“Alexa! Alexa! . . . Do you think I’m ill?”
We might see this as amusing, or a bit futuristic. Wrong! It’s here already. Amazon Health, Amazon Pharmacy and Babylon Health, among many others, are testing new “digital medical systems,” where you ask a computer about your health. This, in time, will spell the end of GPs as we know them.
The same systems could be used for cancer consultations or any specialist medical advice. But, more worryingly, it would mean that the biggest collector of data in the world would have the ultimate in personal data stored on their servers. Imagine for a minute what they can do with that information, and who they can share or sell it to. Imagine too who would control your health, and what you might end up paying for it.
So what has all this to do with our present health systems in Ireland, North and South? Above is the ultimate goal of those who are working hard at every level to turn our health into a monopoly cash cow. The rich and the poor in Ireland have two clearly delineated standards of health service. In the South it’s a straight two-tier system, with private hospitals and private health insurance for the affluent and a sub-standard public health service for the rest. But in the North, though rapidly changing, it is slightly different. We have the legacy of the NHS. And the politics of it.
So the vultures for privatisation and their “management councils” in Stormont and Westminster have to take a more cautious approach in their moves to demolish the National Health Service that they set up to appease the possibility of revolution after the Second World War. They praise it and eulogise it to the world on one hand and undermine it on the other.
The Thatcherite years (1980s) were the beginning of the destruction of the “fabled” NHS. It is a kind of a “slow burn” or “back door” method, using neoliberalist tactics to eventually end a free health service in the North—or at least make it even more profitable for the elite few.
The rot began when GPs became contractors to the NHS. That changed GPs from people caring to budgets and profit management. Next came the ancillary work in the hospitals. Cleaning, food and maintenance were all given to outside contractors, on the basis of competitive tendering, where the lowest price had to be taken—with disastrous results.
Hospitals have been built on “private finance initiatives” (PFI). The South-West Acute Hospital in Enniskillen is but one example. The interest alone on this hospital is £18 million per annum. It cost £224 million to build. By the time the thirty-year lease is up it will have cost £712 million of taxpayers’ money going to the private sector.
The number of basic services that have been moved from this hospital—and but for people’s campaigns there would be more—is legion. And all because the “budgets” didn’t allow for them. This hospital is de facto a white elephant, the first in the North of PFI schemes within the NHS, to facilitate the transfer of wealth to the elite golden circles.
All these costs do not include the wages and running expenses for doctors, nurses, and medicines. On top of that are the 2,300 shortages of medical staff and the long emergency department waiting times and even longer (years) waiting on elective surgery. It’s as bad as, or worse than, the South of Ireland.
With the rapid decline in the number of GPs throughout the North, through retirement, lack of doctors being trained, and amalgamations, large areas of the North are now without adequate GP cover. In turn this has caused A&Es and hospital wards to be overcrowded in the absence of proper primary care.
Covid-19 has exposed the deliberate running down of the Northern health service (and that of Britain). To “save” the NHS, but more so the politicians and civil service mandarins, all elective surgery, cancer and other assessments have been stopped, thus creating a new pandemic of health issues after Covid. But we can be certain that the only solutions that will be proposed are those based on profit for the Richard Bransons and American vultures waiting in the wings to extract profit from the health of the Irish people. The nadir of that plan is condemning the population to “digital medicine.” And, at the time of writing, Covid is being used as a testing ground for just that.
Unless the people seize control of their health services, north and south, and campaign for an all-Ireland public health service, free “from the cradle to the grave,” the profiteers will build a health service for the rich and powerful. And the rest of us will have to make do with an “Alexa diagnosis,” or worse.