Globalisation
Ninian Peckitt
Member University Advisory Board at UPES Dehradun, Uttarakhand, India.
Introduction
The the ultimate end point of a Free Market is Globalisation, in order to achieve maximum exploitation of resources required for a given Industry.
In the West we have seen the consequences of these principles in all Free Market Sectors: Coal, Steel, Shipbuilding, Engineering, Manufacturing and more recently in Healthcare.
This business model is truly Global and affects all participants in the Free Market.
In the United Kingdom, the NHS is being defunded as a matter of political policy to the extent that the NHS is no longer fit for purpose, whilst the Government simultaneously protests its support for the NHS and its ethos. There appears to be no way of challenging this in the UK, although European Courts may think differently, if patients are injured or if their rights are abused.
NHS Trust Deficit
Nearly all Trusts are currently in deficit. Recenctly the North Middlesex Hospital turned patients away from its A&E Department "unless they thought they were dying" and South Glamorgan Hospital recently ceased all elective activity in favour of clearing A&E cases.
Manpower
Doctors appear to be leaving the NHS and/or UK in large numbers and this appears to be unsustainable. Concerns have been expressed that replacement doctors may lack the appropriate training, qualification and revalidation requirements for registration with the General Medical Council.
So what is the alternative?
Globalisation
Medical Tourism is already established in the Private Sector and there are signs that State Systems will use these options.
South Kent Commissioning has already negotiated contracts with France to care for NHS patients and it is to be noted that there are some excellent Private Clinics in India which can offer treatment (e.g. Knee Arthoplasty) for circa 25% of NHS Costs.
Logistics
Medical Tourism Agencies are poised to expolit this opportunity, at a Global Level especially in Europe, United States and Australasia.
The United States is blessed with the highest costs of healthcare provision in the World - but is not number one in league tables for quality. There is much over investigation of patients and defensive clinical practice. This does not always equate with best practice, whatever that might mean.
The process of globalisation is one of political stealth and subterfuge. And this is happening on both sides of the Atlantic.
As the US Philosopher and Intellectual, Noam Chomsky points out:
"That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital."
President Franklin D. Roosevelt also echoded these sentiments when he said:
"In politics,nothing happens by accident. When it does, you can bet it was planned that way".
If these issues are only even partly accepted, then it is easy to appreciate why the British Government doesn't want to see a settlement with the junior doctors. Such a settlement would make arguments for contraction of elective NHS services much more difficult. Sending NHS patients abroad for treatment at much lower cost would be more difficult to sell to the public. An increase of funding of a contracted budget to the emergency services would be impossible to achieve without globalisation plans and the mass deportation of NHS patients abroad. So what is needed is a Scapegoat. A Fall Guy. A Patsy, and there are no prizes in guessing who that might be.
So the Government has no option but to ensure the collapse of the NHS in order to achieve such aims, and has revereted to Noam Chomsky's model of Political Vandalism. And patients are the pawn stars of this programme. Those doctors who speak out, are mercilessly targeted, by fair means and foul to the extent that Whistle blowers are now supposedly protected by law. But in order to be protected you have to be a recognised whistleblower in the first place. And even then you are afforded no protection whatsoever. This has to imply that Government is the driving force behind the targeting of doctors.
And therein lies the dilemma.
It is only a matter of time until these issues are addressed in the criminal courts.
Attempts to distract the Public with an announcement of an EU Referendum are well timed. It is clear that the EU and its courts currently have the ability to call National Governments to account, if they abuse their respective citizens, so it is not surprising that there is serious opposition to this "loss of soverignty" by Brexit supporters, whose personal, and nor importantly, financial interests are at conflict with those of the General Population. It is clear that the EU and its Courts are the only viable second chamber that can make Government responsible and accountable for abuse. And we should all remember this.
Should the Free Market prevail and become the Norm, e.g. for services such as healthcare, the soaring cost of delivery in the home country will be offset by Medical Tourism. This will of course include "Plaquage holdays" for the Globalisation of Dentistry.
This will open the door for other Service Industries. The Prison Service springs to mind. We have already seen the setting up of Prison Colonies in Australia, which founded a Nation.
The modern analogy would seem to be the incarceration of inmates in secure penitentiaries abroad, where costs could be substantially be reduced. If the globalisation model is accepted there seems to be no reason why such a proposal could not be re-enacted - maybe with no exceptions.
There are many countries that could submit bids for commissioned prison service contracts. North Korea for example has a prison service that is quite unique and its method of execution which would address the problems US penitentiaries have in accessing drugs for execution by lethal injection.
References
Globalization of Healthcare ISBN: 9780199917907
Edited by Glen Cohen:
Description
The Globalization of Health Care is the first book to offer a comprehensive legal and ethical analysis of the most interesting and broadest reaching development in health care of the last twenty years: its globalization. It ties together the manifestation of this globalization in four related subject areas - medical tourism, medical migration (the physician "brain drain"), telemedicine, and pharmaceutical research and development, and integrates them in a philosophical discussion of issues of justice and equity relating to the globalization of health care. The time for such an examination is right. Medical tourism and telemedicine are growing multi-billion-dollar industries affecting large numbers of patients. The U.S. heavily depends on foreign-trained doctors to staff its health care system, and nearly forty percent of clinical trials are now run in the developing world, with indications of as much of a 10-fold increase in the past 20 years. NGOs across the world are agitating for increased access to necessary pharmaceuticals in the developing world, claiming that better access to medicine would save millions from early death at a relatively low cost. Coming on the heels of the most expansive reform to U.S. health care in fifty years, this book plots the ways in which this globalization will develop as the reform is implemented.
Table of Contents
Introduction Glenn Cohen Patient Mortality In Medical Tourism: Examining News Media Reports Of Deaths Following Travel For Cosmetic Surgery And Bariatric Surgery
Part I: Medical Tourism For Services Legal in the Patient's Home Country
Chapter One Leigh Turner Patient Mortality In Medical Tourism: Examining News Media Reports Of Deaths Following Travel For Cosmetic Surgery And Bariatric Surgery
Chapter Two Thomas R. McLean Jurisdiction 101 For Medical Tourism Purchases Made In Europe
Chapter Three Valorie A. Crooks Canadian Print News Media Coverage Of Medical Tourism:
Chapter Four Nathan Cortez Cross-Border Health Care And The Hydraulics Of Health Reform
Chapter Five Hilko J. Meyer Current Legislation On Cross-Border Healthcare In The European Union
Chapter Six I. Glenn Cohen Medical Tourism And Global Justice For Services Illegal or Unapproved in the Patient's Home Country
Chapter Seven Richard F. Storrow The Proportionality Problem In Cross-Border Reproductive Care
Chapter Eight Kimberly M. Mutcherson Open Fertility Borders: Defending Access To Cross Border Fertility Care In The United States
Chapter Nine Hazel Biggs Tourism: A Matter Of Life And Death In The United Kingdom Caroline Jones
Chapter Ten Aaron D. Levine The Roles And Responsibilities Of Physicians In Patients' Decisions About Unproven Stem Cell Therapies
Chapter Eleven Vivien Runnels Global Policies And Local Practice In The Ethical Recruitment Internationally Trained Health Human Resources
Part II: Medical Worker Migration
Chapter Twelve Nir Eyal Conditioning Medical Scholarships On Long, Future Service: A Defense Till B?rnighausen
Chapter Thirteen Allyn L. Taylor A Global Legal Architecture To Address The Challenges Of International Health Worker Migration: A Case Study Of The Role Of Non-Binding Instruments In Global Health Governance
Part III: The Globalization of Research and Development
Chapter Fourteen Trudo Lemmons Clinical Trials Registration And Results Reporting And The Right to Health
Chapter Fifteen Robert Gatter The New Global Framework for Pandemic Influenza Virus and Vaccine Sharing
Chapter Sixteen Bethany Spielman Offshoring Experiments, Outsourcing Public Health: Corporate Accountability And State Responsibility For Violating The International Prohibition On Nonconsensual Human Experimentation
Chapter Seventeen Cynthia M. Ho Beyond Patents: Global Challenges to Affordable Medicine
Chapter Eighteen Kevin Outterson Combating Antibiotic Resistance Through The Health Impact Fund
Part IV: Telemedicine
Chapter Nineteen Gil Siegal Electronic Medical Tourism And The Medical World Wide Web
Chapter Twenty Deth Sao Legal And Regulatory Barriers To Telemedicine In The United Amar Gupta States: Public And Private Approaches Toward Health Care David A. Gantz Reform Part V: Health Care Globalization, Equity, and Justice
Chapter Twenty-One Jennifer Prah Ruger Global Health Governance as Shared Health Governance
Chapter Twenty-Two Daniel S. Goldberg Global Health Care Is Not Global Health: Populations, Inequities, And Law As A Social Determinant Of Health
Chapter Twenty-Three Pavlos Eleftheriadis Global Rights and the Sanctity of Life
Author Information
Glenn Cohen, Assistant Professor of Law, Harvard Law School
Risk analyst, 6 sigma analyst and founder of medfinbank project. Doctorat d' Universite a PARIS 2 FRANCE
4 年The conflict of interests in the field of health is located in ?tug-of-war between the public and private health sectors. Let's not forget that global pharmaceutical spending has reached $ 2 trillion and total health spending exceeds $ 8 trillion. That is why we are creating the bank and the group of health companies, for the benefit of the patients and not only for the benefit of the small investors. This will increase the speed of scientific knowledge, the speed of investment and the improvement of health conditions.
Member University Advisory Board at UPES Dehradun, Uttarakhand, India.
5 年In order to understand why government is persisting with a failed Free Market System of National Healthcare, we need to examine the financial interests of MPs and their backers. What are former Secretaries of State doing at the moment - and are these examples conflicts of interests. If so, why have there been no prosecutions? And what are we going to do about it?