Health (And immigration)

Health Here And There (And Immigration)

With the junior doctors' strike in the UK in the news, the following experience of my friend Steve has immediate resonance. Steve picked up on article in The Telegraph which stated, quoting an NHS survey, that 18.1% of people in the UK have to wait more than a week to see their GP and 11% don't get an appointment (who then swell the numbers going to A & E?). He contrasted that with his experience here in France when he fell over last weekend and ended up in pain. I'll state it in his own words.

“Jo phoned our GP at 8.30 Monday asking for an early appointment as I was in pain from the fall on my side. She was offered an appointment at 10.30 later the same morning, after scheduled patients.

I was seen at 11.15, examined and suspected broken ribs diagnosed. Our GP then phoned the nearest X ray hospital department and made an appointment for later in the day at 4pm. We returned home via a pharmacy to pick up bandages and pain killers as prescribed by the doctor. We arrived for the Xray at 4pm, I was called at 4 minutes past and had 8  xrays taken by 4.15. After 10 minutes wait the consultant arrived with the Xrays and confirmed that I had broken 3 ribs. We were home by 5pm. As an aside, this cost me nothing as the costs were covered by the government and my supplementary health insurance”.

As Steve also pointed out, he was confident he would have received the same treatment in the UK; the difference was in the waiting (or lack of it). I've stated before that I think health services have to be limited in some way, but a great deal depends on how. In the USA it is simply money, a policy unacceptable in Europe (rightly, I believe). In the UK, the shibboleth of a totally(?) free health service means that waiting is the only possible restriction, apart from restricting drugs that can be supplied on the basis of some form of cost/benefit analysis (benefit to whom?). The French have had to tighten up on what has been an extremely generous health service but seem still to be achieving a good balance between service and cost. Here you need a health insurance policy (very cheap by UK standards) to supplement what the State pays but what Steve would have had to pay in the UK in prescription costs for his bandages and painkillers was probably less than his weekly health insurance payment here. And there his waiting time would have been……..who knows?

What seems to be happening in the UK, apart from the waiting, is supplementary payments by stealth (e.g. prescription charges) and ad hoc use of private services at generally huge cost to the State. A recent investigation found that the NHS had paid £1 billion over a year in private agency fees, excluding the direct costs of the staff supplied. The current government doesn't care and Corbyn and the opposition are very unlikely to ditch the shibboleth. Moreover, there seems to be much more emphasis here on early detection of illness than in the UK. It follows that if you are constantly fightng fires, as seems to be happening in the UK, you don't have a lot of time or resources for fire prevention. That costs you more in the long run and shows in comparative figures between the UK and the rest of Europe regarding cancer and other illnesses where survival rates depend on early diagnosis. It is all a very great shame.

There is an immigration footnote to all this. Polio, tuberculosis, small pox and various other nefarious diseases have largely been eradicated from Europe, primarily through inoculation programmes. So how many of the current influx of immigrants do you imagine have been through such programmes? And how rigorous do you imagine screening is when a new wave of immigrants arrive? Germany seems to be more thorough on screening than most other countries and is thus proving a useful source for discovering time-bombs. It recently reported finding a number of cases of these “vanished” diseases among the recent influx of immigrants; and Germany found them because it screened for them. How many other countries are doing likewise?

Perhaps I should add, in case it is not already clear, is that I am not against any European country taking the proportion of the recent influx of immigrants that it can reasonably accommodate. On the contrary, particularly in the case of the UK which did much to help create the current crisis. What worries me is the focus on such matters as benefits payments and terrorist infiltration and apparent total disregard and complete unpreparedness for the social impact.

Immigration,The EU, The UN And The Public

Immigration And The EU: Chickens Coming Home To Roost

My last posting was a rant against the English (or UK) culture test in the context of immigration. I have also formerly expressed doubts about the advisability of conferring rights, human rights as accorded by the UN or EU, without also noting concomitant responsibilities. It seems these chicken are coming home to roost with avengeance in the ongoing debate about immigrants to Europe.

The culture test can be set aside now. I've no idea whether other countries have such a test but, if they do, it is hopefully more relevant and less inane than the UK one. But my point about differences in culture with respect to the treatment of women has now been made in spades (or, more specifically, in Germany). Political correctness, incidentally, another of my betes noires, seems to have played a role in the cover-up of sexual assaults by recent immigrants in Germany and some other countries. Two important points clearly emerge, the first to do with Schengen and the second with human rights.

Only the EU commissioners sitting on their cloud (entrance to cuckoo land) on top of their ivory tower seem to have failed to see what must have been obvious to a blind man. If you remove border controls from a set of geographically contiguous nations you automtically increase the need for controls at the boundary of the contiguous area. And if the countries at these boundaries don't have an exemplary record for control, or the means for exemplary control, you are going at some time to be in serious trouble. The EU's official response so far, giving Turkey 3 billion euros to attempt to stem the tide of immigrants entering from there, strikes me as a concrete example of the rather crude expression of a flea wiping an elephant's arse with a piece of confetti. I've no doubt the 3 billion was gratefully received by Turkey but grave doubts as to how much of that sum has been used for its stated purpose rather than to line individual pockets. Who could possibly have thought otherwise, other than the EU Commission? The Schengen agreement clearly has to be scrapped, indeed is already being so piecemeal by individual EU countries, but will the EU commission officially repeal it? Dream on (as they do).

The UN long ago, and the EU more recently, declared that all human beings had rights which, unfortunately, the vast majority of people in the world don't currently enjoy. Compared to all but a handful of other nationalities, Europeans in general have a relatively “soft” existence, notwithstanding that life can still be very hard for some. It follows that the vast majority of people outside of Europe are having their human rights infringed in some way, often very many ways, so there must be a great incentive for them to get to Europe if they can. There the infringement of their human rights in their own countries may well make a good case for asylum. So what stops them coming in even greater numbers than are now being seen? In most cases, they simply won't have the means; inertia, lack of opportunity, wide family ties and an understandable love of their home territory, even if it is very uncomfortable, will also deter many. But, if circumstances at home get dire enough, who can blame them for trying?

So what, then, is Europe supposed to do about accommodating them? I've already addressed this question in greater detail in previous postings so won't elaborate now. My point here is that the EU Commission shows no sign of addressing this issue or, indeed, of having any desire to do so. Angela Merkel has, albeit belatedly, declaring Germany's right to deport immigrants if they commit crimes or show themselves otherwise to be undesirable. But what of their human rights and right to appeal to the EU or the UN? Their defence there could well be upheld, ensuring at least an extended stay in their current country which will have in the meanwhile to cope with their undesirability. The problem, I suggest, is the conferral of rights without concomitant responsibilities. I concede that there may be many marginal cases and can forsee difficulties but think that if an immigrant in any country commits a serious crime, a murder, a rape or an armed burglary for instance, deportation must be an option, even if the criminal faces danger in the country to which he/she is deported (and assuming a country of origin can be indentified). To me it is a matter of balancing rights with responsibilities. The granting of asylum is anyway a privilege, not a right, and privileges too carry concomitant responsibilities, at least in my opinion. Where do the UN and EU stand on this? They appear to stand on rights, not on responsibilities or consequences.

This imbalance does immigrants no favours. Some of the miscreants in the Cologne new year debacle were quoted, accurately or not, as saying Angela Merkel had invited them and so the Germans had to treat them kindly. But if you've come from a region where you had few if any rights at all, it would be only too natural to glory in your new status; which only adds fuel to the fire. Immigrants thereby confirm a resentment felt by many citizens in the country, that they, the immigrants, have a status privileged beyond that of the incumbent citizen. And so immigrant-bashing can easily become a popular sport, championed by the tabloid press and extreme right-wing political groups. Thus an already complex problem becomes even more intractable.

So who will sort out the mess? Certainly not the EU or UN so it will be left to individual countries, hamstrung by the proud proclamations of these international bodies. The only solution I can see is for individual countries, as they are beginning to do, to ignore the EU and UN and, effectively, tell them to get real or get lost. The EU is at root, after all, simply a coalition of individual countries and, if the EU can't help, then these countries will have to find their own solution, with or without EU approval.

The Public

I was amused to note that the final accounts of the north-eastern region railway, just published, show it had achieved greater punctuality and greater client satisfaction than any other train company, and a very significant level of profit to boot. Readers may remember that this region was returned to public ownership a few years ago after the private railway company contracted to run it failed dismally. Jeremy Corbyn may be widely regarded as not far off the lunatic fringe but he is most certainly right in wanting to return all the railways to public ownership. So what happened next? The north east region was returned by the current government to private ownership of course. Better private profit, it seems, than a good public service and public profit. Margaret Thatcher famously said that there is no such thing as society. The current UK government clearly believes that there are no such things as public services. How long before we hear that there is no such thing as the public? And how do you define a nation that has no society or public?

Integrating Immigrants

Immigrant Culture Test

I happen to think that the integration of immigrants into a foreign (to them) culture, any culture, is an important subject. Where immigrants do not become integrated they tend to form ghettos that are, in a sense, outside society and potentially destabilise it. Moreover, the immigrants themselves necessarily have a somewhat incestuous set of contacts and miss out on a lot that the society might offer them. So the subject is important from any point of view.

An invitation to take the the UK culture test demanded of immigrants to the UK recently popped up on my computer screen so I took it. I passed with about 70% correct answers. Now I am a UK national who has lived most of his life in the UK and a university graduate at a time when under 5% of UK residents went to university (although admittedly not a graduate in UK history, the subject of the questions). My historian friend Steve would probably have got 100% correct answers. All of which, in my mind, is totally irrelevant to the real question.

My point is that, at a realistic guess, around 90% of people who have lived all their lives in the UK and are thoroughly steeped in UK culture, good or bad, would have failed the test. So the much more important corollary is to know what on earh this has to do with integration into UK society.

Home Secretary Teresa May is recently quoted as defending the test, saying that it should be difficult on the grounds that UK citizenship is to be valued and not obtained easily. Amen to that but if ever there was a Parliamentary answer that was totally beside the point this was it. As I have no doubt mentioned before (several times), I despair at how politicians are allowed to get away with glib and irrelevant answers by their questioners. For the brief time I was in the public limelight in the 1990s, frequently in the press and on TV, I despaired also at how politicians were allowed to blatantly waste time talking platitudes or arrant nonsense at length in order to avoid having to answer another question. And this question happens to be important. It can reasonably be assumed that immigrants from outside Europe may have a slender grasp of English and come from cultures where corruption is a way of life and respect for individuals, particularly female, is scant, let alone any regard for so-called human rights.

It would be wrong to assume that immigrants from outside Europe necessarily do not respect western standards of expected behaviour but equally wrong to ignore that these standards are not part of their ingrained culture. Those differences seem, to me, to be the obvious factors that need explaining to immigrants from outside Europe. So where are the questions on those points? Totally absent. Again, most of those immigrants will have come from autocracies and the UK is supposed to be proud of its democracy. So how is that explained to immigrants? It isn't. The whole UK culture test is a grotesque farce and Teresa May should be pilloried for even tryng to defend it.