Thursday, 5 June 2014

Defending the NHS

The NHS is under a sustained attack both from media and government.  I wrote about this a year ago (see here) and very little has changed.
One effect of these attacks is to demoralise NHS staff who deliver an excellent service despite shrinking resources and falling pay. The other is to destroy public trust in the NHS. Both pave the way for a takeover of the NHS by alternative healthcare organisations.
There are many reasons why we should defend the NHS to the hilt. Here are my top five:
1.      The NHS delivers universal comprehensive healthcare. It delivers not just a basic acceptable standard of healthcare, but the best possible healthcare for everyone regardless of income. This means that when you fall ill, the NHS takes you in and does its best to fix you regardless of your income or employment status. A recent analysis by the Commonwealth Fund (see here) shows that contrary to media reports, the NHS ranks overall first amongst 11 other healthcare systems (and first or second in almost all categories including effective care, safe care, equal access, efficiency). All of this it achieves with the lowest expenditure per head of population (and lowest % GDP expenditure).

2.      More equal access to healthcare improves healthcare outcomes. Life expectancy is worst in unequal societies. In the US, heart attack patients with no health insurance have a 30% higher chance of dying than someone who is insured (see here).
3.      The NHS is the most cost efficient healthcare system in the world (apart from perhaps Cuba). Administration costs were 5% but are expected to approach 20% of the NHS budget as market forces dominate. Also the bargaining power of the NHS allows it to negotiate the best possible prices with industry. Privatisation of the NHS is NOT going to reduce healthcare costs as a % of GDP.
4.      The NHS embraces effective, proven technologies and can implement them nationwide in a way that no other healthcare system can. Primary angioplasty (emergency coronary angioplasty and stenting) as a treatment for heart attacks is an excellent example of this. See here for details.
5.      The NHS has always had an international reputation for training nurses, doctors and other healthcare professionals. Anyone who dismantles the NHS should not underestimate the effect this will have on training future nurses and doctors.