Illness, which I suggested in Part Two, is not an easy condition to determine. Here I want to begin to look at things that we might all consider to be “not-illness” but with which the National Health Service is lumbered – mainly. I would suggest, as a result of unintended consequences.
At all times we need to remember that the founding fathers of the NHS really did believe that as the NHS improved the health of the nation so the costs involved would reduce. This was but one of the many serious mistakes that have been made by politicians over the years.
First up, then, is being old: being old is not an illness (which is not to say that old people do not become ill). Being too weak to do the housework properly or to go out shopping is not an illness.
In the old days people in this situation were usually cared for by their families or friends. That is how it was for my grandmothers, both of whom lived with the family after their husbands died. Would we have done the same for my parents? My father looked after my mother until she pre-deceased him and then we did offer him a home with us. He preferred to be independent and remained quite able to look after himself until a few days before he died.
Some, sadly, received no such care and generally succumbed to one of the illnesses that the old and frail are prey to: pneumonia, influenza, etc. It was not all good and that was not a golden age.
Now the position is different. In part it is that “nanny state” has taken over but we cannot just put the blame on that. We have all enjoyed more personal space than previous generations and all (old needing care and young capable of giving it) hate the idea of losing that personal space. Multi-generation families together are now a rarity.
Then there is a difference between the relationships of parents and children (and thus grandparents and grandchildren). It is all, frankly, a right old muddle. It is probably true that the parents of those born in the 1960’s or 1970’s were the first who wanted to be friends with their children – and that has had interesting consequences that my wife sometimes explores in her novels (where, unlike here, there is room for such thoughts).
Back to the frail but not ill. Within the concept of our modern society there is a requirement for the needs of the vulnerable to be met but this should not be the job of the NHS. How has it become the dumping ground for other authorities who will not (perhaps cannot) take responsibility?
* * * * *
Does being hurt in an accident qualify as ‘being ill’? Not according to insurance companies who separate out illness and accident when offering cover. Even then there are limits to what they cover. The following is rather interesting: it is taken from the Key Facts Sheet issued by Aviva regarding their personal accident insurance. I have put the three really interesting ones in bold.
What are the significant or unusual exclusions or limitations?
• War and similar risks.
• The Insured Person serving on active duty in any Armed Force.
• Suicide, attempted suicide or self inflicted injury,
regardless of their state of mind at the time the incident
• Accidental Bodily Injury does not include any sickness,
disease, bacterial or viral infection (unless this is a direct
result of an accidental bodily injury), naturally occurring
condition or degenerative process, or the result of any
gradually operating cause.
• Deliberate or reckless exposure to danger (except in an
attempt to save human life).
• Radioactivity. Any claim caused by ionising radiation, or
• Participation in any crime which that involves deliberate
criminal intent or action.
• Pregnancy, childbirth, miscarriage or abortion.
• Flying other than while travelling as a fare-paying
passenger on a licensed aircraft.
• Hazardous pursuits.
• Intoxicating liquor or drugs taken by the Insured Person.
• Driving or riding any vehicle while the alcohol level in
their blood is higher than the legal limit of the country in
which the accidental bodily injury occurs.
Is riding a cycle through a red light at a road junction “deliberate or reckless exposure to danger”?
Is riding a horse “a hazardous pursuit”?
Is tripping over a kerb stone, falling and breaking a wrist after a glass of wine or a pint of beer going to present you with a problem when you make a claim?
In all these cases, I’m pretty sure that an insurance company would refuse to pay up. Not so the NHS: all of these would be treated without charge and without any thought of there being a charge. All. A rather sideways thought: unless attended to by the A & E department in accordance with the targets laid down there will be trouble for the people running the department – and none for the idiots who, through their own stupidity, arrived there in need of care.
I hope that doesn’t make me sound heartless. That is the fate for anyone who tries to take a rational look at the way the NHS has developed. Of course we want these people to be looked after but if we go on as we are the level of care will fall away as funding becomes more and more impossible. However, if we want the service to survive we must decide what it should be doing – and what it should not. So far we have looked at no more than the tip of a very big iceberg.
How do they manage these matters in other countries? We’ll look at that question in the next blog.