Dr. Dan Goyal Profile picture
Jul 7 11 tweets 3 min read Twitter logo Read on Twitter
No doubt we are at a tipping point for the future of healthcare in the U.K.

You will hear a lot of misinformation, disinformation, and barefaced lies over the next 18 months - a £200bn/yr industry is on the table.

So here are the facts…

Has the NHS been value for money?
Here is the funding in relation to GDP (a measure for the wealth of a country)
You can see how far off our comparative nations we have been for decades.

This can be seen in number of measures, such as doctors per head of person
France has 10% more doctors (enough to get on top of our waiting lists)

Germany has 50% more.

So, underfunded and understaffed, we would expect the U.K. to have worse outcomes.

Here is the Breast Cancer survival rates
Our performance is similar to Germany’s and Switzerland’s.

Even the overall preventable deaths category (⬇️), the U.K. does similar to Germany and NZ.

(Sadly, the UKs avoidable deaths have increased since 2016)
You will note the three worst performers include a tax-based system (U.K.), one social insurance system (Germany), and a private insurance system (U.S.).

The argument for changing the healthcare model is nonsensical.

Here is how much of health costs are state versus private:
You will note that all other models spend significantly more through the state than the U.K., and the proportion of state versus out of pocket expense is about similar.

There is no cost advantage in changing systems, at all.
We have used the figures from 2018 (or nearest). This is prior to the mass pillaging of the NHS funds. Bear in mind that all budgets since 2020 are contaminated by the fact all Covid contracts awarded to private providers were included in the NHS budget - PPE, Tests, T&T, etc…
All analyses have identified underfunding as the cause for at least 0.5m being unable to work, 500 deaths per week, 7.5m on the waiting lists, etc…

The only people calling for a change in the NHS model are those who seek to profit from it. They don’t care about patient care.
Yes, we are not performing as the 6th richest economy should. Some of our outcomes could be better. But no comparable country’s health system is as efficient as the NHS

Look what the NHS has achieved on well below average funding, imagine what we could achieve if properly funded
It pains me to have to point out these easily discoverable and uncontested facts, but this is the age we live in - where truth is optional in the struggle for more money & power

So be careful… changing our model of healthcare may not affect you and your family now, but it will

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More from @danielgoyal

Jun 28
Yesterday we examined Hancock's central argument to the Covid Inquiry: "No one said you could stop a pandemic"

Ironic, his unwavering confidence that this was his 'get out of jail' excuse led to a spectacular witness statement with jaw-dropping admissions

Here are the big ones:
First, let's look at a very clear and catastrophic failure...the failure to prepare Adult Social Care

KC points out the illogic in Hancock's answer: his dept had identified the vulnerability of care homes in 2016 but Hancock says not his responsibility to sort it out.
These are the activities that were stopped due to Brexit...

They include "healthcare surge capacity" and "adult social care".

And even some of those meant to continue did not - Pandemic Preparedness Committee was supposed to meet 6-8 weeks but it didn’t meet for an entire year.
Read 17 tweets
Jun 27
So, Hancock's first appearance at the Covid Inquiry did not disappoint.

I will share the critical moments below.

But first, it is clear that his entire justification for the admitted calamitous response rests on one point, and it is a fabricated argument...
🧵
Now, I am not suggesting Hancock intentionally fabricated this argument. Indeed I think he genuinely believes his post-hoc justification for why he failed in his post. Indeed, I am sure it helps shield him from the gravity of his failures. It is simply that it is not true.
Hancock's central point made throughout (to the irritation of the KC) was that there was a critical "Doctrinal flaw". That is, he says, the assumption made in all pandemic preparedness that once community transmission was reached then you could not "stop" the pandemic.
Read 14 tweets
Jun 26
If you can get passed the slow pace of it and the terminology, the Covid Inquiry is turning into quite the drama...and, dare I say, may well have some teeth!

Today Dame Jenny Harries (Head of Test & Trace and HSA) was in the hot chair, and it certainly got fiery!
For those who don't know Dame Jenny Harries (DJH), she moved from Deputy CMO to Head of Test & Trace and then Head of UK Health Security Agency...

Watching her performance at the Covid Inquiry it is easy to see how DJH could progress so well in Johnson's government
For me, DJH was a terrible witness. Evasive, defensive, and at times almost annoyed at the (much more impressive) KC questioning her. DJH seemed to try and detract by using terms she hoped the Inquiry would be lost in, and bringing in vaguely relevant explanations.
Read 18 tweets
Jun 19
Partygate is triggering, I assume for most of us.

For me, it is the abandonment of the public by the Govt that causes most trauma.

So I wanted to share with you what I found to be one of the most shocking parts of the national covid response..
1/n
It was March 2020 and I was charged with reviewing our local hospital's Covid Triage Pathway.

For those unfamiliar, triage is how we decide what level of healthcare a patient needs - so when to send Covid patients to hospital!
The UK had taken a very odd position. It had been decided (centrally) that all triage was to be done online via an automated, patient-led triage system. This meant the patient would input their details into '111' and an algorithm decided what level of healthcare they needed.
Read 26 tweets
Jun 18
People realise that Johnson was the reason lockdowns were so long and severe, right?
1. He delayed acting. This turned a few weeks of lockdowns into months.

2. He refused to invest in NHS capacity - leading to a 9% shrinkage of bed capacity, when we needed a 30% increase. This meant the point at which the health service would become overwhelmed was much lower.
3. He cut out the GPs from the Covid triage pathways. Instead pushing people online to 111 and then on to private testing companies. This meant the opportunity to prevent disease from getting worse was lost…leading to much longer admissions and “overwhelming” the system earlier.
Read 9 tweets
Jun 4
There is no doubt in my mind that Jack Monroe is a force for good.

So I couldn't quite understand what she was supposed to have done to deserve the level of abuse (albeit by a minority) that she has been receiving.

Surely it must be real bad?

No. It really wasn't...
From what I can tell, there seem to be a few issues some folk keep picking at.
Firstly, there is the issue of whether or not she was working or middle class. It seems like a pretty straightforward answer, really. Her mum was a nurse and her dad was a fireman. Working class! Regardless of how senior they each became, she is of working-class background.
Read 15 tweets

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