30.05.1996

NHS pocket calculator

Last week an 11-year old girl died after a six-year battle against leukaemia. Tragic, but not in itself exceptional.

What was exceptional about this death was that the case of Jaymee Bowen, earlier known as “Child B”, highlighted key problems of the National Health Service before her untimely death.

Dealing with leukaemia involves highly expensive treatment, including radiation and chemotherapy, bringing unpleasant side-effects for the sufferer, but which merely staves off this essentially terminal illness without destroying it. The NHS administrators of our time are increasingly reaching for their pocket calculators to determine whether to treat or not to treat. This is part of the capitalist ethic of the “bottom line” which has eroded the NHS, like so much else. To put it most crudely, life has a price tag.

Army doctors in wartime are accustomed to separating the wounded thought to have a chance of recovery from the ones thought to be beyond medical help. This is particularly the case during major battles, when the surgeons are swamped with cases.

A feature of the new ‘cost-effective’ NHS is that its administrators in the modern and peaceful UK are acting more and more like captains in the Royal Medical Corps at the Third Battle of Ypres, 1917.

That said, terminal illness and injuries leaving permanent effects do raise problems not to be dismissed with a flick through Das Kapital. Some have even suggested that advances in medical science prolong suffering rather than relieve it. To return to the World War I parallel, progress in the medical sphere kept alive many soldiers hideously smashed by shot and shell who would have died of their injuries in previous wars. But what kind of life did these limbless, faceless men have?

The treatment Jaymee was refused by the NHS was granted through a private benefactor. Few will have the luck to attract the attention of the rich, however. Answers to the problems of serious or terminal hospital cases cannot be found by looking to rich and charitable individuals. They have to be found by the collective and by society as a whole.

At the moment healthcare and medical science, like all other areas of science or the daily needs of people, are being developed or rationed according to the profit motive.

Scientific discoveries are patented rather than put at the service of society as a whole. Childcare facilities, education, the arts - you name it - are all determined by money and what the working class has to fight for.

An individual’s life is not valued according to human-social questions and the quality of life of humanity as a whole, but by whether this individual is lucky enough to be allocated the money for treatment.

The push to private health is the logic of a survival-of-the-most-privileged world, rather than one which has at heart the interests and development of society as a whole.

Andrew MacKay