There was revulsion amongst doctors and nurses through out the NHS today as word spread that Karol Sikora had been duped by a slick American businessman into providing a “rent-a-quote” service for a notorious right-wing American organisation.

Some outside the NHS may not have heard of Sikora. When he has his NHS hat on, he is a Professor at Imperial College. Outside the NHS he has strong commitments to private medicine. He is Dean of the medical school of the “independent” (= private) University of Buckingham - take a look at the fees here - and is medical director of CancerPartnership UK, a private organisation that puports to provide private medical care for cancer patients. Sikora is often styled as a “trailblazing oncologist” and of course has an eponymous dot com website.

Interviewed by Dr Natasha Murray he said:

“I have no hobbies whatsoever but I do like trains! I was Father Christmas on the ‘Santa Special’ train and my daughters were my little helpers!”

Dr Natasha Murray

Today, the train spotter has been derailed. Sikora has made a fool of himself. He has been suckered. He has allowed himself to be used as a vehicle to denigrate the NHS so that a fat cat American business man can con gullible Americans into thinking  that universal health care must be a disaster. Sikora has probably already had a phone call from the Department of Health because on Radio 4 this evening, he was backtracking. (Listen again here : the Sikora story starts forty minutes in, but will only be available for a few days) 
Take a look at some of the “NHS horror stories” being currently being run by Conservative for Patient Rights on American television.

Katie Brickall’s story is tragic. But hard cases make bad law. One case of cervical cancer in a 19 year old is not initself a justification for a national cervical screening programme directed at teenagers. Sikora knows that. May be there should be such a programme. May be there should not be.  But this one case is irrelevant.

Another emotive, dishonest video. Another tragedy.  But not a reason for supplying an expensive drug which offers no prospect of a cure. Think about it logically. A new drug offers, not a cure, but a possibility of extending a cancer patient’s life by three months. A course of treatment costs, say, £200,000. There are a hundred patients who want the drug. That’s £20 million. £20 million that could be spent on, for example, nursing care for patients with Alzheimer's Disease.  Heart breaking resource decisions. In the USA the problem is “solved” by depriving some forty million citizens, mainly black, Latino, and unemployed, of all medical care. In the UK we have an organisation called NICE that tries to make these resource decisions rationally. It is a job for Solomon. Do they get it right every time? Hell, no. But can you think of a better system? Shall we just provide the drug for the well-heeled middle-class as they do in America?

There are between forty and fifty million US citizens who do not have health insurance and who, therefore, cannot get proper medical treatment. They bounce round the system getting a bit of charity care here and there, but no one takes ownership of their problems. They do not get the expensive drugs. Often they do not even get a diagnosis.  The American healthcare system is business orientated. The insurance companies have no interest in universal health care. Their sole interest is profit. Now they are feeling threatened. They saw off Hilary Clinton when she, as first lady, dallied with universal healthcare, but President Obama is a much more powerful politician. He has popular support and now he is planning to introduce a system providing universal health care. If he is to do that, there will have to be some state enterprise. Those forty million citizens cannot afford to pay themselves. State enterprise? Socialized medicine?  This might threaten the bank balance of the US insurance companies, so they are mounting a cynical campaign to appeal over Obama's head and are pitching the campaign directly at the right-wing red-necks in the US flyover zone.

So who exactly areConservatives for Patient Rights who are running this campaign with the help of Professor Sikora?

Conservatives for Patients Rights is a non-profit, 501 c(3) organization dedicated to educating and informing the public about the principles of patients rights and, in doing so, advancing the debate over health care reform. Those principles include choice, competition, accountability and responsibility. 

"Not for profit" always makes an organisation sound well-meaning and plausible. So what, exactly, is in it for them? Perhaps CPR is run by charity workers. Who is in charge of Conservative for Patients Rights (CPR)?

CPR is headed by the former chief executive of a health group who was at the forefront of one of the country's biggest healthcare fraud scandals. Rick Scott was forced out as CEO and chairman of a healthcare company, Columbia/HCA, in 1997 after the government accused it of a massive fraud through overbilling. walked away with millions of dollars in severance pay, but the company was forced to pay $1.7bn in compensation to the government, fines, interest and other payments to avoid prosecution and settle with claimants. Scott has responded to the criticism by saying: "I was never charged with any wrongdoing."

The Guardian 

More details emerge about Rick "I have never been caught doing anything criminal" Scott in the Washington Post.

"Those attacking reform are really looking to protect their own profits, and [Scott’s] a perfect messenger for that. His history of making a fortune by destroying quality in the health-care system and ripping off the government is a great example of what's really going on."

Scott, 56, seems unfazed by such criticism, emphasizing that he was never charged with any wrongdoing and that other health-care companies were also fined for overbilling problems. A lawyer with no formal medical training, Scott built Columbia/HCA into the largest U.S. health-care company before he was ousted by the board of directors in 1997. He was also once a partner in the Texas Rangers with George W. Bush. Scott now runs an investment firm and owns, among other things, a chain of walk-in urgent-care clinics in Florida called Solantic.

The Washington Post

Dr Crippen has long since stopped worrying about political doctrine when it comes to healthcare. Provided always we provide a reasonable standard of medical care for all UK citizens it matters not a jot how we do it. The monolithic NHS with all its Stalinist bureaucracy is far from perfect and, at times, drives me to distraction. Much could be done to improve it. There are lessons to be learnt from the private sector and from America. Similarly, the Americans can learn much from the NHS. There is good in both systems. 

Sikora is a talented man. But he is a Professor of Medicine working within the NHS. His behaviour in making this video is despicable. He has connections with private medicine but did not declare any conflicting interests in his interview. If he made similarly critical remarks about the University of Buckingham he would have been sacked. If he wishes to denigrate the NHS in this manner,  he should resign.