I would have thought that translation fees were a drop in the ocean compared with most other NHS budgetary expenditure in any case?

I feel a rant coming on. This new debate and debacle stirred up by some Tories in the US , and the rightly indignant retorts of David Cameron, like the issue of the location of the next Jerk Day, has provided some news interest in a generally quiet month. The footage of some of the hysterical US opposition to health care reform in the US has been good fun given that so many seem to think public health care free at the point of need = communism. Good luck to Barack Obama in attempting to reform the system, I feel that everything is weighted against him but perhaps he may just have the persistence to get things through.

I was taken to hospital once in the US some years ago shortly after landing- I was ill on the plane and became dehydrated which raised my blood pressure to scary levels and affected my heart rate. As I wasn't talking very coherently ( ho ho) The airline called an ambulance ( Fire Department) and we sped off to a private hospital in West Virginia. Once there I was put on a bed on a drip and waited to see the doctor. The first person who came to see me was the bursar who wanted to see the colour of my credit card before I was seen by any professionals. As I was barely coherent because of the lack of fluids it was a difficult conversation. It was also difficult to sign the invoice with a drip in my right arm. Basically I had to hand over ?500 in cleared funds before any doctor would see me, a sum which included the cost of the ambulance. When we returned to the UK another bill arrived for another ?500- the ?500 paid in the US was apparently a deposit. In total a 20 minute ambulance ride, a saline drip, a blood pressure test, a brief chat with a junior doctor and occupation of a hospital trolley for one hour cost me ?1000. Just as well nothing was really wrong apart from a temporary effects of being ill at altitude and dehydration. And that was over 10 years ago. Thankfully we had insurance which covered 80% but only retrospectively. Apart from the general hospitals in the US which tend to be free for emergency services,( lets face it, these exist to prevent the well off having to trample over dead and dying people on the pavement) this is what most US citizens would have experienced had they not had insurance cover, and as we hear many don't, or many are thrown out of policies if the company has a bad year. It was a chilling experience to be asked for money before anyone would see me. I had lost the comfort zone and unconditional care of the NHS albeit temporarily, and it was frightening. An eye opener. In the next bed there was a debate going on about a tetanus injection. A child had been cut and the staff recommended to his mother that he have the jab. Only it cost $50US , she had no insurance, and she felt it was too much, so she wanted a full explanation of the risks of tetanus. The conversation went on for the full hour I was in the adjacent cubicle. In the UK he would have just had it as routine. I think she opted not to have it.

With medical advances and treatments people will become more and more demanding and won't always get the cutting edge treatment that they want. We have a long way to go on many things not least cutting MRSA rates, but at the end of the day, as long as we appreciate that decisions have to made concerning probabilities and outcomes, we have a fantastic system here that will always have the moral edge over so many others. The maternity/birth services and child health are fantastic. It costs a fortune but it gets things right at a time when it can make a lot of difference to the lives of mothers and babies. I don't want to see people dying in the street or people being turned away from hospital because they don't have the right paperwork as can happen in the US. I am proud that we have a system that treats pregnant women even if they're not otherwise entitled to free treatment. There is likely to be more pressure on the NHS in coming years, lets not be complacent and instead fight to retain our wonderful although never perfect system.