Friday, January 19, 2007

Living in the UK: NHS and BBC

There are two institutions in the UK with which everyone living here comes in contact sooner or later. Both of these institutions symbolise something that can be either called "big government" or "quality through solidarity", depending where one stands. These institutions are the National Health Service (NHS) and the British Broadcasting Corporation (BBC). Both are often in the news and a constant source of discussions.

This is especially true for the NHS. It was founded in 1947, and it provides free health care to everyone in the UK. This is financed by taxes - the NHS is a big budget item every year in the country's budget. In principle, this is a great idea: everybody can receive health care, independent of their income. For somebody who has lived in the US, with its dismal non-existent healthcare system, this is quite something remarkable. But in practise there are big problems: the care for patients here in the UK seems to be somewhat substandard. Last year I had one encounter with the NHS, when I got a flu and decided to try them out. First, one needs to be registered. So I made an appointment for visiting the GP (General Practicioneer) in my neighborhood. I could not choose my GP freely - instead, I have to select from a few "surgeries" around my place of living. This is the first thing that bothered me. What if I wanted to go to a "good" doctor, about whom I might have heard, and who was recommended? I would not be allowed to go there...

The surgery I went looked quite run-down (actually it fell victim this summer to arson), with shabby furniture. The employees seemed to make the best of it, being friendly, with a good upbeat attitude. But they could not mask the general feeling of being in a government-run institution in which they could not really make a difference.

When I went to my appointment, I had thought that I could get a visit of the GP too. But now, the visit was only for the registration. For seeing a doctor I would have to come again some other day, because they are not available in the afternoon. Now that sucks....

I decided at that time not to make that 2nd visit. It would actually not be an appointment, but just a walk-in - with the "great" prospect of waiting for a few hours. Making an appointment is not possible. Well, this is typical for government-run institutions - no service for the customer.

So instead I tried the cost-reduction-version of NHS: the NHS Direct. I could phone in, describe my symptoms to a nurse, then get advice on what to do. She told me to buy some medication from the "chemist" (pharmacy) which I did.

Ok, this worked out ok, I got healthy again. But what if something more serious would happen? I do not dare to think about that. Waiting time at hospitals for non-emergency operations is many months. When wanting to see a specialist, I would have to get a referal from my GP - what if he/she does not give me that referal? There have been cases when - through cost cutting efforts - referals are not given or are delayed.

Also, recently in the news were more and more cases where the NHS declined to pay for the medication of seriously sick people (e.g. for a cancer drug) - the "Beckhams" even had to chip in and pay for the medication of a young boy who is chronically ill.

On the other side, the wages of NHS employees have dramatically risen over the past 3 years: the annual GP salary moved from about 80k pound to almost 120k (see article), with top salaries around 250k. I think this is top of the world - not even in the US they earn that much.

So something is deeply wrong here - but what to do and how to fix the NHS?

The other British flagship of government-provided service is the BBC. Of course, the situation here is a bit different: the BBC provides actually a state-of-the-art service, with some of the best TV programming in the world. It has high-quality content, and top technology. Yes, they also finance Augmented Reality research! But what is the price for this?

Everyone who owns a TV, has to register and pay an annual fee of 131.50 pound per year, that is $250. Quite an amount. And the whole sum goes to the BBC - none of the other broadcasters (ITV, Channel4, ...) gets a piece of this. I wonder if this is justifyable...

The amount is quite large, and I would commit an offence if I would not pay. This is, in my view, quite an unfair government subsidy to one single company. What, if I would decide not to watch BBC anymore? Why would I have to pay for it? Actually, the same system is implemented in Germany... but at least there, two independent TV companies (ARD and ZDF) get the benefits of this fee which is currently a bit over 200 Euro per year (which comes to the same amount as here in the UK).

The benefit of this fee is of course that the BBC TV and radio programs are free of advertisement - quite a relief. But this guaranteed income has the danger of bloating the BBC - why would anyone in BBC management try to safe money and be lean and efficient, when the funding is "extracted" from viewers with the help of government authority? It would somehow be better it users had a choice: they could decide if they want to pay for it or not - as a pay TV, like the satellite TV Sky. Of course, there would be the obvious complaint coming from the BBC: "We would then be underfunded.". My reply would be: "You do not seem to trust in your own programming, that it can attract enough people to watch it."

But then again, when I scan through the 4 BBC TV programs, listen in the car to BBC Radio 4, get my latest news updates on the BBC website, or watch such jewels as the TV series Little Britain, I think that my money is actually well spent.

Of course, Channel 4 demonstrated more than 10 years ago, that also without such guaranteed income a high quality TV program could be produced - Father Ted (also on Wikipedia. Just check on YouTube for video sequences from this hilarious series, and you know what I mean.

Long live the British humour!!!