[from "The Birth of a Service", 2008]


The National Health Service has not been, is not, and never will be perfect. It is operated by humans for humans, and therefore necessarily subject to the failings to which the human condition is susceptible. While setting out to be all things to all people, it has to be limited by funding and resources. None of this should ever be allowed to detract from the inestimable benefits it has bestowed on so many people, and the shining example of humanitarianism, the care for one's fellow creatures, embodied in its concept.

In countering any criticism, it is fashionable to point to the situation in countries which are not so blessed, and, usually, the United States of America is the whipping-boy. In this instance, it might be enlightening to cite the case of a man identified in American medical case-histories as John O'Connor. Mr. O'Connor was fifty, and until the day of his admission, was in perfect health, and had never had a day's sickness. He was admitted to the Massachusetts General Hospital in 1969, literally at death's door, with a temperature of 108 degrees, and a white blood-cell count of 30,000 (normal would usually be between 4,300 and 10,800). At first he continued to deteriorate, and during the 31 days he was a patient, he was seen by consultants in every speciality the hospital had, or could call in, had every test for which the laboratory was equipped, and every treatment which could be suggested. He was discharged fit and well, which might not be remarkable but for the fact that from that day to this, his illness has not been diagnosed, and though they undoubtedly saved his life, it is therefore unknown which of the treatments was successful. On his discharge, his debt to the hospital was $6,172.55, a few dollars less than his total annual income; his bill, when it was printed out, was 17 feet long.

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