Susie, John and the National Hairdressing Service
This is a story about Susie and John. And the National Hairdressing Service. Susie and John were a hard-working couple with two young children. Because Susie had a busy, hands-on job and spent all her non-working time looking after the family, she had a low-maintenance hairstyle. She looked after her hair, conditioned it and got it cut at the hairdresser once a year to keep it healthy and under control. John didn’t have any hair left, having gone bald in his late thirties.
Both of them paid a subscription of £400 a month into the National Hairdressing Service to cover haircare treatments, which came directly out of their salary, as this was the law. Even though John didn’t have any hair.
Angie lived in the next street along. She liked to do all sorts of things with her hair, which resulted in it getting damaged. She exposed it to noxious chemicals in home dyes and got heat damage from using hair straighteners on it when wet; generally, she did all the things that people are advised not to do in order to keep their hair healthy. As a result, she needed frequent hairdresser appointments to repair the damage done to her hair over the years. This was all provided as part of the National Hairdressing Service subscription. She also had a subscription, but because she didn’t have a job, she didn’t pay anything for it.
One day, Susie received a surprise wedding invitation for a cousin who was getting married in six weeks’ time. She realised she hadn’t had her hair cut in over a year and that it desperately needed a shape-up before the wedding. She tried ringing the hairdresser to make an appointment, but the automated message said she must book via the app. She downloaded the app and tried to book, but there weren’t any appointments available for the next six weeks. In desperation, she decided to go in person to the hairdresser.
The next morning, Susie walked to the hairdresser. Angie pulled up as she arrived and parked her Motability BMW in the only disabled space outside. One of Angie’s children had anxiety, so Angie needed a car, which the subscription scheme provided for her. A taxi deposited the remainder of her children shortly afterwards and they went in.
Susie’s neighbours, Peter and Joan, pulled up outside the hairdresser just after Angie. Peter needed a frame to walk, but the disabled space was occupied, so Joan dropped him off, then drove away to park in the car park before walking back.
Susie went into the hairdresser. The franchise manager, Rachel, was at the desk. She explained that there were no free appointments and suggested Susie try the Urgent Hair Centre down the road. Peter and Joan were just going in as she left.
Although they were slightly early for their appointments, they had to wait an hour until they were seen. They told themselves they didn’t mind, as they didn’t have to pay for their subscription, although they had both paid it for forty years before retiring.
Peter had a long-term hair condition and if he didn’t get regular treatments, he could become very poorly. One hairdresser, Eric, had looked after his hair for years and kept him well. Eric sadly told him he couldn’t keep coming for the treatments at the hairdresser. Rachel had told all the hairdressers that people like Peter couldn’t keep returning for regular appointments and could be treated just as well at the Minor Haircare Centre attached to the supermarket. Both Peter and Eric didn’t believe this, but they had no choice, as Rachel had decided. This was necessary, she said, so that more people could get their hair done in a timely manner.
Joan was settling in for her routine cut and dry. She had a new hairdresser from China. She tried to explain what she wanted and asked for his thoughts on her style choice. He didn’t seem to know how to cut her hair in the style she wanted, but she wasn’t sure whether this was due to a lack of skill, knowledge and experience with cutting hair or whether he simply didn’t understand her. She knew she couldn’t mention this to Rachel, because her friend Andrea had said to Rachel the previous week that she thought the new foreign hairdressers needed extra support to settle in, and Rachel had reported Andrea for racism.
Joan had read in the paper that a lot of hairdressers had come in from abroad over the last few years and also that many British-trained hairdressers were now unemployed. That seemed an odd state of affairs to her.
The assistant came over. She was very sweet and kind, smiled a lot and brought over a cup of coffee before sweeping the floors. The assistant seemed lovely, but Joan did wonder why they needed assistants to come all the way from the Philippines when Angie’s daughters were living in the next street and not working.
Joan noticed there was a bit of a ‘kerfuffle’ at the next chair along. There was a customer who was new to the area, called Amina. Joan overheard a hairdresser and assistant talking about her. “It’s her third appointment, you know. The first time we hadn’t got the translator, the second time we didn’t have a female hairdresser to see her. Today we’ll need to find out what hair treatment she had in Somalia and whether we need to do an emergency treatment to correct the damage.” Joan saw that Amina was cradling a bump.
Meanwhile, Susie had walked over to the Urgent Hair Centre, as Rachel had advised. She waited an hour in a queue for reception. While waiting, she observed the other people. Some were clearly in need of urgent treatment for hair disasters. Susie had no qualms about the National Hairdressing Service giving immediate treatment to the person who had horrible burns to one side of her hair, but she wasn’t so sure that the woman with a self-inflicted pink and green home dye deserved emergency treatment as she was rushed past. Still, everything was free, or rather included with her subscription, so she knew she should feel grateful.
Eventually, she got to the front of the queue and explained her dilemma to the receptionist. The receptionist looked disdainfully at her, patronisingly pointed out that it wasn’t an emergency and said it was people like her who put the National Hairdressing Service under strain. Susie was so indignant as she tried to explain that Rachel had told her to come here that the receptionist pointed out the ‘Zero Tolerance’ poster and advised her to leave before she called security.
Susie walked back into the high street. She passed the vets, which had a dog grooming parlour. She thought wryly that maybe she’d be better off going there. At least there was a choice. You could choose to have a dog, if you could afford it. You could then choose whether to have the dog groomed, whether to pay for each grooming or whether to take out a subscription plan to cover some or all grooming costs. But there was a choice and if you kept your dog tidy and looked after the grooming yourself, you reaped the financial benefits.
A Deliveroo rider crashed into a puddle just in front of her, messing up his hair. He’d be able to get it restyled on the National Hairdressing subscription and because he worked in the gig economy, he claimed he had no income, so his subscription was free.
Susie was feeling desperate. The wedding was soon and her hair felt lank and flat, with split ends. She was prepared to try something bold. She turned the corner and walked into the small private hairdresser. “Can I get a haircut?” she asked tentatively. “Of course, when would you like it and with which hairdresser?” She got it done there and then, just how she wanted it. At the end, she paid the bill on her card. It felt odd paying for something that was supposed to be ‘free’, but at the same time it felt liberating. Everyone had been polite. They didn’t make her feel a nuisance or threaten her with security. In fact, it felt like a two-way transaction between human beings, a partnership. She had explained what she wanted to the hairdresser, who had listened, made some helpful suggestions and then delivered what she had asked for.
The private hairdresser also offered subscription membership. It was a bit like the dog grooming parlour: you could choose to pay for individual treatments or have a subscription that covered everything, or some things you might need, and pay for extras on top of that. It left the choice to the customer who was paying. Susie liked the idea but couldn’t afford a subscription, because she was already paying £400 a month to the National Hairdressing Service, which she had no option to leave.
She thought how many cut and dries she could have in a year if she were able to use that £400 a month for her own hair needs rather than subsidising other members who didn’t pay the subscription fee and yet seemed to use the hairdresser more.
She saw Angie having a facial in the beauty salon. Because Angie’s National Hairdressing Service subscription also paid for her rent and car, she had a bit of money left over at the end of the month. Susie thought bitterly that she’d love to have a facial but couldn’t afford it, and pondered why people didn’t mind spending money, if they had it, on keeping their face healthy and looking good, but expected the subscription to pay for all hair needs.
She walked home, reflecting on the difference between the ‘free’ National Hairdressing Service, which she paid £400 a month for, as did John, who didn’t even have hair, but from which she couldn’t get the treatment she wanted in any kind of timely or pleasant way, and the experience at the private hairdresser. The latter had left her feeling engaged and empowered rather than disenfranchised.
There was a letter from Rachel on the doorstep.
Dear Mr and Mrs Smith,
The National Hairdressing Service has been under unprecedented strain in recent months. This is due to a combination of factors. There are more people in the National Hairdressing Service membership, more people have greater need for haircare and fewer people are paying into the subscription as unemployment and sickness rise.
Therefore, we have changed the subscription fee bands. Paying subscribers will need to increase their payments. As of next month, the subscription will increase to £800 a month each for paying subscribers in your salary band. The subscription remains free for the unemployed, people on disability benefits and newcomers to the country.
It’s only fair that those with the broadest shoulders pay more. We must protect our NHS.
Rachel
National Hairdressing Service Manager
Susie looked in the mirror. Her hair looked great, but her shoulders didn’t look all that broad to her.
Vanessa Linnett is a hospital consultant, and has worked in the NHS for over 30 years.
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Great article, Vanessa.
A Mr LSO wrote a similar article, although with more sausage.
https://lowstatus.substack.com/p/alternative-medicine
The NHS is obviously badly broken and turns out to have been a terrible idea.
I guess the thing I struggle a bit to get past is this: Let’s say that we should buy medical insurance privately. That’s great – I am all for that. I’m also all for insurance companies staying solvent by using sound underwriting approaches, and for them to seek the best information possible to enable them to do that. There are going to be people for whom insurance is unaffordable because they have health conditions that will cost a lot of money to treat. I guess you could let them die, or socialise that cost somehow. I mean, car insurance is kind of socialist to an extent because underwriting doesn’t have perfect information. I think it’s a lot easier to predict/know about future costs with health than it is with driving. But even then, information on driving will get better – however driving is under your control, largely, apart from people crashing into you which is their fault not yours. Health is complex and by no means under our control in all cases. How do continental European insurance based systems address this?
I cannot think why a product is socialist just because it does not have perfect information. If it had that, those which were not to have a claim in the succeeding year would get a very low price whereas those almost certain to have a loss would not be able to afford the premium.
I regret to say that my experience of medical insurance is that it is much less efficiently run than motor or household insurance.
The article was a good one and represents life in Britain today. If you are from a favoured section of the population you get most things free. If not you pay for them and for yourself and tax on top to keep the elites in bread and milk.
I don’t know much about medical insurance. I would think it has the potential to be much more accurate than many forms of insurance but perhaps they don’t take advantage of that because they don’t want to seem intrusive or because it’s simply too expensive for them currently to gather that level of information.
My point is that the more information you have, the more the price reflects the likely risk and the more that low risk people will pay very little and high risk people will pay a lot more. Insurance shares risk among the insured and spreads it over time. For random, unpredictable events it works well. If you’re a diabetic, good luck finding an insurer that will charge you less premium than your lifetime treatment expenses.
Presumably health insurers would have to be forbidden from carrying out genetic testing or asking about the health of family members so they couldn’t bump up the premiums of people with a genetic risk of developing serious conditions and people blessed with good genes/health would have to accept they’ll end up subsidising those who are less fortunate. Being asked questions about your lifestyle is potentially a trickier subject as it could well end up in people being penalised for making choices, the obvious one being not having certain vaccines, that “the science” says massively increases their risk of needing expensive treatment. If everyone paid the same amount for basic health insurance, there could be enhanced levels of cover for people who are prepared to pay more, less well off people would end up having to spend a higher percentage of their income on health insurance compared with better off people which could be seen as regressive. What happens if someone doesn’t buy health insurance then needs urgent medical care? Are they left to die or treated and have to pay back the cost of their treatment, plus interest? Insurance companies collect premiums which they invest to increase the value of… Read more »
All good questions. I wish I could envisage in my lifetime a sensible debate on all of this but the Holy NHS looks like it will remain sacred for a long time to come – until it bankrupts us.
Yes, but Net Zero will bankrupt us more quickly than the NHS.
Have a look how the Frogs and Krauts do it.
The health insurance is nationalised, it comes straight out of your wages as a tax. Pensioners and benefits scroungers obviously don’t have to pay it but are covered.
The key difference is that the hospitals are private. You chose where to go for your treatment, and the government insurance pays them. Crap hospitals lose customers and go bust. Good hospitals grow. There are no waiting lists, because Dr Piere doesn’t want to turn away hip surgery customers and miss out on the dosh, so he builds another theater and trains another surgeon.
The NHS has no incentive to treat patients, so they don’t
Ok so it’s basically a voucher system- the risk and costs are socialised but there is not a monopoly on provision. Makes sense.
How much choice do people actually have?
If you’re in a large city and need to go to A&E there may well be 2 or more hospitals you can easily get to but in rural areas people won’t have this option. As an example I’m in Inverness, my nearest A&E is less than 2 miles away, the next nearest is in Aberdeen which is at least 75 miles away.
If someone is referred to a specialist by their GP are they going to be able to request which hospital/specialist they’re referred to and are people going to know which is the best option?
In a lot of ways it seems like the best option would be to somehow introduce root and branch reform of the NHS so it puts patients first and offers value for money. I don’t know if this is possible or if it’s inevitable that a large monopoly will always end up becoming a bloated inefficient beaurocracy.
The NHS thinks patients are a nuisance and it could run much better without them.
Kafka would be quite proud.
Thank you Ms Linnett.
All I can say is that this country is in a terrible, terrible place.
Our NHS is so awful on purpose in order to encourage people to stay healthy and not to use it.
Meanwhile Angie’s feckless former partner Jimi, father of Angie’s two youngest kids, has played the mental hair card with a National Hairdressing Service consultant hairologist and referred FOC to the private specialist hair transplant clinic Rasta Re-Rooting…
Amina was initially told she couldn’t get the same hair treatment as she’d had in Somali. She managed to get legal aid to challenge this decision as it was clearly racist and breached her human rights. After winning her case, at the cost to the tax payer of over £50,000, she was provided with with a free taxi once a month to take her 200 miles to a hair clinic where there was a hairdresser who specialised in “Somali” hair styling.
Amina was delighted by this and quickly texted all her friends back in Somalia telling them about the excellent hair care that was provided free of charge in the UK, especially if their hair was a bit bedraggled and damaged by salt wind after 12 hours on a small boat crossing the channel.
Excellent article! Amusingly highlights the deadly serious absurdity of
the, sorry I mean “our”, NHS model. In fact, the metaphor can be extended to the way that we organise our society in general nowadays.Beautifully put, but the answer simply is, dont pay in, dont take out, genuienely ill/disabled exempt, if you have no record of contributing you should not be able to use, and to the people that say, “oh people will die, its not all about money” well yes some will die, but people are now dying because these freeloaders are at the front of the queue and getting all the attention. Other countrys manage so much better than our apology for a Health service.
Brilliant sums things up pretty well!
I feel your pain. I have worked in the nhs for thirty years myself and today’s incarnation of it makes me sick!
I had second hand experience of the way NHS management operates the other day. We had an overnight visitor during the snow fall the other day. A nurse unable to get home and stuck outside our house a 9pm in the country. The following morning when “management” turned up for their morning meeting they discovered about this nurses predicament (which by that time was only a drama to them and was over). However the nurse then received 5 individual calls from each of them asking about her welfare etc. Maybe if one of them had phoned then quickly texted the others. A very small example of waste and cost but the safeguarding box ticked for each. Mind you not doing anything or checking for 12 hours hardly ticks the box.