More UK Government Harassment Of Diabetics

As I have mentioned before on this blog, I have Type 1 diabetes which comes about because of a disease or a failure in the body, typically before middle age rather than Type 2 which tends to arise from obesity or old age.  For some reason the current government is particularly hostile to diabetics.  As I noted in 2013 we are treated as if we are drug abusers and if involved in a car accident that was not out fault we can be arrested and the perpetrator let off: http://rooksmoor.blogspot.co.uk/2013/04/diabetic-driver-discrimination.html   The difficulty the police have with diabetics was re-emphasised recently as new laws are coming against drugged driving.  Diabetics are being told to carry medical 'evidence' or face being arrested as if we were abusing heroin or cocaine.  This is ironic because, unlike drug abusers, diabetics are highly aware that with care they can maintain good health and prolong their lives, so they tend to safety-minded rather than reckless.  In one step, however, people with a disability (diabetes has been considered a disability legally since 2005 in the UK) are now assumed to be on the same level as criminal and drug abusers.  I might as well have a letter from my doctor tattooed on to my body to ensure that even if I am beaten unconscious by the police who decide to stop me, the medical evidence cannot be lost.

Anyway, today's posting is about something slightly different.  Britain has long been proud of its state-run health service and its welfare system.  However, there has long been a concern that provision should only go to 'deserving people' and that both run the risk of abuse from 'scroungers' and 'fiddlers'.  Diabetes is one of ten conditions which means you get free prescriptions.  The reason for this is that I take four injections per day of two types of insulin and I take four other sets of tablets.  Each prescription lasts me twenty-eight days (when the doctor gets it right, sometime they only prescribe a fortnight's worth).  At the current rate of £8.05 per item I would be spending £629 (US$968; €849) per year just on the medicines, this does not include the needles for the two insulin injectors or the blood test strips which tell me my blood sugar levels and which I have to use 30 minutes before every time I drive and then every 2 hours of a journey, so getting through a pack of 50 a week very easily.  An acquaintance of mine in the USA has to keep down a good job to fund his Type 1 diabetes and it eats into the money he has for rent and food, the costs there are so high.  The UK prescription charge is a fixed rate not what I would have to pay to buy this medication and appliances on the open market.

With the drive of the coalition government to reduce public expenditure to the level of the 1930s they are incessantly trying to hunt down and charge people who are defrauding the system, that is unless they are high salary tax avoiders or bankers.  Today Diabetes UK reported that many legitimate diabetics were being fined for apparently trying to defraud the NHS (National Health Service) by claiming exemptions from prescription charges.  It was stated in the news that most of those affected were people diagnosed before 2000 when the need to renew your exemption certificate every five years was introduced.  Before them you had a certificate for life because at present Type 1 diabetes is incurable.  The NHS Business Services Authority said it was down to the individuals to make sure that they complied with the rules as they now stood.  What was neglected on the news was that even people who do still face fines.

I have had Type 1 diabetes since the 1980s.  In 2000 I was told by my pharmacy in East London that they could no longer serve me without an exemption card so I got one and have renewed it every five years since.  I have a current one at the moment.  However, even this has not spared me for receiving a fine of £96.60 (US$148; €130).  The letter was very threatening and starts from the assumption that you are guilty.  There is only a tiny section which tells you how to contest the charge laid against you.  If you do not pay within a month they add another £48-50 on to the fine.  Obviously I rushed to contest the fine, though of course they were not there on the weekends.  They finally admitted that they were wrong. 

Apparently the problem arose because they had an old address for me and that did not match the one I was now using.  I asked them how it came about that they did not have my latest address.  Every time I move house I have to register with a local doctor and from there my new address goes on to my NHS file and is not only used by the local surgery but also hospitals in the surrounding area so that they can call me for associated checks on my eyes, my feet and my diet.  I could not understand why they did not receive the same information as I had been at this address for seven months already.

It turns out that the NHS Business Services Authority is not connected to the NHS records system so every time you move you have to inform them separately.  All they do is compare fee-exempt prescriptions coming in against a list they hold and if something does not match then they send out a fine.  What this seems to be is a private company doing something for the government as so often is the case these days.  It does not bother with the processes in place and simply applies its own rules, funding itself from the fines it gathers.

There is a further unpleasant aspect to the Business Services Authority's approach and that it utterly disparages the staff working in pharmacies.  As I collect a prescription from mine every two to four weeks, I am well known in there.  However, every time I go in, I have to produce my exemption card and it is checked by the staff even before they accept my prescription.  Clearly however the Business Services Authority has absolutely no trust in the assiduousness or the capabilities of the pharmacy staff even when dealing with patients they are very familiar with.  Their whole approach is an insult to these professionals.

One can imagine that similar cases will come forward from those with one of the other nine conditions that have been treated in the same way.  I do fear that given this government has overseen two steps to harass diabetics what will happen in the next five years if the Conservatives are even part of the government let alone if they have a majority.  This is despite Prime Minister David Cameron having had a disabled son.  What will he next steps be?  To ban diabetics from driving even though no-one has shown any evidence that they are any great risk and certainly not more than the speeding Clarkson-wannabes who apparently are in full health?  Will the next Prime Minister choose to follow the path of Winston Churchill in the 1900s and seek the sterilisation of those deemed to be at risk of 'sullying' the Great British blood?  By 2020 will I find myself at a risk of not simply an unwarranted fine but a summons to an institution to house me where I will never return from and will be lost to 'complications'.  Remember the Nazi regime killed 70,000 disabled people even before they started the Second World War.  Diabetes is an 'unseen' disability so if people with it are suffering harassment what can be expected for those with more visible conditions?

P.P. 24/03/2015 - The Penalties
Just to sum up how horrendous the prejudice is against diabetics these are the penalties now in force that I will suffer as a Type 1 diabetic if someone decides to crash into me.  In contrast, they may walk away with absolutely no penalty.  This comes from the UK government official website:

"Prescription medicines

It’s illegal in England and Wales to drive with legal drugs in your body if it impairs your driving."

However, if you are involved in an accident that was not your fault they still can arrest you as if it was, because as a Type 1 diabetic you are no longer considered to be like normal people.

"If you’re convicted of drug driving you’ll get:

• a minimum 1 year driving ban
• an unlimited fine
• up to 6 months in prison
• a criminal record

Your driving licence will also show you’ve been convicted for drug driving. This will last for 11 years."

So all I need to spend time in prison and get a criminal record is to have one of those Clarkson-deluded speeders shunt me.  If this is not discrimination against a minority, I do not know what is.

We All Cannot Be 'The Apprentice'

I am no fan of the television series 'The Apprentice' in which Lord Sugar is presented with a group of budding entrepreneurs who want to become his 'apprentice' but it has a cultural impact and is discussed on so many other television programmes and on radio that it is difficult to be oblivious to.  In the programme Sugar assigns the group various tasks, sometimes bizarre, involving running businesses and on the basis of their success he weeds them out over the weeks until he is left with one winner.  The job even the winner receives is often very mundane, but being on the programme can help win the contestants attention.  What is most alarming is the nature of the contestants who are all unreformed Thatcherites with a clear belief that they are God's gift to business, and yet ironically, that 'greed is good'.  The 'junior' version of the programme was very alarming, suggesting that it is right for children to be so obsessed with money that they have lost all individuality, awareness of others and, in fact, most of their personality: they have simply become their goal.

The programme reminds me of criticisms from a woman from Hong Kong who I met at university back at the end of the actual Thatcher regime.  She whined that the trouble with the British was that they saw someone in a luxury car and complained about it, whereas in Hong Kong people would be inspired by such a sight to get on in business and make themselves wealthy.  She was wrong both about Hong Kong as she was about Britain.  For a start there was no greater opportunity to succeed in Hong Kong than there was in the UK.  The privileged tend to remain privileged and so do their children.  Occasionally people make a successful business, but ironically in the UK the ones who succeed most are people who have come into the country from the outside, this is why being opposed to immigration is so contradictory with people wanting the UK to be an entrepreneurial state.  The people who succeed in that way are a tiny percentage.  This is why 80% of the UK working population earns less than the average salary and in fact 80% of entrepreneurs do not earn above £20,000 which is in fact less than the national average salary, currently around £31,000.

Thus, even a small percentage of those who have the drive and luck to become successful in their own businesses succeed; 50% of new restaurants in the UK close within 6 months of opening.  However, what seems to be forgotten is that the large bulk of us have minimal ability to be self-employed.  Since human civilisation started the majority of people have been employees, even if it has only been to the head of the family or clan or the local landowner.  Certainly since the rise of industrialisation in the mid-18th century the bulk of us have worked for other people.  You may say we are conditioned not to take the initiative.  Certainly this was the attitude in the 1980s that anyone who was unemployed should be setting up their own business and if they were not, then they had to be lazy.  I certainly had this charge laid at my door in the 1990s.  It seemed a bitter thing to say given the efforts I had made in terms of training and development in order to be an effective employee.  Why should I throw that all away and try and run a business in something which was statistically likely to fail?  It would be a waste of time, effort and education.  Such challenges to the unemployed are returning, though these days it is even harder to raise capital than it was twenty years ago.  The banks, the beloved of successive governments, have created this position through their own failed entrepreneurial efforts and ironically have created a banking market in which it is now harder than ever for new businesses to get funding and so to comply with the New Right agenda of people's business. 

I would imagine if you took 20 ordinary people in any British town 1-2 of them would be capable entrepreneurs.  When I take the boy in my house to school, out of the 60 parents/carers waiting for children to come out of the two classes that make up his year, I know that only two of the families run their own businesses and in one of these the woman only bought into a franchise when she found no-one would re-employ her having been out of work raising children for eight years.  The rest of us are either out of work or are employees.  This is in prosperous southern England too.  The woman who lives in my house, would count as the third if she ever collected her son, but in herself shows why so few, even if they have the skills, would want to run their own business.  She has been self-employed for six years and exports a third or more of her sales.  Yet, despite ploughing back around 80% of her profits into the business (a style of re-investment not common in the UK since the 19th century) she has yet to break the magic £20,000 (€23,600; US$29,800) per year mark and there is a good chance even another six years from now she will not have done.  She would be better off working in a supermarket.  The reasons why she persists is because she has a particular mental approach.  She, unlike the bulk of us, is no good as an employee and much prefers her own business.  However, on pure earnings basis she should chuck it in and head down to Asda to get a job.

Why am I getting so fussed about those who can and cannot be entrepreneurs?  Well, in fact my point goes further than just the divide between self-employed and employed.  We also need to consider the difference between public sector and private sector work.  Of course, the New Right attitude that Thatcher and now David Cameron and George Osbourne subscribe to, is that the state is 'too big'; that people are much better off doing things for themselves.  Sometimes this attitude is sold as we need to get back to small communities providing facilities and charity and that the faceless state trying to do this is unresponsive and bureaucratic.  In fact this is all just a facade.  What the New Right want is capitalism unfettered so that they can increase their profits through no safety regulations, low wages, bad conditions and a compliant workforce.  Cameron with his focus on the budget deficit has a good excuse for pursuing the New Right agenda vigorously and aiming for 25% cuts across the public sector.  Though the public sector is not as broad as, say, in France, it does encompass not only government departments but also elements such as health and education at all levels, and effectively things like transport and utilities though these are in private hands now; they still impinge on how society functions.  Around 6 million people work in the public sector; 530,000 of these are civil servants.  Ironically the greed of UK banks actually led to the increase of the public sector when the state had to take over Northern Rock, HBOS and Lloyds.  If they had been a bit less greedy these banks would still be in private hands, probably Spanish, US, Australian, Danish or Chinese hands, but still privately owned.

Having worked in the civil service, which is mainly what people think about when they refer to the public sector, I know that a lot of civil servants are perfect for the job.  They are polite and efficient but they are not sales people or marketeers.  They can run the administrative machine well, but are never going to get you to buy a used car.  With the haranguing of the civil service for the last thirty years, no-one dare be inefficient.  Often the staff work long hours and the pay is very low.  In 1994 I left a job in the civil service paying £8,600 per year; aside from me everyone in my office including all but one of the managers, had one other job, some had two others.  I was supposed to work 37.5 hours per week but regularly did 50 hours.  My next job was £9,500 per week for 15 hours.  In 2001 I applied for a job as a tax inspector and would have earned £13,000 per year at a time when the average salary had passed £20,000 per year.  I applied two weeks ago for a managerial post in the civil service overseeing a whole office of staff and yet paying £24,000 per year.  No-one works in the civil service to become rich and yet they keep being told they need to be cheaper.  In the 1980s under the Rayner reforms around 250,000 civil servants were laid off.  Since then the number has risen again.  However, David Cameron says he wants to see a reduction of 500,000 staff across the public sector.  This would mean the end of the civil service so implies heavy cuts in health and education too.  Local government, (2.256 million, including 42,000 social workers) education (there are around 460,000 teacher posts alone; some held by more than one person) and the National Health Service (1.431 million in hospitals, community health and general practice) employ 4.507 million people, 16% of the UK workforce.  As you can see taking 500,000 people from these sectors in the next 5 years is going to have huge impacts often on the most vulnerable people in society.  In addition, in times of high unemployment as we are now quickly experiencing, more civil servants are needed to administer the welfare system and employment in the civil service always rises as unemployment does.

Cameron has said there will be no rise in unemployment because the booming private sector will mop up all of these people.  For a start the private sector has shown no signs of booming in the past few years.  Second, there is an all too easy assumption that a former civil servant or nurse can simply become an effective call centre worker or sales person.  Setting aside all the education and training it has taken to get someone to be a decent nurse or civil servant, if these people had the desire or aptitude to work in the private sector they probably would have done long ago and so got higher salaries and not be abused by the public, the government and the media all the time.  One thing that the Conservatives overlooked since the 1980s is that their policy of encouraging home ownership and permitting landlords/ladies to have the upper hands over tenants, especially fixed-term rental contracts, is that it makes for a very immobile labour force.  When people will lose on their house sale or are tied into paying rent on a property they have vacated months ago, then they are going to be reluctant to move to where work is.  If they want the pool of terrified, fluid labour that they so desire, the Conservatives need to move beyond simple bullying to the structural factors which hamper that.

The New Right, in control of the Conservative Party now, has no sense of the Old Right support of public service.  This is ironic as Cameron's government is keen to laud it when it occurs in the military but no when it appears in civil society.  There will be no easy transition for many people from the public to the private sector.  Customer service in the UK is appalling, just ring up your utility company if you want to find that out and it will jar with the bulk of former public servants.  Of course, many will buckle under because they have to, but in turn they and their neighbours will suffer as the education, health and local amenities deteriorate as the nurses, teachers and civil servants are compelled to go and work for the exploitative elements of the private sector, happy to impose long hours and low pay on workers scared by unemployment.  The sense that there will be no sharp rise in unemployment as the public sector is culled, is an utter fantasy. Loss of the income for public sector workers will further dent consumption on the back of the VAT rise which will do an excellent job of slowing consumer-led recovery.  The rump public sector that will remain will be less efficient and so more ordinary people will suffer.  We cannot all be entrepreneurs and even if we were, many of us would fail or even if we succeed would be poorer.  The same applies to going into the hundreds of thousands of private sector jobs that are supposedly going to appear.  Even if they did, people are not interchangeable parts and the 'frictional' unemployment will rise sharply even if new vacancies do appear and no-one as yet is even guessing where these are supposed to be coming from.  We are heading back to 4 million unemployed as quickly as the Conservatives and their ultra-rich supporters can engineer it.  As a by-product the public services that the large majority of us depend upon will deteriorate, but of course, the true beneficiaries of Conservative policy have the money to buy their way away from that and damn the rest of us.

NHS: Not Perfect But Far Better Than The US Model

Every day seems to bring another story of how the greed of corporations, many of which seemed to have secured a cartelised or a monopolistic position, is distorting the economy and society. The credit crunch was stimulated by corporate greed, but the high bonuses that leading members of Barclays Bank are receiving while so many of us are without work or are losing our houses, have shown, it is not they who are paying the price. The clearest flexing of corporate might in the world at present is the concerted oppositon by health insurance companies in the USA to prevent President Obama introducing a free health care service in the USA to cover the 46 million Americans who have no health cover. That represents about 1 in 6 Americans who lack access to any health care that is not charitable; it is equivalent to the population of Belgium, Spain and Poland put together and is more than the number of adults in the UK. In addition, as many people who buy health insurance in the USA find it does not cover them if they develop a serious illness nor for existing conditions. Unsurprisingly life expectancy is lower in the USA than the UK, there are fewer only 70% as many hospital beds per head of population and infant mortality (i.e. children under 5) is 9 per 1000 compared to 6 per 1000 in the UK. Out of a population of 304 million, that means over 910,000 more children die each year in the USA than would be the case if they had the UK system. This is despite the fact that the UK only spends 8.3% of its GDP (Gross Domestic Product) on healthcare compared to 16% in the USA, which suggests Americans are getting a more costly but less efficient service. In the UK, sometimes hospitals get overloaded but we do not have the situation as often occurs in the USA where an ambulance has to drive from hospital to hospital trying to find one that will take their uninsured patient. British hospitals need to have an increase in capacity and staffing, but never turn people away no matter what their nationality or background, simply because they lack the right insurance.

There are a number of sickening elements about the opposition to Obama's plans. One is that they are being portrayed on a moral basis. This is that somehow state control will lead to 'death panels' deciding when people have to die. This happens now de facto anyway, when families can no longer afford to fund keeping their relative alive. However, in the twisted US morality, ability to afford determining life expectancy is right, deciding on life expectancy depending on quality of life, is somehow wrong. The lie about 'death panelss' can be seen easily if you simply look at the fuss that has arisen in the UK about people even travelling to Switzerland for assisted suicide let alone any consideration of it being permissible in the UK. To conjure up this lie is just a scare tactic and to associate it with reference to British healthcare is offensive. Of course, Americans never consider any other country's viewpoint, so any indignation in the UK or Canada is dismissed as nothing.

The anti-public health care lobby in the USA has drawn support from the religious right who say they want freedom, whereas in fact they want to control people's lives far more than so-called 'big government' does, getting down to controlling their behaviour behind closed doors as well as in public. They lie and say public health care will lead to the elderly being advised every five years when they should end their lives. This is perverse fantasy dreamed up by companies wanting to kill any legislation that they feel would even minutely dent their income. To liken the NHS to approaches adopted by Hitler and Stalin offends not just British people now but also the memory of those who died opposing Hitler and Stalin, among them, Americans. Rick Joyner, a US pastor, has said that if Hitler and Stalin had had health care systems like the NHS it would have made it easier for them to kill millions of people. He forgets that they still killed millions of people and yet the NHS has kept millions of people from dying and suffering over its 61-year history. How patronising is that attitude to the people of the UK to think that we would sit by with a system that did us such harm for so long? Which plaent is Joyner referring to? Clearly not the one he is actually living on. These Americans are so arrogant that they somehow even seen decent, Christian Britons as imbeciles.

What gets me is that Obama's package is primarily aimed at those people who currently do not have health insurance, so why is it any concern of the companies that these people receive a service provided by the state? In that typical arrogant American way, they get offended even if anyone considers thinking differently to their assumptions. In addition, as the sub-prime mortgage fiasco proved, they always hope they can penetrate into those sectors of society not currently buying products from them, however risky or unsustainable such penetration is. Do they not understand that if these people could afford health insurance they would have bought it? They are offended that the state might provide a rival to them in getting health cover to these people, however remote the chance of them ever affording health insurance. US corporations, despite the anti-trust laws of the past, have become so used since the 1980s of having no limits to their activities that to see anything that intervenes in an area of the market, even one they are currently absent from, is an anathema to them.

The second sick thing about the opposition to health care proposals is how these people have attacked the public health care systems of the UK and Canada. Again, being Americans, they believe they have a right to make judgement over anyone else's system and yet not be judged themselves (refer back to my comments on the USA seeking exemption from war crimes laws). They portray the National Health Service (NHS) as somehow an evil system and inherently wrong in its philosophy and behaviour. Living in the UK, I know how clunky the NHS is. It is far from perfect, but ironically a lot of the problems it is currently facing, especially over hygeine in hospitals, stems from the situation created when the Thatcher government of the 1980s tried to move the service in the direction of the US model. If the internal market and competitive tendering for services, including cleaning, had not been introduced, then many more people would be alive today and the NHS would be in a better state. The reason why health in the general population is better in the UK than the USA is because of the NHS. It is not simply about treating people, it also does excellent work in preventative information too, to try to reduce the impact of the health challenges of modern living such as obesity, alcohol and tobacco consumption. The NHS is not perfect. I think it needs massively more funds. I would fund it to the extent that prescription charges introduce in 1950 could finally be scrapped and the care was free to everyone at point of use. The cap on National Insurance was taken off far too late. Everyone needs to pay towards the service and in accordance with their wealth. It is no argument to say that they will not use it. If the rich like they can see it as an insurance that their cleaner will not drop dead or that if they hit someone in their car while speeding, they will not get charged with murder because their victim will live.

I am glad that Gordon Brown, John Prescott, Lord Darzi and the trade union Unison are taking a strong stand against the Americans 'slagging off' (in Lord Mandelson's phrase) the NHS. I despise Mandelson, but am glad he is adding his weight to the defence of our health service. The maverick Conservative MP, Daniel Hannan, who feels that the NHS is an excessive burden on the UK, has a right to his opinion, but it is one that should be strongly contested, ridiculed even. The opposition to Obama's proposals is terrible, immoral and will lead to deaths. We cannot tell how many Americans have died unnecessarily because this opposition prevented Bill Clinton's 1993 health proposals being put into action, let alone the countless lives that have been blighted. This is about people's lives in exchange for profits, well not even that, in exchange for the imagination of profits that could be made and the fight to stop anyone involving themselves in that. Of course, Americans, especially on the extreme right, who feel under pressure now Bush have gone, feel they have the right to tell not only Americans but the whole world how to live. This leads to the deaths of not only Americans but people across the globe. The NHS is not perfect, but it is far, far better than the system the USA has. The American right profess to believe in God, but their god wants health care to be inaccessible to millions of people who will suffer as a result and prefers that people make bigger and bigger profits than care for others. Whoever their god is, he is not the God that millions of Americans and others believe in. Non-Americans need to stand up and tell Americans to stop using what we have done well as a weapon for their own perverse arguments. Britons are proud of the NHS and the vast majority want it improved not scrapped. Any American who falls ill in the UK can go to an NHS facility for emergency treatment, the reverse cannot be said of Britons in the USA. Of course, that does not matter to these opponents of Obama's proposals, they care about no-one, not even other Americans, just their potential to make money. May the NHS prosper and grow and be a model for decent, truly moral people to look to, rather than misuse as a tool for greedy objectives.