The NHS Confederation this week raised concerns about the health service’s ability to cope with a second wave and a vast backlog of treatments over the course of the winter, strengthening an already-watertight case for system-level reform of the UK’s healthcare system.
Over the course of this crisis, the NHS’s status has reached a new zenith. Nigel Lawson famously said that the NHS is the “closest thing the English people have now to a religion” but his words may not go far enough. It has replaced God: omnipotent, eulogised, wholly beyond criticism.
Last week, and not for the first time, the Prime Minister urged us to act as a “human shield” to protect our “greatest national asset”. In July, on the NHS’s 72nd anniversary, the health secretary declared it the “best healthcare system in the world”. As a colleague remarked at the time, it is debatable whether the NHS is the best healthcare system in Britain.
The evidence is so overwhelming that a Dutch or Danish or French or German style of healthcare would be superior that it is entirely bewildering that surveys consistently reveal favourable opinions of our beleaguered system.
According to a recent YouGov poll, just 14 per cent of Brits think the NHS provides worse quality healthcare than other European countries. In one survey, the British public was asked what they considered to be the “coolest thing in the world”. The NHS is an institution like any other, like the Office for National Statistics or the Water Services Regulation Authority. Yet it came out on top, beating James Bond and space travel.
In reality, the NHS is an international laggard in terms of those health outcomes that can be attributed to the healthcare system. In comparisons of health system performance, it almost always comes out in the bottom third, on a par with the Czech Republic and Slovenia. Your chances of still being alive five years after being diagnosed with cancer are generally lower in Britain than comparable countries.
If anything, the pandemic has thrust its shortcomings front and centre. We have the second-highest excess death rate in Western Europe (after Spain). In some of our neighbouring countries, things are already more or less back to normal, healthcare-wise. Here, as the NHS Confederation has flagged, we are buckling under the backlog. Millions will be left waiting months – if not years – for life-altering operations.
Is it any wonder that politicians implore us to shield the very system designed to protect us, given its shortcomings? The UK has 2.5 hospital beds for every thousand people, compared to the OECD average of 4.7. We have 2.8 practising doctors for every thousand people, compared to the OECD average of 3.5. We have fewer CT scanners and MRI units than most OECD countries.
We’ll all be back on our doorsteps before too long, clapping for carers, gushing about the embattled staff the NHS failed to protect back in spring by procuring the requisite PPE. But how can we applaud the broken system in which these brave front-line workers are trapped?
When this pandemic has passed, we will be forced to examine whether international examples of social insurance models which deliver better outcomes and put patients at the centre of the system performed better during this crisis and recovered more quickly. Perhaps then we can convince the British public that there are alternatives to the NHS beyond the US system or the Victorian infirmary.
And perhaps we can ensure that the NHS meets demand in normal times and is able to adapt quickly in the face of unforeseen events — like, say, a global epidemic.
Main image credit: Getty