' and total health care from cradle to grave was always unrealistic: more so now with increased life expectancy and with less tax-paying workers supporting a growing proportion of pensioners needing more care, and demanding entitlement to every new and expensively developed drug that may prolong active life.

I'm indebted to NHS for life-saving drugs which must be costing far more than my contributions over my 50 years of taxation, but I will no doubt claim my right to any existing or new drugs that become available to treat other geriatric conditions that I may require as I degenerate.

I'm not entirely sympathetic with the ongoing row about post-code drug lottery, which seems to conflict with views about less centralized law-making: local health authorities should perhaps exercise more democracy in allowing the local electorate to decide on what is free of charge out of available local taxation (e.g. vote for Viagra versus other drugs that prolong life).

Many of my pensioner friends who have contributed to taxation throughout their working life resent the uncontrolled immigration that has allowed hundreds of thousands, who have contributed nothing, to benefit from what has become the International Health Service.

Finally, I have been referred by my GP to the local polyclinic and found it far more acceptable than having to wait for hospital appointments, and offering a wide variety of services that the local GP could not provide.
Unfortunately, these do not include dentistry, for which I become a health-tourist to Philippines once every year.

I am extremely fortunate to have lived during the operation of the NHS, and I have largely benefited from good health until my forties; not everyone is as fortunate, although the majority are 'Well', into middle age; and we must discount annual colds and sniffles from this.

I have experienced our system and the Australian largely private one, or how it used to be 40 years ago in NSW. There the individual took out private insurance, on a scale of coverage, arbitrarily chosen as a gamble between the likely occurrence of getting ill when one is in ones' twenties, and the wisdom of providing for a serious event. The degree of cover - memory says was based upon grade of premium and period for which the medical benefit would remain in effect. There was also a separation between visits to the Doctor and In-patient Hospital care. I never learnt the niceties of 'Out-patients' care. Nor consciously knew the terms at nineteen. In the State of Queensland - Hospital care was provided out of internal revenue. Whether paid for through contributions or income tax there seems little difference. For those who didn't pay, in either State, I never discovered the penalty of not having cover; since emergency treatment would always be given, but the insurance status discovered later.

Although I have benefited from universal NHS coverage, I have often referred back in my memory to the Australian experience, whenever the Private versus NHS debate arises
and wonder whether we should follow the Queensland model. It has the clear benefit of a deterrent to those miss using GP Services, ie, missing appointments, abuse, obsessional visits for no particular need; since they would unlikely achieve re-imbursement by the Private Insurance/Health Club benefit, and eventually desist. But how private health enables families with chronic childhood illness/disease remains sceptical and flawed in my mind.

In spite of this I have worries due to rising costs, particularly in the area of payment for increasingly elaborate and expensive pharmarceutical medication. I wonder whether these costs will force a rationalisation, and think, are GP services the easiest to commercialise, in order to preserve the highly expensive Hospital and In or out-patient treatment?

MISLEADERS

thegangofone (#8) "I bang on almost everyday about the fact that the population (thats all races in case it is misunderstood) is increasing at an alarming rate".

Well, perhaps you should stop banging on about it then, s you are wrong. The UK has a TFR BELOW replacement level (which is true for the rest of Europe too). It's even lower in the indigenous (White) population too (especially the educable group). It's non-white groups which have higher that replacement level TFRs. The EU increase in immigration is considered necessary by our great leaders in order to compensate for this worrying population DECLINE (and its consequences). Population growth occurs elsewhere in the world, largely where cognitive ability levels are rather low (TFR and IQ are neatively correlated). When people like Jeffrey Sachs are not travelling the world introducing the wonders of 'shock therapy' to planned economies, they are busy misleading those at home about their populations. One wonders why?

I am old enough to remember the days before the N.H.S. If you could afford it and were ill you saw a doctor, if not you relied on old wives remedies and hoped for the best.
The introduction of the N.H.S. made such a difference and is something we need to preserve and to me the biggest problem at the moment is governments obsessions with TARGETS being one of the problems, they want statistics so that they can shout about how well they are doing in running this service, how qualified are they to set targets, how many of them studied for 7 years to become medically qualified ? The second problem is quangos who meet periodically draw a nice salary and tell the medical staff what to do, how many of them are qualified to do so.
No money should go straight to the source of our fine health service

CUCKOO!

Much as I like and respect my recently retired GP, I have kept MYSELF healthy with judicious use of supplements at no inconsiderable expense and avoidance of the usual killers. At 71, I am on NO prescribed medication. I walk, cycle, run stairs and sleep soundly.
If they reward my new doctor (who seems also an excellent chap) will he share the cash with me do you think?
I have a deep sense that the madness of UK governance has now gone critical. How can it be that while many of us have been forced from NHS dentistry through lack of effective policy, in 'body-medicine' we are heading towards a personal physician EACH or even our own hospital.
Are we all caught up in some 1984-type story only written by Lewis Carroll?

The question we should be asking is:

"Can the British economy survive another 6 years of Thatcherite privatisation?"

The reason I say this is because I think the underlying motive behind discussions and questions such as proposed here by Newsnight is driven by an need to soften up the public for the privatisation of the NHS.

Perhaps he final remnant of the moral position that people should be treated according to their needs rather than their means, the NHS by and large is the only institution that is fair and respectful to the poor and should be preserved as being owned by all, even the poor, in order to protect the practice of this moral position somewhere in society.

In other words, he who pays the piper calls the tune. To an ever-reducing extent, we pay this particular piper - and to maintain its attitude, particularly to the poor, where other institutions are failing - education from dominance and impotence induced by privatisation and the capitalist ideology of education as training for work, the church from falling numbers, the Labour Party from individualist cynicism and greed, are failing.

Any organisation can survive if it adapts to changing times and circumstances. It may even keep the same name; no need for image consultants to think up a new one.

If the one-doctor surgery wasn't already doomed, the activities of Harold Shipman signalled its end. Instead, large multi-GP with support nursing care and clerical staff to administer the service to the customer, has taken over.

Well, it has where I live. This is a Suffolk market town of almost 40,000 people. How would I feel, though, if I lived in a village with only 400 residents? I don't have access to a car, so if my surgery was two miles away along a country road with no pavement, I probably couldn't get there if I was ill. At present I can walk on safe pavements to see my GP, so find the distance no barrier.

Please ask your labour representative on the programme if Gordon Brown's visit to a hospital near us today (Leatherhaed)was kept secret for security reasons or because he wanted to avoid our protests over closure of services at Epsom hospital- I had already explained in a comment this morning to you that our local hospital is losing services which are not the specialisms of Darzi and so should not be centralised- we have been ignored by Alan Johnson's office- was GB avoiding issues today??

Long live the NHS. Politicians should stop interfering with NHS as Sir Geoffrey Robinson suggests

#11 JadedJean

Ah the poster with the rep. In fairness I can't cite the exact report, but I think it was an offshoot of the UN report that gave the global picture last year?

I think you are wrong. Last year I believe the government said the population did duly increase. A lot of that was immigration, although as many emigrated there was a lot of debate over the net figure.

But the population is going up. Common sense even if the official figures - that may not cover illegal immigration - don't say agree. I think they actually do.

If its not you should let the economists know as surely that means the supply and demand problems relating to the housing crisis will soon be a thing of the past. Will there be enough people to fill the jobs?
London will be a wilderness in thirty years?

Tosh!

So I assume from the fact that you like to link IQ to whether or not people are up to liberal democracy that you are an expert?

What is your field of expertise?

#11 JadedJean

By the way call me Mr. Crazy but I think the reason we had so much immigration recently was that they would do the jobs that our workers didn't want to do at such low rates of pay. Hence Poles and horticulture. Cleaners and plumbers etc.

I can't actually think why our great leaders would want to "compensate for this worrying population DECLINE "?

Do tell.

thegangofone (#20) Anything to oblige:
/blogs/newsnight/2007/09/wednesday_19_september_2007.html

I can't imagine it will last 20 years, never mind 60! Much of the current decline is down to government policy.
1. Stop allowing it to be all things to all men. Perhaps some frivolous procedures and certain physical requests, should not be freely available. If it is to have any future. While medical advances and the high cost of medication must play a part. That is not what is responsible for the decline of our previously well run, well respected hospitals that are now in such a mess, meddeling on a massive scale has acheived this.
2. The National Health Service has also become the prime destination for health tourists, a well known fact that no one can deny, least of all a government who are responsible for loss of control across a number of areas, where they are not fit for purpose. It seems the only thing Westminster can do is 'control freekery' here they excell, as all the managers and beuracrats running this country would fail to agree.

What can we the people do? Lobby our MP's. Make our voices herd, in the way the french do. Demand our polititians listen. If they don't. Vote them out of office.
They need to be reminded, they are our servants not our masters.

Newsnight shoudl not try to sound smart and then come out with naive comment/analysis. It is misleading for people.

Keeping a tax based NHS was said like it was giving us something.

Tax - based funding is the easy way to siphon money off to private companies- you dont have to sell anything, and people have to pay whether they want to or not. And it brings in loadsa money.

It was also stated that this report has cross party support, as though that proves this must be good.

But this report doesn't question the privatisation of the NHS - not in terms of tax-based funding (easy money), not in terms of universal , free at point of delivery (big money), but privatised in the fact of where the money goes. And this is what has cross party support!

But is it good - it is costing heaps, with poor value for money.

MORE TROUBLE AHEAD

With the demographics being as they are (e.g. well over 99% of London's population growth over the next three decades will be in ethnic minority groups, Black and S. Asian it's unlikely that the health, education or criminal justice systems will be able to cope as they will all suffer from the birth dearth in the upper ability range (whee people are required to provide such services) and expansion of demand at the other end due to differential fertility.

These public services are already showing major signs of strain. This is the cost of ignoring the nature of diversity and of naively assuming/promoting equality. Even the type of medical problems differ as a function of ethnic (genetic) group membership.

It is not rocket science.

If I am ill such that I need the services of the NHS I should get them. There should be no reference to money from my point of view.

Indeed even such nonsense as having pay-and-display car parks is a disgrace. I have to park miles away (because of excessive double-yellow lines). But I WILL NOT PAY. That is the ultimate bottom line.

I, as patient MUST get treated when I need it, and MUST NOT have to pay a penny.

Like I said, it is not rocket science, and we are one of the richest countries in the world -- so to say we cannot afford it is purely nonsense.

This government is following EU ministers directive of the wholesale privatisation of public services. If a government under invests in a service then people cry for something to be done and of course in comes the private sector looking for some of the billions that is flushing around in the health service. Trouble is the private sector is in it for profit for its shareholders who come first, not the patients. How on earth can sickness make money!!!Of course if it's like the USA then maybe by ignoring the sick without insurance and who cannot afford treatment and medication then fine but the poor...... Labour who intoduced the NHS should stand up to these capitalistic vultures waiting to feed on us and out taxpayers money! But like Blair, Brown doesn't care, as also his cronies looking out for gongs and well paid advisory positions in the likes of United health, Virgin etc.

It isn't until you have a close relative with a serious condition that you really appreciate the NHS. World class treatment without a question as to whether or not you can pay. I have had very little need personally of the service in sixty years but the comfort of knowing that it is there and not having the worry constantly at the back of my mind is something beyond price. We are so very lucky to have this service. Private health care employ numerous people to look for loopholes in order to avoid costly treatment,just when you are least able to contest their decisions

In offering "choice" the Government is admitting that it has no wish to see a uniformly good National Health Service, as then any "choice" would be meaningless.

REWARD FOR UNWELLNESS

British governance connives at, or fails to confront, three onslaughts on the stability of the populace: legal drugs, illegal drugs and mentally degrading TV. British governance promotes gambling, debt, and an adversarial ethos: e.g. law, party politics and pre-emptive war. British governance presides over schooling that minimises awareness that could be achieved through philosophy, psychology and logic. British governance sets a terrible example through exploiting foreign labour to save money. British governance has its head in the sand with respect to increasing rage, misery and nihilism, while trumpeting world-ranking GDP.
If rewarding doctors for keeping us well is laudable, how might we properly reward the self-serving set of oddly motivated but inept-in-the-extreme individuals who enact British governance?

I don't know why people cannot see that "choice" is a bait attached the hook of "privatisation" and "privatisation" will lead to millions suffering while a select few earn lots of profit.

If you think I am just nuts then have a look across the pond, IN the US, 50 million people in cannot afford to get ill - BECAUSE OF PRIVATISED HEALTH CARE !!!!

WE DON'T WANT IT HERE !!!

There is a problem which nobody wants to seem to talk about and it relates to insurance.

Let us say that you have no medical health insurance. You notice a lump or a changing mole. This might indicate either breast cancer or some form of skin cancer.

You know that if had health insurance then you might be entitled to a payment. However, if you take out insurance then you are told you cannot claim within six months, or you must not have a diagnosed condition so you take out the insurance and wait for six months.

In six months you go to your GP who then says what you always knew. You have either breast cancer or skin cancer. You then claim on your insurance.

The problem, if you had gone to your GP when you first knew then something could have been done, however, because you had waited six months before seeing your GP your condition is now terminal. Either that or your quality of life, and that of your loved ones, after surgery, is not pleasant. Oh, and you are going to die.

At least you have the knowledge that you have collected thousands on your insurance, you can live life to the full for those last few weeks of your life. If only!

Investigations showed that you knew and therefore not entitled to any payments. The wonders of insurance. Or you may collect on your insurance and then have to pay for any treatment through the NHS.

A fanciful story, or is there an element of truth?

If I had been asked for my input into choice then this is what I would say.

My father died in the early nineties after being discharged from hospital and on being taken home in an ambulance. His bed was needed and he had a heart attack in the very ambulance bringing him home, he died in the hospital which had just discharged him.

My Mother died just over a year ago and effectively died of starvation and dehydration. She was however treated with dignity and care. She died in the same hospital as my father.

Now I have no problem in saying that if anybody thinks that I am going to die in the same way as my parents then dream on. There must be an alternative and that is that I will choose when I want to die. I want that choice!

If I find out that I have either of the curses of modern living, namely either Dementia or Alzheimers, or any of the conditions which result in me not being who I am, if you understand my meaning, then I will demand an early death.

My way, my choice!

This comment was removed because the moderators found it broke the house rules. Explain.

MISLEADERS II



But dysgenic and differential fertility exacerbated by uncontrolled immigration of thise with low native ability might destroy a nation (or 27) if Mr Frattini has his way. It will certainly cripple the NHS.

Does the Ö÷²¥´óÐã only endorse free-speech (e.g. Reith lecturers) when it's message is arrogantly false and does it practice censure when the message is true? Is this a 'newspeak' policy?

Darwin caused a stir in 1859 (as well as the birth of eugenics) when he published "On the Origin of Species by Means of Natural Selection, or the Preservation of Favoured Races in the Struggle for Life". Moe recently, and at a faster pace since sequencing the human genome, we've come to better appreciate that probably most of the diversity that we observe in human behaviour may be expaained not by how we were brought up/educated, but how point (single nucleotide i.e. SNPs) and more complex genetic mutations (Copy Number Variations) or polymorphisms differentiate our otherewise 99.9% identical genomes, and that gene barriers and assortive mating are likely to make diversity at the group levels inevitable.

Yet whilst most of us know that Chiwawas are different from Great Danes and Greyhounds because of genetics, assortive mating and not environment, there are still some walking amongst us who naturally (and usually no doubt unwittingly) assert Lysenkoist (environmentalist) untruths, effectivey censuring scientific discoveries. To many, this tacit Lysenkoism (envirnomentalism) is just de rigueur. For many, their day to day lives (and incomes) are tacitly premised on this discredited Marxist dogma (e.g. teachers, most psychologists and others in the helping professions) and they wouldn't know what to do if they faced up to the lie, as selection would have to replace 'enrichment'. Is this scotoma a deficit in spatial ability perhaps? Is it gender related? Do they not see that there there's something highly problematic about asserting the efficiacy of environental variables or agencies where in fact there is no good evidence for any of this as conventionally stated. Do they not see a problem proclaiming and even legislating for equality where there is in fact clear evidence for biologically driven diversity?

Do any such folk seriously think that Chiwawahs and Greyhounds should be given equal opportunity down at the track? No - that wold be silly. Would any of them think that Chiwawah's just needed some New Labour funded canine 'Brain Gym', 'SEAL', 'Aiming High' and SureStart (perhaps with drop-in Supernannies, when pups)? Of course not? But with humans, none of this applies seemingly. Is this scotoma not a little worrying?

Is it not time that we demanded that our leaders were driven more by the evidence rather than just asserting that they are (presumably because it sounds good) and isn't it time we stopped censoring the facts? See Earl Ferris (see p.23 2nd Parliamentary research paper link).

One should not, I suggest, expect to argue with empirical reality without being made to feel just a little bit silly. It's how we learn if the truth be known.

This comment was removed because the moderators found it broke the house rules. Explain.

Apologies if any of the above submissions were in breach of House Rules, but it remains unclear to me what the problem is in posting live links to two pdf files, the first of which was to a very readable, published online (by one of the authors, at University of New Mexico), paper entitled 'The Evolutionary Genetics of Personality' published in European Journal of Personality in 2007, and the second was Parliamentary RESEARCH PAPER 05/77
17 NOVEMBER 2005 on the Equality Bill - section D of which was entitled 'Arguments against equality law'.

I was seven years old when the NHS was born and to get over the vested interests of the medical profession Bevan had to 'stuff their mouths with gold' It is still going on today only we call it PFI initiatives. This governments shameful act of pursueing Thatcherite policies will eventually kill off what is left of a noble and proud institution. The Brown/Blair doctrine of wars and private good and public bad has gone so far down the road of destruction only mass action can turn it around and we British don't do that...do we?

DON'T SHOOT THE MESSENGER

theganofone (#19) Have a look through some of the archived threads (there's more than one) where immigration and human rights was debated last November (and see what 'Adrienne' had to say).

The developed world economies (including Japan, Singapore, S. Korea) have a crisis of below replacement level TFRs. It's only ageing indigenous population which temporarily mask the severity of this. For a stirring thought, bear in mind that with a TFR of 1.1 (ceteris paribus) a population will halve in a generation (i.e. 30 years). Some European TFRs are as low as 1.3 (60 years) or lower. Russia is in a bad way. Hence large scale immigration from outside Europe (but at what costs looking at their own stability). So yes, expect more trouble on the streets (and in the schools, polyclinics, hospitals etc) of London (and not just London alone).

/blogs/newsnight/2007/11/the_big_immigration_debate.html

leftieoddbod wrote:

"I was seven years old when the NHS was born and to get over the vested interests of the medical profession Bevan had to 'stuff their mouths with gold' It is still going on today only we call it PFI initiatives"

PFI is basically the same principle as a mortgage: I didn't have 110,000 in cash when I bought my house so I borrowed at 5% over 25 years. My house will basically cost me 240,000 in total. The government doesn't have the cash to build new hospitals outright so pays more in the long term to get new buildings now. I don't think its the greatest idea in the world either but PFI has nothing to do with 'vested medical interests' and everything to do with big business.

Bevans 'stuffing the mouths with gold' was to compensate the doctors for the massive loss of earnings the NHS was going to cause them. If its still going on today then its to stop the doctors all jumping ship and working privately. Personally I think the man/woman who cures my cancer deserves to eanr more than the man/woman who does the paperwork for my house purchase.

If we want the brightest kids to spend 6 years in medical school then another 10 or 15 years working very long hours training to be fully capable consultanst we need to offer them roughly the same pay as they can get in other proffesions.

'Pay peanuts - get monkeys' is a good rule of thumb...

THE TAO OF JADED JEAN

God Save the Jean! I don't claim to understand it all JJ, nor do I take it all as absolute truth (as with all things) but I recognise and salute your effort to address FUNDAMENTALS. So much political ping pong is played out in media and blogosphere, with not a hope of understanding, let alone of tackling, any root cause.
In passing: I have often used the 'dog breed' analogy but suspect there is a flaw, in that dogs are scent-led and would appear to all smell much the same. We, on the other hand, seem to work from other senses (possible I am talking male only here) such that DIFFERENCE (any difference you care to countenance!) can trigger unease, suspicion, antagonism, aggression and killing. This is heightened in the group mind, and by alcohol. Any thoughts?
I do hope some maverick mole in the Newsnight wheelhouse (mixed metaphor?)
will spot a 'gap in the market' and decide to step outside the lie to properly address these issues. They have nothing to fear but
the 'coming of the Campbell'.

DIFFERENCES AND DISCRIMINATION LEARNING

Barrie (#40) We do seem to differ most from other (non primate) mammals in the extent to which our neostrial-neocortical systems are vision and fine motor control dominated and that we are able to delay responding (or exert self-control/behavioural inhibition) relative to more smell, or limbic, paleostrial-paleocortex dominated behaviour of other mammals. But this ability to defer gratification (or plan-ahead and build/calculate with the aid of symbols) may also be where we show most individual differences.

As you imply, we do tend to be levelled by alcohol and other drugs here. Genes and national groups are differentially genetically at risk even here (see Scandinavians, Slavs etc) just as some groups are more prone to Type II diabetes (S. Asians), or prostate cancer (Black Americans/Carribeans) or breast cancer (e.g. Ashkenazi Jews).

The canine reference was (as you no doubt appreciated), essentially just to remind people that they are the same species (can breed with each other), but that they differ dramatically both in physical appearance and temperament/behaviour.

Phenotypic differences in appearance are markers of other genetic differences, and difference does elicit neophobia (fear or withdrawl and if frustrated attack of the unfamiliar - xenophoba being just another contextual word for this with other people as a referent). It's one of the most powerful innate defence mechanisms (probably endogenous opiate mediated) which animals have, so it won't be suppressed without at the same time suppressing our general ability to discriminate and learn - i.e. our intelligent behaviour (although some appear to be trying).

That national health care is in need of reform is not disputed.

Please do not forget that when engaged in that reform, life for many UK citizens will be unsustainable without a free NHS.

To abandon the sick and poor is criminal.

geoffthereff (#42) "To abandon the sick and poor is criminal."

Not unless there are laws proscribing it.

Sady, to many, the sick, the ignorant and the poor, make excellent money-pumps. In fact, the more the better as far as they are concerned.

That this is anathema to many of us is just grist to their mill, alas.

Sadly, there ARE 'evil' (self-intersted and endogamous) people about - they tend to do quite well at other peoples' expense.

Having worked in the Health Service for many years I am very annoyed at the fact that many Hospitals are managed by people who have a background of Commercial business. I think it would be much better to have on the Board a number of Section Managing Doctors/Consultants, a Matron who can co ordinate with all Nurse Managers and Domicilliary Staff and a Chief medical officer who co ordinate with the Doctors and Technical staff Managers. With Ambulance an Mental Health representatives co ordinating with their respective staff. It seems to me that there are too many Chiefs and not enough Indians, so why not kick out the Chief Executives and bring in the people who know what its like to work on the hospital wards and in the clinics. It is a National Health 'Service', not a Business! Leave the Health Specialists to do their job without interference from businessmen and Non Medical Government. They know what they're doing.

NHS PLC (Ref: #44)

Recently, while propped up on a hospital bed, having been 'assessed', I was on the receiving end of some very un-subtle pressure from stethoscope-bloke. He seemed to take it on himself (or to have been detailed) to make me take decisions that would minimise hospital costs but elevate my stress. The guy was so inept as a diplomat, it was more like a Python sketch. My son broke into a broad grin of understanding and I grinned back. However, if this had been done to one more vulnerable, and unaccompanied by an ally, S-Bloke would have won. This was the unacceptable face of NHS PLC.

Those taking part in the programme discussions seem to live in major cities and towns. The large numbers of people who live in smaller towns and villages do not seem to be able to be included or consulted.

There is much talk about choice, but most people live within easy reach of only one hospital, hence their choice is rather limited.
The suggestion that "poly clinics/surgeries" will provide a better service are, I believe, somewhat misguided as most patients prefer to know their GP and other staff and receive good treatment as well.
Remoteness to stimulate the egos of NHS management's ability to create something new - does not generally provide a better NHS