The health of nations

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.

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6 Responses to The health of nations

  1. Stuart Sorensen says:

    Wow. What a cracking little piece. These are the kinds of comparison that we really need to make more of in UK.

    I edit Care To Share Magazine. It’s a free online monthly focusing on social & health care issues. We’re on wordpress so feel free to check us out here:

    Would you mind if I put this blog in the next issue? You’ll get full credit & a backlink to your blog but I can’t pay you. Part of the point of Care To Share Mag is that it’s completely free & non-commercial.

    Please let me know either way if that’s OK.



  2. kizza says:

    have been reading this blog and as a Ugandan find it rather insulting. I was actually diagnosed with a serious aliment in Uganda at a very good hospital which the NHS failed to diagnose(paid £60 for consultation medication etc..).Your comment about cake tasting better in the UK well that is probably because we us natural ingredients in Uganda your pallet is obviously used to additives added to nearly everything in the western world.

    • britishgaz says:

      Hi kizza – not sure why you are insulted and that certainly wasn’t my intention. My point about healthcare is that the best care should be free for everyone. I didn’t say that cake tastes better in the UK, I commented that cake is different in Uganda and that I miss British cake. Good day to you.

  3. David W says:

    Nice one Gareth! One of several lines that got to me was your “guilt” at “using a facility beyond the reach of the general population”. How many people feel this? Some obviously don’t, but if the starting point of healthcare is that it is a universal good accessible to all irrespective of their income or wealth – something that can easily be justified economically by the potential, financial and otherwise, of every human being – some level of guilt at receiving better treatment is surely inevitable. The NHS cannot always provide the very best of care in every single case, but the day it ceases to aspire to provide treatment that is, in principle, at least equal to that on offer privately will be the day it dies.

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