Surgery's Dirty Secret BBC Scotland Investigates

The tools of a surgeon's trade can mean the difference between life

and death. Every single thing needs to work at

the time it's handed to you. what if it doesn't? It's an eye

instrument. I cannot tell you how bad it is. We uncover The Truth

about what goes into our hospitals. Look in here. This is what they've

been making. The lies about where they are made. You don't want

people to know this is from Pakistan. Child labour in a

dangerous industry. And the deception we're all paying for.

Would I ever have to admit that it wasn't German steel? Tonight, we

reveal Surgery's Dirty Secret. cannot believe anybody in the NHS

Every year, millions of operations are carried out in Scotland and

across the UK. Our National Health Service is one

of the biggest and busiest health care services in the world. Modern

surgery has come a long way since the first medical procedures were

attempted centuries ago. What has not changed in this time is the

importance of the tools used by the surgeon. Paul Srodon is a surgeon

at St Bartholomew's Hospital. The operations he carries out are live-

saving. We have somebody with a threatening limb situation, you are

fighting to save their limb or life, those tools of the trade, they need

to be just right. Every single thing handed to you needs to work

at the time it is handed to you. It's no good discovering something

doesn't work as it should do and have to hand it back and get

another one. Any bit of that process nudges that towards

delaying a person's recovery, resulting in an incomplete recovery

or resulting in limb loss or death. We all assume that surgical

instruments are made to the highest of standards. After all surgeons

use them in hospitals to help save lives. Over the last year, I have

been investigating these instruments. The evidence I've

uncovered suggests all isn't well Nottingham is home to Dorothy Brown.

She was a nurse for more than 30 years, until two years ago when she

became unwell. One day when I was working and I could feel my heart

really pounding heart and -- hard and fast. I sat down, I thought

there's something wrong here. Dorothy underwent a couple of heart

operations to repair a faulty valve. It was after the second operation

that things started to go badly wrong. Dorothy didn't know it, but

a number of other patients had undergone the same heart surgery

and become well. All had developed a -- become unwell. All had

developed an infection. I knew I was dying. All I was thinking, was,

let me go to sleep now. I'd just had enough.

In total, five of the 11 heart patients who contracted the bug

died. I managed to get a cop pi of the confidential report into --

copy of the confidential report into what happened. It could have

been transmitted through small punctures in the surgeon's glove.

They are often caused by purely made surgical instruments. If this

is the case then poorly made surgical instruments could be

killing patients. The trust insists all cardiac surgeons wear two

gloves or thick sets. There are no official figures in the UK. We have

come across three cases where sub standard instruments have been

caused to death or causing serious harm. In the US there are almost

1,000 recorded adverse incidents involving badly made surgical

instruments every year. I made contact with three NHS

surgeons, who told me that sub- standard surgical instruments were

all too common. Worried that speaking out could destroy their

own professional representations, they refused on-camera interviews.

They felt so strongly about what I was investigating, they said I

could use their testimony. These are their words.

There's not an operating week where nothing goes wrong. Rough edges on

the instruments will slice my hands. You know this patient is bleeding

longer than he should because your instrument is not working You look

at your glove torn by the rough edge of a instrument, and you think,

"Have I cut that patient's bowl with this?"

-- bowel with this?". We are meant to fill out incident report forms,

you know an instrument failing. Now because it happens so often many

surgeons I know just don't bother. If he filled in a form every time a

instrument failed, we would spend the afternoon operating and the

morning doing paperwork. I've made contact with one NHS worker who is

prepared to be interviewed on camera. He's someone who would

normally never speak out in the media. He's so worried about the

quality of surgical instruments that he's agreed to talk to me. And

effectively blow the whistle on the situation. Now the workshop where

he works is down here. This is where all the instruments that have

come into the trust get tested. I am guessing this is it. Tom, I'm

Sam, from the BBC. Nice to meet you. Tom Brophy is the lead technologist

at the bartsand London NHS Trust. He's the last line of defence

before the instruments get to the surgeons in the operating theatre.

He says the quality of many of the instruments is so bad he's begun

dock you meanting the faults he sees. These are eye instruments,

used in ophthalmic surgery. For me, I don't know how they have made it

that bad. For it to have a trench. That should not be there? That

should be flat. That is a trench. There's the tunnel. Look at the

burrs. That is used for the eye? Look at the burrs, all the way

along. This is so bad, I can not tell you how bad. These defects

might seem small, but in the precision work of surgery they can

mean the difference of saving an eye or blindness, saving a life or

death. Tom Brophy shows me other faults he has picked up, from

meticulously checking the instruments through his microscope.

There is everything from burrs to sharp metal.

You can see how sharp that guide pin is. That is really sharp. That

will easily puncture into a surgeon's glove. He often finds

fractures and wells on some instruments which can trap body

tissue and blood, even after sterilisation. One example was a

heart retractor, designed to be used on a baby. That was a 15

millimetre burr. Actually along the blade of the retractor, along there.

That is like a needle. If we hadn't stopped that, that could be

potentially used on a very young baby.

Tom Brophy now rejects almost 20% of instruments sent to him.

That's one in five of all the surgical instruments supplied to

the trust. Some suppliers even send him used equipment, but sell it as

new. One instance, there is blood still

on the actual instruments. There's actually dried blood on about 11%

of the order. So what happened happened they have rerouted

themselvess back into the sales market as brand new. I don't know

how they get back in. They have. There are over 180 health trusts

and boards in the UK. Companies which supply Barts can supply these

same organisations up and down the country. With exactly the same

surgery instruments. There's no Tom Brophy equivalent here in Scotland.

In fact, Barts is the only NHS Trust in the UK where every new

instrument is hand-checked by a technologist to British standards.

On more than one occasion a supplier has rang me up and said,

you rejected, I passed it on to another hospital and they accepted

it. My answer to him was, of course they're going to accept it because

they haven't checked it. More worryingly, when he spoke to me it

was corroding and it was a cardiac instrument. Some suppliers whose

instruments are rejected by Barts are selling them on to other UK

trusts. Suppliers can be manufacturers or middle men, major

companies or one-man bands. There are at least 900 licensed

manufacturers who can sell surgical instruments to UK hospitals. The

vast majority used 234 our operating theatres are -- the vast

majority used in our operating theatres are not made here, but

I'm on my way to see Sialkot. It's an industrial city in the Punjab

and where two-thirds of the world's surgical instruments are made. One

in ten of them is sold to the UK. Only Germany and the United States

Few westerners come here. Today, I'm going to see two factories,

both visits arranged for me by Sialkot's Chamber of Commerce. The

companies make surgical instruments for the UK and are two of the

largest in Pakistan. The first factory visit arranged

for me is with Hilbro. Outside its chief executive, Muhammad Ashraf,

is waiting for me. Asalaam Alikum. Nice to meet you.

What we are about to see? It's so noisy. This is the manufacturing

process. The manufacturing process. Wow! My goodness! Inside, a massive

The clatter of the drills is deafening.

All of the workers making surgical instruments.

Many here have worked in the industry for years. And these would

be for the UK? So, to you do many You sell to a different dealer? The

instruments Mr Ashraf's firm makes can pass through several suppliers

before reaching UK hospitals. Over three levels and sitting in 26

acres of land, Hilbro is one of the biggest factories in Sialkot. Mr

Ashraf shows me floor after floor of machinery, which he is very

proud of. In one part is a massive vacuum furness, which hardens the

metal. One of only three in the whole of Sialkot. Is that acid?

Shouldn't they be wearing goggles? It says this! None of them are

doing it. But you are the boss! Aside from the obvious health and

safety breaches, Hilbro looks impressive.

It is nice to see women working here. Clean and spayous, it has

some of the latest machinery. Upstairs is the quality control

room, the final process before items are shipped around the world.

Every instrument is examined under a magnifying glass before being

Can I have one of those to take? As Can I have one of those to take? As

his sister of get me a sample, the manager makes a surprising request.

You don't want people to know this is from Pakistan? Thank you very

much. His request for me not to tell anyone that the instruments

are made in Pakistan is to become a common thread throughout my time in

the country. Just a short walk away is the second factory set up for me

to see by the Chamber of Commerce. This one makes surgical instruments

for countries all over the world. The UK is one of its biggest

customers. Looking around, it seems even more impressive than Hilbro.

The staff are all wearing uniforms, and the production process itself

looks well-organised. The factory is busy and clean, and the

instruments seem to be rigorously checked before being packed. I came

to Pakistan to see how our surgical instruments are made. And from what

I have seen, it all looks incredibly professional. Well, that

have no very clearly was the public face of the surgical instruments

industry which the Chamber of Commerce wanted us to see. It is

professional, spot last, but it makes me wonder, from what I have

heard, what I have been told, whether it is the true face of the

industry. And I don't think it is, not by a long shot. But exposing

the true face of the industry is not going to be easy. Pakistan is

regarded as one of the most dangerous countries in the world.

Last year alone, more than 2,500 people were killed in terrorist

attacks. As both a Westerner and a journalist, the safest place for me

to stay is in Lahore, a or 3.5-hour journey away from Sialkot, but it

is a journey and will have to make every day. The area where I'm

filming is close to the Indian border, and the disputed Kashmir

region. Every day at sunset, flags are symbolically lowered at Wahga,

between Pakistan and India. Roadblocks and coils of razor wire

add to the already tight security on this stretch of no-man's land.

Wahga is known as the Berlin Wall of Asia. It is often a barometer of

the tensions between the two countries. This ceremony is seen by

few foreigners. This is everything to do with pride, passion and

Apology for the loss of subtitles for 50 seconds

Previously at this border, shots have been fired and people have

been killed. The ceremony is impressive, but the intimidating

gestures and underlying aggression reinforce how volatile the area is,

and stress the differences of investigating working practices

here. Overnight, I have received a phone call from one of my contacts.

An owner of one of the smaller factories in Sialkot has agreed to

meet me and let me film inside one of his units. Maybe this is my

chance to see the private face of the surgical instrument industry. I

head down numerous dusty lanes in A local translator comes with me to

Regal Medical Instruments. I have been told it provides surgical

instruments for several companies in the UK, which in turn supply to

Inside are conditions for isn't It is so dark, it is difficult to

see. The dust is so thick, it takes It is difficult to know what I am

looking at. Surely these can't be surgical instruments? But they are.

Which country will this go to, do you know? And how many workers do

you have? 40, 45 people working. I going to another part of the

factory, it becomes even more difficult to see. Our camera,

already struggling to cope with the dark conditions, has to be

constantly reset. The electricity goes out. It happens often, I am

told. But it is difficult to see how the quality of instruments can

be controlled in these conditions. Upstairs, my concerns about quality

control are increased. This is where the instruments are supposed

to be checked before they're stamped and packed for shipping.

This is the most important part of the manufacturing process. This is

where it is decided if the surgical instrument is safe enough to be

used by a surgeon somewhere in the world. If it passes what should be

a rigorous inspection, it is stamped with a quality mark, the CE

mark, meaning a product is safe enough to be sold in Europe. Unlike

the other factories I have seen, there would appear to be no

magnifying glasses, which are essential for identifying

microscopic flaws. What checks we see being carried out are made with

the naked eye. So, this is the quality control stump? Yes. Can I

have a go? Do I have to check it first for quality? They allow me to

stamp a setter for sex, used to graft body tissue. -- a set of

I have now witnessed the entire process of a surgical instrument

being made in this one factory, right down to the stumping of the

quality mark which acknowledges a job well done. It looks to me as if

Sylvinho real rigorous quality control here. But the only way I

can be sure about this is to take some instruments and get them

checked. Later, Regal Medical Instruments told me they always

focus on qualifying -- on quality. That night, I start recording a

video diary to document what I'm finding. I feel absolutely filthy.

I just can't believe that... I cannot believe those instruments

are made in those conditions, using the equipment that they have, in

the places that they're made. And there is no real definitive barrier

between those units and the NHS in terms of real quality control. I do

not mean giving them a cursory glance, checking that they're all

the same length, I mean really checking the instruments, in the

same way that Tom Brophy checks his instruments. The following morning,

and I'm back in Sialkot. I was about to discover an entirely

different face of the surgical instruments industry, one I was

completely unprepared for. Driving through the backstreets, I noticed

a number of small workshops. In them, there were only a handful of

men, making what looked like surgical instruments. I speak to my

contact, who tells me the larger medical instrument companies often

farm out the work to smaller units so they can fulfil their contracts

in time and increased profit. It is called outsourcing, the lowest and

Street after street, in every conceivable the bit of space, are

workshops. Men sit cross-legged on the ground. There's barely enough

light to see their faces. This is what they have been making. Open

sewers at the doorways often make filming difficult. Each of these

workers, I'm told, will earn just �2 a day. There are more than 3,000

outsourcing units like these in the city. Conditions are often so bad

that many larger companies do not like to admit to being involved in

the practice. I was told that the large factory we filmed at the

beginning of the trip, Hilbro, was also using this kind of labour.

Renews beat to Hilbro about this, they're quite kaygee. This is one

of them now, we will go and see what they do. So, this is one of

the outsourcing units for Hilbro? All around me, surgical instruments

are being made. This is where most of the manufacturing happens, where

the forged metal is taken and turned into tools for the world's

hospitals. Even though the instruments which lie on the floor

are destined for health services like the NHS, those who will be

using them, the surgeons, can have no idea that this is where and how

they're made. Do you know which country these are going to? The one

on your hand is going to Russia. That one is going to Japan.

Germany... Have you got any for the UK at the moment. This one is for

England. So, manufactured in Pakistan and destined for the UK.

But unbelievably, a different country will be taking the credit.

They will be stamped, made in Germany. And it will be stamped

I understand, but the stamp does not say, material from Germany, it

What he's telling me is true. Surgical instruments, even ones

made in the dreadful conditions of the outsources units are allowed

bylaw to be stamped with another country's name. According to

European legislation, a country can claim ownership if it has helped

transform a product. In this case, it could mean providing the

original steel. Instruments stamped "made in Germany" sell for a lot

more than instruments stamped "made in Pakistan."

That was Hilbro, the outsourcing unit. I am delighted about that.

That means we can categorically link the outsourcing unit, that one

there, which is Hilbro, which then supplies to the larger company

Hilbro, which we have seen, the very large face of the surgical

instruments industry. We can categorically link Hilbro with the

NHS in the UK. There are instruments being used today, on

patients, in the UK, which have been made in that outsourcing unit.

So it's great to be able to tie all that together.

I'm only able to link these workshops with the UK because I

came to Pakistan. Responsibility for labour standards rest not with

the NHS, but with its suppliers, who can sign up to a code of

conduct. Here the people I speak to in Sialkot tell me British health

care companies make full inspection visits. Working here is difficult.

I've had to move to a second hotel, after my first one was threatened

with a bomb attack. The level of security just to get into my room

is a frightening reminder of how volatile this country is. When we

film in the streets we find ourselves targeted with anti-

western sentiment. What do you mean by BBC. Take it away. Get it out.

We are constantly stopped by the This is getting ridiculous.

Despite the dangers, surely a more robust system is needed at a

national level in Britain to ensure proper inspections take place here.

It does make you kind of look at the way we view cheap labour, and

how we deal with it. I think the NHS has got a big

problem here. I really do. Whether the NHS likes it or not,

whether the NHS knows it or not, it's involved in all of this. It's

party to all of this. It's party to the workers in Sialkot that we met,

to the factory owners who can't afford to pay their staff decent

wages. If the NHS is party to this, and our taxes are funding the NHS,

then I guess we are just as The majority of the world's

surgical instruments are made in Sialkot. With the UK buying more

than 10 million of them a year. It means most of the instruments

being sent to Tom Brophy and used on patients like Dorothy Brown, who

I met, are made here. Globally the industry is worth �18 billion a

year. Pakistan receives just a fraction of this - less than 8%.

The bulk of the money goes to middle companies which sell the

instruments on with massive mark- ups. But I was to discover there's

another hidden cost of our health While investigating the badly made

surgical instruments which could be endangering lives in the UK, I was

to find out they also often harm He said, I was working with the

press and I was carrying a piece in my hand. I put it under the press,

He's also lost the sight in one eye. The irony here is these workers end

up going to hospitals to be treated with the very instruments which

helped cause the industry in the first place. A surgeon who often

has to operate on them agrees to If the hand is missing, we like to

Really? Yes. Thank you very much. It was nice to

look around your hospital, and oh, thank you very much.

Asalaam Alikum. She's lovely! Right, thank you very

much. Goodbye. It's not difficult to understand the pressures these

men are under to get back to work. Nearly half of the country live

below the poverty line. The typical wage in the surgical instruments

industry is 7,000 rupees a month, that's �50. Many are paid much less.

I've heard things are so bad that outsourcing is not just confined to

the city. The industry has now taken over entire villages. I head

to a village 20kms from Sialkot. So, it's right in the back streets this

one. Yes, the narrow streets of the villages. As I walk through the

back lanes I heard the unmistakeable sound of grinding

metal. This is in the middle of nowhere, this. I'm being taken to

what used to be someone's house. Come and have a look at this.

It's packed full of workers, some look very young. The NHS has

publicly committed itself to ethical pro-kurment.

Manufacturers -- procurement. The NHS can have little way to know

whether their scissors,Les and foreaccepts are being made in

conditions like these. -- forseps are being made in

conditions like these. I can't believe the conditions and

the dust and the dirt. Everything is just awful.

Some of these instruments will be sent back to the larger factories

where they will be checked. Watching the speed at which these

instruments are made though, again it's difficult to see how any kind

of quality can be maintained. How much would you sell something

like this for to the next company? 40 rupees. That is less than 2p an

instrument. They will be sold to the NHS for several pounds. These

factory owners admit the quality of their work can depend on what they

If you are given an order, but the money is very, very bad, will you

spend less time on the quality and more time on the countries that are

paying more money? So, the less money you get, the

less effort you will put into the quality?

In other units I notice young faces hard at work. The Chamber of

Commerce told me child labour didn't exist in the industry.

Whilst I haven't seen lots of children, I have seen children.

This is Kabir. Although we were not allowed to film him in his usual

workshop, we ask him to show us the machinery he normally uses. He is

14 and has worked in the industry These surgical instruments, which

Do you wish you didn't work in that If you could do anything, Kabir,

anything at all, what would you The fact this is a child's life is

shocking enough, but then Kabir shows me the true cost he has paid

since working in factories since he was eight.

You have crushed your fingers? They Just like this, my leaf was crushed.

Your hand was crushed like the leaf?

And you have some fingers just In some accidents some kids die, so

his fingers were used to put in there, it's not his own fingers.

They are somebody else's fingers? Somebody else's fingers. A young

kid died in an accident and their So these two fingers....? They are

from two different boys. One was younger, one was older. That's the

reason one is shorter and one is Any name is Sam.

My name is Sam. My name is Kabir. My name is Kabir. Very good! Blue.

I am blue. No, blue. Blue. A report estimates that up to 5,000

children here are employed making During my time in Pakistan, I've

witnessed terrible working conditions, questionable quality

control and children working. All in the manufacture of surgical

instruments, which will be used on patients in the UK. I want to ask

the trade body which represents the industry here their thoughts on the

situation. Do you accept that you have

problems with this industry that I have described?

We are working very hard, but I will not deny the fact that if he

has to choose between sleeping and working, the child will choose to

work a little bit. What about the lack of quality control? Don't be

concerned about that, because a company which stamps the CE mark,

they're qualified to do that. want to show him the reason why I

started this investigation in the first place - dangerous and poor

quality instruments in the NHS. When you say there is no danger

from surgical instruments... But if they're made badly...? If we are

using the proper stainless-steel... But that's not true. Are you happy

with that? It is made in Sialkot. It is very common. I don't know

wattages. This is a guide pin, it should be flat. It can puncture the

surgeon's gloves. Forceps, with a bit which has come off. Corrosion...

This is wrong, I agree. If you operated on somebody and a piece of

that was left behind, it could kill somebody. It was sent from Sialkot

into a hospital trust in the UK. That might have been done by some

unscrupulous manufacturers. what about the practice of stamping

a different country of origin on an instrument which was clearly made

in Pakistan? The industry is not My time in Pakistan has been an

unforgettable one. I have seen pride and passion in a country in

turmoil. I have seen skills in an industry the world's health care

systems are relying on. But I have also uncovered the exploitation of

workers, child labour and questionable instrument quality. I

came here not just looking for answers, but possibly looking for

someone to blame. It is only when I return home that I discover where

Back in the UK, and I want to show my footage to someone firmly on the

side of patients when it comes to health care, the world's first

professor of patient safety, who has investigated cases of serious

adverse incidents in hospitals on behalf of the Government. Do you

know what they're making there? were told those instruments were

used for cutting away tumours. My God, I find that almost

unbelievable. I would not believe that you would make surgical

instruments in this kind of condition. I showed the stamping of

the instruments to Professor Brian Toft. Surgeons are taking

instruments which they believe to be of a high-quality, using them on

patients, believing they are doing the best they can, when really they

have been made under these conditions. This is unfair on the

patients, unfair on the people buying it, and unfair on the people

making it. Procurement officers, if they knew this was happening, those

surgical instruments were coming from that room into their hospitals,

they would faint at the thought of it. And cannot believe that anybody

I head to Barts to catch up with Tom Brophy, who has been testing

some of the instruments I brought from Pakistan. In this envelope, we

have all of the failures. These are the failures? Yes, these are the

one has the trust would accept. most of them have failed. Yes, 63%

have failed. I can list the reasons why they failed. My instruments

failed for having faulty screw heads, pitted metal and burrs.

you see that? I can. There were also poorly made guide pins. We're

trying to protect the patient and the surgeon. That's going to rip

through the gloves of a surgeon. is, there is no need to have it

I feel really disappointed that those instruments failed. Having

spent time in Pakistan, you can see the workers are really doing the

best job they can in really difficult circumstances. It is

frustrating, because they have got the skills, there's a willing

workforce, but all the while countries like us, and remember,

the UK is Pakistan's third biggest customer in surgical instruments...

So, all the while we exploit this kind of Labour, we do not pay the

right kind of money, and we do not give the right kind of support,

then I guess, you ask, is anything going to change? The body

responsible for the quality of surgical instruments is the

Medicine and Healthcare Products Regulatory Agency. They were

unavailable to be interviewed. But in a statement, they told us they

One man who's trying to make a change is a surgeon in Oxford who

has walked the same street as me in Sialkot. Since his return, he has

been lobbying government to ensure there is ethical procurement as

well as greater transparency within the supply chain. That's the first

time I have seen anything like this since I was in Pakistan. It is

strange to see them in such a clean environment. It is quite odd

because now that you know where these products could have been

manufactured, it puts a slightly different slant on it. Dr Mahmood

Bhutta believes it is patients who now have the power to influence NHS

purchasing. The reputation of the national Health Service is at risk.

You cannot boycott the national Health Service, but what we can do

is... Hospitals are accountable to local populations. If people

actually care about this issue, and they say, I want my hospital, my

surgery, to buy things ethically, not to be engendering these

horrendous working conditions, then the voice of the patients must be

listened to. But for the NHS to answer patients' questions about

ethically made instruments, there needs to be greater transparency

within the supply chain. Remember Regal Medical Instruments, the

company which allowed me to stamp their instruments with the quality

control mark. They told me they did not have a company in the UK. But I

found a Regal Medical Instruments in London which shares the same

Pakistani fax number. Posing as a buyer wanting to sell on

instruments to the NHS, I made contact with a Mr Shahbaz Hussain.

What he told me on the phone suggests he would bend the law to

secure a contact. -- contract. I have arranged a business meeting in

a London cafe. What he doesn't know is that I will be secretly filming

him. Sorry, let me get your name. Which one is Shahbaz Hussain? Just

to tell you a bit about myself... I tell them I work for a company

which will ultimately be selling surgical instruments to the NHS.

it a British company? Yes. You're a product manager... Have you got

samples with you? If instruments their markings of countries and

companies other than where they're made, it makes it difficult to

trace the source when things go wrong. I ask them what country of

origin markings these instruments will come with. They then tell me

the different grades of steel I can buy. Different qualities.

that's important for me. What are Presumably German steel is the

best? We can stick the German stamp on even if it is from Pakistan?

Would I ever have to admit that it was not German steel, that it was

actually from Pakistan, would anybody ever know the difference?

It is not very easy to judge it. they were offering me lower-quality

Pakistan steel for using the NHS, but they will stamp it German. This

is illegal. For what they tell me, it is already happening within the

industry. So, other people do that? Yes. All the while companies like

these are willing to break the rules to make a quick profit, how

are those responsible for surgical instruments in the NHS able to act

to clean up the industry? Scotland's Health Secretary, Nicola

Sturgeon, said procurement was the responsibility of NSS, National

Services Scotland. NSS refused an interview, but said it required

operators to apply ethical standards. Just as consumers are

demanding to know how their tea and coffee is grown, how their clothes

are made, surely our Health Service should start to examine where they

sourced their surgical instruments from, and make sure that they're

trading ethically. Dr Mahmood Bhutta is right, we cannot boycott

the NHS, we all needed and we are all paying for it. But after what I

have seen, I'm not sure how comfortable I feel about funding an