Tuesday, 16 March 2010

Indians and the NHS

There are various categories of Indians living in the UK. Many came to the UK from the 1950s onwards to work in the numerous factories that proliferated in the Midlands, migrating mainly from Punjab. There are those who came from East Africa in the 1970s, forced to leave behind most of what they owned, by politicians like Idi Amin. And then there are professionals like doctors, engineers and bankers who came to the UK for career enhancement and because they got to make more money than they would back home. Educated in some of the finest schools and colleges in India with toppings from UK institutions in many cases, these professionals have very strong ties to India and some of them will eventually go back for good, once the CV has been updated and the bank balance hits a certain ceiling. Most of the Indians I am in touch with in the UK belong to this category.

If there is one thing that unites Professional Indians of the type described above, it is the ‘NHS’. Ask any of them what they think of the NHS and without a moment’s hesitation, you will get the reply. ‘Horrible’. ‘Nightmare’. ‘Terrible’. The adjectives may vary, but they all convey a sense of horror which is interesting enough to analyse.

India is a country where a big chunk of the population goes without medical facilities. However, most middle-class Indians however have access to private health care. Though the quality of the private health care itself is debatable, it is delivered by an abundance of doctors, some of whom make good money, supported by an equal number of nurses who are almost uniformly worked very hard and badly paid. What every middle-class Indian takes for granted is the ability to be able to see a doctor of his or her choice at less than twenty four hours’ notice. As mentioned earlier, the quality of the private care is not necessarily very high. It is very common for GPs in private practice to buy antibiotics by the carton (literally) and sell them (as part of the treatment) to their patients by the bottle. Antibiotics are also available over the counter in India. As a result, most Indians are so used to taking antibiotics at the drop of a hat and do not respond to less harsh forms of treatments.

The National Health Service or the NHS, as it is commonly called, is the exact opposite of the Indian medical system. The NHS prides itself on offering the same medical care to everyone, irrespective of their status in society. Anyone can walk into the A&E section of an NHS hospital and receive medical care, even illegal immigrants, though these days registration with a GP is restricted to those legally in the UK. Even the family members of a doctor working for the NHS will have to book an appointment or stand in a queue to see a doctor chosen either by a receptionist or an administrator. It may be necessary for wait for a few weeks to have an operation to fix a broken arm. Serious surgeries require a longer waiting period. Antibiotics are rarely prescribed. Pharmacies will definitely not sell antibiotics over the counter. Women delivering babies are encouraged to deliver naturally with assistance from a mid-wife rather than a doctor.

In India, a middle-class woman in labour will have a doctor and a few nurses at her beck and call. Even if it is not really needed, a caesarean section will be performed since the doctors get paid more for C-sections than in the case of a natural delivery. As a result, very few middle-class Indian women actually get to deliver naturally. The World Health Organisation says that the Caesarean rate should not exceed more than about one in eight births. The UK rate is double this number and I am sure (from anecdotal evidence) that this rate is much higher among middle-class and rich Indians, though no official statistics exist. For course, there are those who dispute the WHO’s advice.

On the whole, I think the NHS is a fairer system, though most of my Indian friends in the UK will disagree. NHS treatments are almost entirely free and are paid for by the government using the tax payers’ money. It hardly needs reminding that income tax rates in the UK are much higher than in India, even though the rate of corruption in the UK is a lot less and most of the tax payer’s money does reach its destination. Again, unlike in India.


Wobi said...

Very interesting observations and one that is fair and well thought out as well.

I remember speaking to an old friend who I had not spoken to for many years when the NHS came up and as you mentioned, his views were typical of educated, upper middle class Indians.

I am a firm believer in the NHS. I think free and universal healthcare of a certain minimal level should be available to all human beings irrespective of their background, educational levels, economic class, etc. And the NHS achieves that. I continue to be shocked and horrified that anyone could think otherwise!

But interestingly, most Indians seem to feel that they deserve private healthcare (perhaps their lives are far more precious than us other mere mortals), or that their children deserve a private education (ofcourse State schools are JUST NOT GOOD ENOUGH).

Me personally, I would rather stand in a queue than watch someone die because they were not able to afford healthcare...but then, perhaps I am a dangerous socialist! ;-)

Winnowed said...

Wobi, I agree with you fully.