NHS Creaking but Revered, True or False?


The New York Times recently published an article about the impact of the management of the NHS by the prospective UK Government after the General Election on 7th May - Britain’s National Health Service, Creaking but Revered, Looms Over Elections – April 26 2015.

The thrust of the article was that even the creaking, underfunded and poorly performing institution we call the NHS has a dramatic impact on how folk will use their vote on 7th May.

It starts with a startling image: “LONDON – The room was bare and crowded, and as patients waited impassively to see a doctor, workmen labored noisily around them installing seating while one man vomited discreetly into a bucket…” Well, we’ve all been there!

The article recognises that the combination of aging population and tight budgets is a bad one, but notes that despite this there is no serious debate in the UK about moving away from the principles of universal healthcare.

Is this true? As reported in the Guardian Society (3rd April 2015), Dr Mark Porter (Head of the BMA) says that ‘finances are so dire it will be inescapable the next government will consider fees’, despite the main parties all denying this. And Professor Sir Malcom Grant, Chair of NHS England is on record as stating that additional fees are something ‘a future government will wish to reflect on, unless the economy has picked up sufficiently, because we can anticipate demand for NHS services rising by between 4 to 5% per annum’.

There is no doubting the problem. Depending on whose view you believe about achievement of efficiency savings, there is somewhere between an £8bn and £30bn affordability gap to be closed. What is clear is that under current NHS arrangements demand and supply are not in step. In the US this would be addressed by curtailing delivery of care to those who were insufficiently insured – essentially rationing care to ensure that there is sufficient funding for care delivered. But this flies against the principle of a healthcare system universally available regardless of ability to pay.

No one would claim that the UK healthcare system is optimally organised and has no room for efficiency gains. However, it is clear that the ability of each party to make credible claims in the election battleground to commit to provide the funding required by the NHS could be a key factor in determining who will be running the country from May 7th.

Next week – SiriUS Stateside provides a glimpse at healthcare delivery – US-style.

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