Thursday, October 15, 2009

Free Speech - vital for democracy

Thank you Rita, for information on this

Dr John Hart is the kind of man I admire, he however a fiction. Because what he does can only be done undercover

There is no doubt that the BMJ often prevents free speech and is clearly proud of it. Very few controversial posts are allowed on there. One such post was recently written by BMA member Dr John Hart. His response related to the letter issued to the US and co-signed by numerous people. The letter was entitled Setting the Record Straight About the NHS.

Having waited for sometime for Rapid Response to publish his opinion, he approached us. As the opinion was well written and a true reflection of the NHS today, we decided on publication. There is nothing libelous in the opinion piece therefore we have no idea what the BMJ's justification is for preventing publication.

Recently, he wrote to Sharon Davies in the following terms

"Thanks "very much. As this is a HIGHLY CONTENTIOUS I am writing under a pseudo name (ie Dr John Hart). Can you kindly please ensure that if published it goes under the the name Dr John Hart. I am a member of the BMA"

He then wrote to us

" I sent almost the same to the Rapid responses in the BMJ almost 2 weeks ago and it has not been published"

We present a Response written by a BMA member and clearly banned by the BMJ.

In response to the BMJ Open Letter by 100 NHS professionals & patients on “Setting the record straight about the NHS” by J Hart.

Patient choice

The NHS proudly performs > 500,000 abortions/year at tax-payers’ expense.

We have a recent report on cruelty to the elderly in the NHS

There are limitations on GP services, next year the government plan lifting geographical restrictions

When admitted to hospital, you can be lucky and be looked after by a caring highly skilled consultant or otherwise. In general, you don’t have choice and are assigned to a consultant (among whom there is huge variation in levels of care)

Care for those with pre-existing conditions

UK Private health insurance companies also fails people with pre-existing health problems. Governments must ensure that people with chronic illness get excellent health care.

Care of the elderly

I doubt if the average 77 years old man with a brain tumour (or most surgical conditions especially if complex) in the UK will have as good treatment as someone of 37 years. Neurosurgical units and ICU beds in the NHS are restricted which influences the consultant’s decision on whether to operate or not as in general older patients require more ICU care. There is no official age cut-off in the NHS but practice is often very different. There are at least 4 fold more specialists, ICU beds/million population in the USA than UK which gives choice.

Care of disabled people

Governments must ensure excellent healthcare for disabled people.

Free medication


UK Private hospitals only give privileges to NHS consultants. Once appointed as NHS consultant you get both life tenure and private privileges. Only NHS consultant’s are allowed work in Private hospitals (or receive payment from BUPA)

The cost

If USA health care costs more, maybe that is the cost of competition, good for patient care the economy and employment.

There is usually a set fee to the Primary Care Trust per procedure which leads to a tendency to avoid surgery in more risky patients, whose operations may take longer, have longer hospital stays and may adversely affect statistics.


The NHS is the third largest employer in the world with 1.4 million employees. In 1948, there was resistance by doctors to the introduction of the NHS. Bevan commented that he had to stuff the consultant’s mouths with gold. By this he meant that he had to introduce a merit award system which pays consultant’s extra and which New Labour renamed as clinical excellence awards. Awards are for life and may double a consultant’s salary & pension.

Government “Waiting list targets” are often met by paying consultants extra – classified as “waiting list initiatives”. Consultants often have additional remunerative NHS management roles. There is no competition to the NHS it is almost the sole provider of UK health care. Much support for the NHS is for personal reasons and most who signed this letter are beneficiaries of the NHS.

Politicians know that promising more for the NHS wins votes. Daniel Hannan is to be congratulated for triggering much needed discussion about UK healthcare. Healthcare is complex and I don’t know the answers – NHS, Medicare, Medicaid, Australia, Singapore etc.

Yours sincerely

Dr John Hart

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