Marketisation and Openness to Change: Solutions to Britain’s Ongoing Healthcare Crisis
Recent months have no doubt witnessed Britain’s National Health Service (NHS) suffer from a monumental level of turmoil. Numerous cancellations, prolonged waiting periods, and an increasingly overwhelmed workforce have all featured prominently in what has proved a remarkably challenging period for a health service widely viewed in the UK to be “the envy of the world”.
On the back of such occurrences, many in the British political and medical establishment have been quick to point the finger of blame at the current Conservative Government, viewing insufficient funding as the main factor behind the crisis. Whilst a lack of resources certainly do appear to have played a part, is it factually accurate to declare underfunding to be the root cause of it all? Or, would it be more apt to assert that the mounting problems ultimately stem from something far more endemic and central to the NHS model itself, namely its top-down, state-centric, anti-market complexion?
Whilst the deficiencies that currently overwhelm the NHS do seem unprecedented in their size and scale (being exacerbated by resource shortages, as well as an ageing, growing population), they can hardly be viewed as anomalous. Statistical findings produced by the Organisation for Economic Cooperation and Development (OECD) have repeatedly found NHS performance in areas such as a survival rates for major diseases; average waiting times; and patient choice to lag considerably behind the performance of the market-orientated social insurance systems present in other western countries.
On the specific issue of outcomes, the Independent went as far as to declare that, according to OECD research, the “UK now has one of the worst healthcare systems in the world”. Moreover, spending on the NHS in real terms has been on the rise in recent years whilst outcomes have simultaneously been in decline. Drawing upon such empirical findings, Kate Andrews from the Institute for Economic Affairs concludes that the “NHS is consistently behind Western Europe, North America and the developed parts of Asia. It is usually about on a par with the Czech Republic and Slovenia.” With all this in mind, can one really maintain with confidence that all that is needed to rectify the situation is a further injection of public funds?
Regardless of what the evidence may affirm, many in Britain’s political and medical establishment remain unyielding in their rugged emotional attachment to the current model. In doing so, they effectively give priority to populism and dogma over empirical data, opting to turn a blind eye to the research findings of a myriad of mainstream sources (from Eurostat to the Commonwealth Fund to the Wealth Health Organisation), all of which confirm that the outcomes of Britain’s health service to be inferior to those achieved in other developed states.
Such apologists for the NHS are no doubt motivated by a noble intention, namely that of preserving what is, in theory, a functioning health system, delivering comprehensive free coverage to all citizens regardless of age, income, or class. The problem remains, however, that in their refusal to even consider the possibility of moving towards a less more market-centric model, they effectively deny the opportunity to implement the kind of reforms needed for delivering optimum health services for all British people.
Whether they like it or not, those loyal to the NHS must contend with the truth that numerous developed Western states including the Netherlands, Switzerland, Australia, and Israel all feature social insurance systems which allow for the kind of competition and enterprise conducive for greater innovation and choice, whilst preserving the universal coverage which is widely cherished. Not only have such systems repeatedly produced superior outcomes, they haven’t always required substantially greater funding such as that which the NHS presently receives. At present, Italy, Finland, and Israel constitute just some of the examples of western countries that spend less on health as a percentage of GDP.
Attempting to extinguish the present crisis through mere increases in public funding, whilst leaving the current model unaltered, is thus about as facile as attempting to fix a faulty car through a new paint job. Truth is, one simply cannot remedy a faulty model without first reforming the model itself.
Unless the British people and Government can bring themselves to embrace a different approach, no shift in the current trajectory can be expected. It is therefore vital for all those committed to maximising quality, competition, and choice in the economic realm to make themselves heard in championing the injection of greater freedom and market forces into the provision of UK health care. The future health and freedom of millions could well depend on it.
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