There are many people in the UK who are very proud to have a quality healthcare system that accessible for all regardless of socio-economic standing. Indeed, this was celebrated during the London Olympics in 2012, when we saw performers give a tribute to our much-loved NHS during the opening ceremony. In fact, Foreign Secretary Boris Johnson even recently declared that the NHS is ‘one of the great unifying institutions of our country’.
Despite this however, it seems that a day never goes by without us hearing a negative news story about the NHS. It could be about the lack of funding or hospital waiting times. We often hear in the media how certain hospitals or entire trusts are failing to meet targets. So just how good is the NHS and indeed is it really the envy of the world?
The cost factor
Let’s first take a look at the cost factor. Value for money is a key factor in determining how good the NHS is. You get what you pay for. However, if you paying very little but getting a lot in return, then your viewpoint automatically shifts to a more positive one.
To put this into context, the Department of Health plans to spend £123.7bn on health in England in 2017/2018. This equates to around £2,200 per head and approximately 18% of total government spending. In fact, if you factor in what is being spent in Scotland, Wales and Northern Ireland, then this figure is even higher. Most of the money (around £50bn) is spent on staffing costs. After all, the NHS employs more than 1.3m people making it the world’s fifth biggest employer. £16.8bn will be spent on drugs and medication. Around £2bn of this is being spent on a selection of ten ‘blockbuster’ drugs used to treat conditions such as arthritis and breast cancer. Overall, around £108bn of the £123.7bn will be spent on the day-to-day running of the NHS with the rest being used for public health initiatives and infrastructure.
Around a fifth of your taxable personal income is spent on directly funding the NHS.
So is all this money worth it?
That depends. If you are a healthy person who rarely visits a hospital and you are lucky enough not to have any significant ailments later in life, then the answer is ‘no’. You have essentially been funding a healthcare system for others to use. However, if you and your family suffer from many health problems and you find yourself using NHS services at least once a month or more, then the answer would most likely be ‘yes’.
A lot of this also depends on your own personal opinion and viewpoint. You could, for ideological and prestige reasons, believe that the UK should support a system of healthcare which is free for all at point of delivery. However, if you eliminate any leftist and/or patriotic views about the NHS and just merely look at the figures, then it’s quite clear to see that the system is not working.
Determining how good the NHS is not simply a question of whether your political views are left or right leaning. Opinions around the world vary. If you spoke to somebody living in the developing world, where access to healthcare can be non-existent, they would probably tell you that our NHS is a wonderful idea. Even if they don’t appreciate the costs involved, they probably wouldn’t have such high expectations.
However, the NHS does have it’s many critics right here in the UK. According to Mark Littlewood, Director General at the Institute of Economic Affairs, ‘the UK has one of the highest rates of avoidable deaths in western Europe’. Mr Littlewood goes on to say: ‘it’s all very well to say the UK has the safest and most affordable healthcare system, but if more patients are dying in the care of the NHS than in other healthcare systems, something is not right’.
In contrast to this, a report produced by the Commonwealth Fund, a US based foundation known for its expert analysis of healthcare in different countries, tells a very different story. The report ranks the UK number one on quality, access and efficiency. However, it does recognise that the NHS has a poor record of keeping people alive. It is this point that Mark Littlewood is drawing to our attention. Indeed, Mr Littlewood’s assessment of the report is that it is ‘dangerously misleading’.
So, opinions do vary wildly. It depends on what factors you are taking into consideration. It also depends on your expectations. It is true that people’s expectations today are far higher than those of 50 years ago. Indeed, some might even say that your political viewpoint is also a contributing factor.
How the NHS is viewed around the world
Some argue that if the NHS was the envy of the world, then why isn’t it replicated in other countries? The UK is somewhat of an anomaly when it comes to offering free healthcare to all. Almost all other developed countries around the world offer high quality universal healthcare via some kind of insurance or subsidy scheme. Healthcare isn’t simply funded through taxes like here in the UK.
One of the main sticking points is that people are living longer and thus, the burden on healthcare, regardless of where you live in the world is increasing. Healthcare costs are only going in one direction and the money has to be found somewhere. The conundrum for the government is how to find this extra money. Raise taxes and fear the wrath of the voters or cut costs elsewhere? For several years now, it has been the latter. One thing is clear and that is whatever is being done about the funding gap is not working. After all, two thirds of hospital trusts are in the red.
The NHS is a highly emotive topic. Your viewpoint may depend on personal opinion, political standpoint even nationality. Trying to determine whether the NHS is the envy of the world is difficult. After all, how do you measure how successful the NHS really is? Patient waiting times? Profitability? Individual personal experience?
We are very lucky to have a system of free healthcare. Furthermore, the healthcare system in the UK is home to some of the best clinical specialists in the world. Nevertheless, there is certainly room for improvement. The NHS probably needs more money and improved efficiencies. So perhaps instead of asking whether the NHS is the envy of the world, we should really be asking how it can increase funding and make tangible cost efficiencies?