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One of the things I think will probably happen is that the US public will shift to be more favourable towards a primarily public health service such as many oth

One of the things I think will probably happen is that the US public will shift to be more favourable towards a primarily public health service such as many other countries have in one form or another. As a Brit, I am very sceptical of that. In the UK this crisis is painfully exposing the deep structural flaws of the NHS. The UK is now at the bottom of the world leaderboard for testing, because its 100% centralised and government run healthcare system has totally failed at scaling up capacity. One reason - it's actually refused and ignored testing capacity in the private sector. e.g. here's a firm saying they could run lots of tests but the government hasn't returned their calls https://www.telegraph.co.uk/news/2020/04/15/british-company-can-deliver-one-million-coronavirus-tests-per/ https://www.telegraph.co.uk/news/2020/04/15/british-company-... Here's another analysis that mentions private sector companies being baffled by lack of swabs being sent to them: https://reaction.life/why-is-the-uk-so-slow-at-increasing-testing/ https://reaction.life/why-is-the-uk-so-slow-at-increasing-te... Places like Germany have an apparently much lower death rate because they're testing far more aggressively. Why is that possible, well, because there's no ideological problem with involving the private sector in healthcare like there is in Britain. It's really hard to fail more severely than the UK has done. It's uniquely terrible at handling this crisis, and that's the fault of its unique healthcare system. Nobody rational in America will look at this performance and say, yep, that's what we need. nations that do follow the science and support their healthcare professionals and ultimately get it under control to a useful level are going to be very wary of undermining that progress So far the data says the epidemic is basically following the same path everywhere, regardless of what governments do. There appears to be no correlation between how governments reacted and outcomes, so no, nowhere is going to be blocking travel to the US because of coronavirus. As for "follow the science", that phrase is being used mostly to mean "listen to epidemiologists". But their models are all being disproven in real time, over and over again. Nobody is going to have any respect that so-called science when this is over. It simply is incapable of making accurate predictions. It's no more a science than economics is.

Silhouette 7y ago
There are some serious questions to be answered about the UK's response. However, those concerns mostly seem to originate with the political leadership (or, arguably, the lack of it) rather than the NHS itself. It has never been the case that the NHS was the only provider of healthcare facilities in the UK or that it did everything "in house". We have biotech firms and medical equipment providers and direct clinical healthcare services in our private sector, too, and the NHS works with many of them routinely. Some of the big questions seem to be about why the government and NHS aren't making use of the capabilities those organisations might be able to provide in this particular situation. I'm not sure the data we have so far does support your claim that everywhere is on the same path regardless of government response. Indeed, your own example of Germany suggests otherwise. There are also the (relative) success stories in Asia where they appear to have managed to avoid imposing the heavy restrictions we've seen in Europe without letting the virus get out of control. The widespread use of testing and the willingness to engage in population-scale track-and-trace programmes seem to be recurring themes in the places with better outcomes so far. It looks like the thinking from governments in the UK and other locked down European nations is rapidly evolving to these heavy lockdowns being unsustainable for more than a few weeks, but possibly being a useful bridge to a time when we can adopt a track-and-trace strategy with a manageable number of cases. This brings us back to the same questions yet again about testing and engagement by the UK leadership with other facilities that might be available.
DanBC 7y ago
The body you intend to complain about is not "the" NHS, but the government Department for Health and Social Care. > The UK is now at the bottom of the world leaderboard for testing, because its 100% centralised and government run healthcare system has totally failed at scaling up capacity. The NHS had capacity. The DH&SC decided that testing wasn't worthwhile. (I disagree with them, but they were saying that covid-19 is so contagious and testing doesn't affect the treatment someone gets so there's no point testing them, and when they made that decision we didn't have reliable antibody testing). > One reason - it's actually refused and ignored testing capacity in the private sector. That's not a decision for "the NHS" to make. Testing the population for Covid-19 would be Public Health England, not the NHS. PHE has a central arm, but is mostly split out to local authorities. But PHE can't make that decision if the minister has said not to test. > because its 100% centralised and government run healthcare system That's not at all how the NHS works in England. It's mostly not centralised. Most commissioning is done locally by Clinical Commissioning Groups. They buy services from NHS providers who, again, are mostly local organisations. There's some central commissioning, but that tends to be very specialised services. ("inpatient mental health treatment for deaf adults", for example.)
- thu2111 7y ago
  Ministers have been saying test for a long time now. But if you want to play civil servant lawyer and argue "any failing part of the British healthcare system isn't really the NHS", go for it. From the international perspective nobody cares. Public Health England is the Department of Health is the NHS is the government. How the government divides up responsibility between variously branded bureaucracies doesn't alter the overall outcomes, nor the reasons for them. The UK centralised all CV testing in a bureaucracy that was quickly overwhelmed, didn't scale up, didn't involve the private sector and didn't react quickly to need. Privately run healthcare systems managed all these things.
  - DanBC 7y ago
    Here's a politician saying it's the fragmentation, not lumbering centralisation, that has caused problems for the English response to Covid-19. https://twitter.com/Debbie_abrahams/status/1252881474459537411?s=20 https://twitter.com/Debbie_abrahams/status/12528814744595374... Newsnight have a good point when they say the Lansley reforms caused problems.

Silhouette 7y ago

There are some serious questions to be answered about the UK's response. However, those concerns mostly seem to originate with the political leadership (or, arguably, the lack of it) rather than the NHS itself. It has never been the case that the NHS was the only provider of healthcare facilities in the UK or that it did everything "in house". We have biotech firms and medical equipment providers and direct clinical healthcare services in our private sector, too, and the NHS works with many of them routinely. Some of the big questions seem to be about why the government and NHS aren't making use of the capabilities those organisations might be able to provide in this particular situation. I'm not sure the data we have so far does support your claim that everywhere is on the same path regardless of government response. Indeed, your own example of Germany suggests otherwise. There are also the (relative) success stories in Asia where they appear to have managed to avoid imposing the heavy restrictions we've seen in Europe without letting the virus get out of control. The widespread use of testing and the willingness to engage in population-scale track-and-trace programmes seem to be recurring themes in the places with better outcomes so far. It looks like the thinking from governments in the UK and other locked down European nations is rapidly evolving to these heavy lockdowns being unsustainable for more than a few weeks, but possibly being a useful bridge to a time when we can adopt a track-and-trace strategy with a manageable number of cases. This brings us back to the same questions yet again about testing and engagement by the UK leadership with other facilities that might be available.

DanBC 7y ago

The body you intend to complain about is not "the" NHS, but the government Department for Health and Social Care. > The UK is now at the bottom of the world leaderboard for testing, because its 100% centralised and government run healthcare system has totally failed at scaling up capacity. The NHS had capacity. The DH&SC decided that testing wasn't worthwhile. (I disagree with them, but they were saying that covid-19 is so contagious and testing doesn't affect the treatment someone gets so there's no point testing them, and when they made that decision we didn't have reliable antibody testing). > One reason - it's actually refused and ignored testing capacity in the private sector. That's not a decision for "the NHS" to make. Testing the population for Covid-19 would be Public Health England, not the NHS. PHE has a central arm, but is mostly split out to local authorities. But PHE can't make that decision if the minister has said not to test. > because its 100% centralised and government run healthcare system That's not at all how the NHS works in England. It's mostly not centralised. Most commissioning is done locally by Clinical Commissioning Groups. They buy services from NHS providers who, again, are mostly local organisations. There's some central commissioning, but that tends to be very specialised services. ("inpatient mental health treatment for deaf adults", for example.)

thu2111 7y ago
Ministers have been saying test for a long time now. But if you want to play civil servant lawyer and argue "any failing part of the British healthcare system isn't really the NHS", go for it. From the international perspective nobody cares. Public Health England is the Department of Health is the NHS is the government. How the government divides up responsibility between variously branded bureaucracies doesn't alter the overall outcomes, nor the reasons for them. The UK centralised all CV testing in a bureaucracy that was quickly overwhelmed, didn't scale up, didn't involve the private sector and didn't react quickly to need. Privately run healthcare systems managed all these things.
- DanBC 7y ago
  Here's a politician saying it's the fragmentation, not lumbering centralisation, that has caused problems for the English response to Covid-19. https://twitter.com/Debbie_abrahams/status/1252881474459537411?s=20 https://twitter.com/Debbie_abrahams/status/12528814744595374... Newsnight have a good point when they say the Lansley reforms caused problems.