ANOTHER VOICE

On our patriotic duty to die before it is too late

AUBERON WAUGH

Alady telephoned The Spectator's susceptible young editor recently to com- plain that I wrote too much about drinking, driving and smoking. Conscientiously, he passed the complaint to me, but when I wrote to ask what she wanted me to write about — animals, perhaps? I am not qualified to write about sport, technology, modern art or fashion — she replied that she wanted `facts, facts and more facts, with perhaps a little comment as well'.

I did not suggest that this voracious appetite for facts seemed a trifle morbid at her age (whatever it is) but feel it might be a good idea to draw her attention to the 1988 edition of Social Trends, newly pub- lished by HMSO at £21.00— a stiff price, but rather cheaper than a year's subscrip- tion to The Spectator.

The annual arrival of Social Trends — on this occasion, sent by the Independent for review — generally leaves me feeling smug and superior. At last I am in possession of all the facts about what is happening in modern Britain, or at any rate all the facts which are available to members of the public.

Before discussing what seems to me the two crucial factors on the health scene — life expectancy and NHS costs — I might point out a few minor aspects which confirm my constantly reiterated theme that journalists who rely for their facts on DHSS briefings, or briefings from pressure groups such as the BMA, AAA (Action against Alcohol Abuse), MoT etc are guilty of printing increasingly wild distor- tions of the truth.

For instance, drug addiction, as notified, far from rising uncontrollably (cf Mr David `Dave' Mellor, passim) fell by 17 per cent between 1985 and 1986. The United King- dom has the lowest road accident death rate of any developed country in the world, at nine per 100,000 of the population, as against 30.2 per 100,000 for Portugal, for example.

The ludicrous MoT statistic of £300,000 as the cost of a fatal road accident is here broken down to reveal its composition: £151,000 for lost output (who pays?), an allowance of £145,000 for `pain, grief and suffering', and the balance of £4,000 for medical and ambulance services. Tell that to the Marines when the highest cost per National Health hospital in-put unit (i.e. patient) is £106 a day, and that is in maternity. Yet responsible newspapers produce this grotesque, Bottomley- inspired fabrication as if it were a genuine statistic.

The chapter on the nation's health also reveals that it is a total untruth that most road accidents occur after pub closing in the evenings. The correct order for road accident casualties, by time of day, is: (1) 5-6 p.m., (2) 4-5 p.m., (3) 3-4 p.m., (4) 8-9 a.m., (5) 6-7 p.m., (6) noon-3 p.m. Pub closing time, 11 pm–midnight, comes ninth.

Other useful facts to be noted on health, before we discuss what I see as the two crucial aspects, are that the NHS is indeed treating more patients in fewer hospital beds, but despite this increased 'through- put' the queue is longer than ever. Despite the colossal increase in NHS expenditure (see below) one in ten people now has private health insurance. Finally, although this is peripheral to the main argument, geriatric beds cost a mere £40 a day (by coincidence, exactly the cost of heating Combe Florey) against £106 a day for maternity beds, but of course the through- put element in maternity cases is somewhat brisker.

Now for the nub of the matter. Accord- ing to the Central Statistical Office, the cost of the National Health Service in both current and capital expenditure rose from £13,348 million in 1981-1982 to £18,813 million in 1986-7. That is a rise of nearly 41 per cent in 5 years, a catastrophic and insane increase.

Under these circumstances, anyone who uses the phrase `government cuts' in dis- cussing the present decline and collapse of the Health Service should be drummed out of whatever newspaper, television or radio station employs him. Needless to say, every single health correspondent, taking his cue from the DHSS press officers and professional health organisations, con- stantly uses the expression, and treats 'government cuts' as a synonym for what- ever half-baked and ineffectual financial controls anyone tries to impose. This no- tion of government health cuts is the Big Lie of the decade — far bigger than the Health Council's lie, which I nailed two years ago, that there is any appreciable danger of contracting Aids from heterosex- ual intercourse in Britain.

Social Trends also nails this secondary lie. Of 842 cases reported up to June 1987, 778 were homosexuals and/or intravenous drug abusers. The total number of males who seemed to have contracted the disease heterostxually in Britain was 2, with 5 females who may or may not have caught it from submitting to anal intercourse. So much for that famous Durex advertise- ment.

If the observable decline and, in some cases, collapse of hospital services are not attributable to non-existent government cuts, they must be attributable either to the geriatric explosion or to the incompetence, laziness and greed of NHS employees. I include the consideration of new, expen- sive equipment under the latter heading, since if it does not improve the system there is no justification for indulging in it; as the system is declining, purchase of n.e. equipment must be attributable to the incompetence, laziness or greed of NHS employees. QED.

No doubt the NHS 'crisis' is to be explained by a combination of both — the geriatric explosion and the i. I. and g. factor in NHS employees. The latter is not something we can do anything about, unless we happen to sit on the appropriate committee of a local health authority. The geriatric explosion, painfully chronicled in Social Trends, is different. A glance at the tables of figures will show how we are inexorably turning into a nation of old women.

Perhaps the girl baby born today will have an average life expectancy of only 78 years or so, but as soon as she becomes 78 she will find she has a life expectancy of 10-12 years. Even in 1984 the ever- increasing number of women who reached the age of 80 found they had an average life expectancy of 7.6 years. The situation is becoming desperate.

I am not, of course, suggesting that the National Health Service should cease to operate once a citizen has reached three score years and ten. At least I do not think I am. I am certainly not suggesting a programme of euthanasia, voluntary or otherwise. But it does seem to me that government efforts, through National Health Council advertisements, to per- suade us to prolong our lives are ill- conceived, and that the responsible citizen has a patriotic duty to eat, drink, smoke and be merry — even gay, if his tastes lie in that direction — and just jolly well die, rather than hoard the prospect of a dismal longevity.