A friend of mine had problems with asthma this morning, so off we went with travel insurance certificate in hand to the hospital for foreigners. It wasn’t extravagant, and it reminded me of an NHS walk-in centre, except there was a cash desk in the foyer. We waited about half an hour before my friend was seen by a doctor, who ran some tests and dispensed a sizeable bag of tricks from the on-site pharmacy. It wasn’t as expensive as I had imagined, but still unaffordable to the average Ugandan.
On the way there, we passed a government hospital. If we were Ugandan then we probably would have had to join one of the queues of patients that wound out of the main doors and around the car park. I’ve seen the facilities in smaller government clinics and the buildings are basic to say the least, although there is of course a fair amount of modern kit. Drugs are less readily available.
Now, I’m no expert on health policy and I don’t know much about the system or the outcomes in Uganda. I do know from interviewing people living with HIV in Wakiso District that getting ill here is usually a costly business and even if you are treated for free you are still likely to be faced with logistical problems and struggle to cover your transport costs.
If I get ill while I am in Uganda then I will have to pay for treatment (albeit via an insurance company) wherever I go, so it wouldn’t make sense to go anywhere other than the best clinic available to me. I would, however, feel quite guilty using a facility beyond the reach of the general population.
But when I need healthcare in Britain, I receive good quality care and I don’t feel guilty, just fortunate. Ugandans don’t require an affordable private healthcare system, they deserve a good quality health service that is free to everyone according to need.
Every now and then, someone writes a comment piece saying that the NHS should be a safety net for the poorest and the general population would receive better care via private health insurance. Government policy is driven by a need for private involvement and competition. Today’s brief adventure reminded me how wrong that is. If you have a free service for the poor, the service will be poor. The private clinic we attended was better than the alternative, but it was no better than a public facility in London. Patients pay for a level of service they could receive for free from the state in a properly structured and funded system.
We in Britain should never forget how important it is to protect our National Health Service from whichever government of the day would like to mess it up.