Happy Birthday, NHS

Happy Birthday, NHS! I’m proud to celebrate the 70th anniversary of one of Britain’s best and most brilliant institutions.

The NHS is absolutely fantastic. I’ve personally been fortunate enough in my health that I’ve not needed much from the NHS beyond childhood vaccinations and the mending of a broken finger, but every other member of my immediate family, and many of my friends, owe their lives to it. I don’t normally talk about my family on this blog, but I’ll break the rule on this occasion: between them, they’ve had 3 operations, 2 ambulance rides, more than 40 scans, over 70 days and nights spent in their care and a further 100+ daytime visits. My Mum has received eye operations at the country’s leading eye hospital and, when my Dad became ill, he was seen by the same national specialist and given the same treatment received by Terry Pratchett (a multi-millionaire, major celebrity and knight of the realm) – because their conditions and medical needs were the same.

As a son, Dad and husband, seeing the absolutely first class care they’ve received; the rapid, responsive way in which doctors and hospitals have given treatment; and the final results, have reinforced my knowledge of just how lucky we are to have the NHS.

I’ve lived in a country which relied on privatised medical care and I’ve seen at first hand just how terrible such a system is:

  • It’s terrible because poor people die for lack of antibiotics that could be bought for a few pounds.
  • It’s terrible because people remain trapped in jobs they hate, because of their absolute dependence on the health insurance that comes with it.
  • It’s terrible because of the inefficiencies and the waste; hospitals that look like hotels, unnecessary scans and procedures carried out (sometimes not just unnecessary but actively harmful) and stupid use of resources, for example consultants used for procedures a midwife would be fully qualified and capable to do, simply because the patient ‘expects’ (and can pay for) the best.
  • It’s terrible because of the huge financial cost placed on even those who do have insurance.
  • It’s terrible of the way it damages the fundamental trust that should exist between doctor and patient, by transforming them into a salesperson. When you know the doctor directly benefits financially from recommending unnecessary procedures – and know that thousands of such procedures are prescribed every day – it’s very hard to genuinely trust them, at least until you’ve been with them for a while.

When we lived in such a system, we were amongst the fortunate few to have fully comprehensive insurance, capable and ethical doctors and good care. But I was still deeply relieved to be back in the care of the NHS. Privatised systems are monumentally inefficient, too: the US spends almost twice as much as a share of GDP (and their GDP/capita is higher!) than the UK and gets no better result. For that matter, the US spends a greater share of GDP purely on state-funded healthcare – i.e. Medicare and Medicaid – than we do on the whole of the NHS.

There are systems which are better than the privatised systems I’ve described above; notably the mandatory social insurance schemes that exist in much Europe. These are not terrible, but still involve significant elements of complexity in terms of the procurement and provision of care, elements of co-paying and cost on those who need treatment and, at times, what treatment you receive depending on what insurance you have, rather than your need (even if everyone is able to get treatment of some form).

If anyone is reading this expecting there to be a ‘But…’, you’re in for a disappointment. Like any large organisation, there is always room to seek further efficiencies to ensure ‘every penny is well spent’, and I admire and respect those seeking to do so, just as I admire the healthcare workers on the front-line. I’m certainly no expert on the intricacies of how this should be done. What I do know, however, is that the fundamental principles of its operation are not just good but ideal. The fact that in this country everyone can receive treatment when needed, without any consideration of personal financial implications, is a treasure beyond price, and one that must be defended and preserved. In particular, that means:

  • Robustly defending the principle that the NHS is a service free at the point of delivery, meeting the needs of everyone, with treatment provided based on clinical need, not on the ability to pay, funded solely through general taxation.
  • Absolutely resisting any move towards a privatised or insurance-based model, including any suggestion of a European-style mandatory insurance model.
  • Absolutely rejecting any form of co-payments, means-testing or other contributions other than through general taxation, including rejecting any schemes such as a nominal fee for a GP consultation. Whatever the pros and cons of such schemes when considered in isolation, the experience of universities tuition fees shows how rapidly a nominal contribution can develop into a fully ‘consumer pays’ model, and any similar scheme in the NHS should be firmly rejected as the thin end of a wedge.

Since its creation, the NHS has consistently been supported and championed by all three of the parties who’ve been in government during that time. It is a genuine national treasure, one of the few institutions that enjoys genuine and whole-hearted cross-party support – and long may it stay that way. Attempts to portray it as only belonging to one party are invariably mischievous, and have the potential to do more harm than good to the NHS in the long-term.

Although my own recent experiences with the NHS have been of an organisation performing very well (contrary to the media portrayals, which love to portray it as falling apart, the typical experience is a very good one), I’m aware that there are financial pressures. I’m therefore delighted that our current Government has given the NHS is receiving a £20bn ‘birthday present’ and am more than happy to pay a little more tax to help sustain it, to ensure the NHS can continue providing the fantastic care it does into the future.

Long live the NHS!