Thursday, December 28, 2006


Our small dog was in a bad way – vomiting, and with a dreadful case of the ‘scoots’ as we say in Scotland. We thought he had eaten something nasty, and it would soon pass. But by 6pm we realised that we needed a vet.

It was Sunday evening. Indeed, it was Christmas Eve. But the vet answered the phone straight away, and told us to come round to the surgery. Ten minutes later, he was examining the dog, and fifteen minutes after that, he had diagnosed the problem, given him three injections, bottled up a week’s dose of two different kinds of medicine, told us he would recover just fine, swiped 34 pounds off our credit card, and assured us that it was just fine to call him on Christmas day if we had any further problems. That’s what I call good service.

By contrast, as I say, a few weeks back I needed to see the doctor. It was a Friday evening, and a recorded message told me that the surgery was now closed until Monday. If I had a real emergency I could leave a message and someone – obviously not my regular doctor – would call me. It wasn’t an emergency, so I called back on Monday, and managed to get an appointment ten days later (though in honesty, I could have seen another doctor in a shorter time). The doctor wrote me a prescription, again for two medicines, but I had to walk half a mile up to the chemist to get them. They cost me around £14 (the standard NHS medicines charge), almost half what the vet charged me for his whole on-the-spot consultation and prescription.

Why do vets give such better service? I am sure that doctors are just as dedicated to their vocation. But with the vet, the link between serving your customers and getting paid by them is immediate. It concentrates the mind on giving good service. In the NHS, remuneration is negotiated and paid by government quangos. There is no clear link between getting paid and giving a good service to your customers.

Doctors should be remunerated like vets. And if some people cannot afford their fees, then those people should be subsidized through the welfare system. The rest of us should pay cash. We might grumble at that thought: but we would get such a better service that overall, we would probably grumble far less.

Until that happens, though, next time there is something wrong with me, I shall be consulting a vet.



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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