Wednesday, December 13, 2006

What is the point of the NHS?

No, it's not a rhetorical question - I really want to know what the point of the NHS is.

Is it ...

a) to provide high quality health care for the British people which is free at the point of delivery?

or

b) to provide jobs and security for state employees?

The answer should be obvious - but is it? My thinking is this.

First of all, the health care provided by the NHS is not of consistently high quality. Parts of it are, for sure, but much more is very, very poor. Amongst the poorest in the developed world. So it fails in the first part of (a) - to provide high quality health care.

Secondly, it does not prioritise health care for British people. The NHS is available - free at the point of delivery - for anyone in Britain. This makes Britain a prime destination for health tourists - particularly from Africa. Almost all of the increase in heterosexual HIV cases in the UK is made up by immigrants from Africa. Few cases of heterosexual HIV infections are indigenous. The more thinly you spread your jam, the more bits of the bread don't get covered. So it fails on point 2 of (a) - for the British people.

The only part it succeeds in is to be free at the point of delivery.

Look at the NHS from the perspective of option (b) and the point of the NHS is far more clear.

It is the biggest employer in Britain.
It is the biggest employer in Europe.
It is the biggest employer in the western world.
It is the third biggest employer on the planet - only the Chinese Red Army and the Indian state railway employ more people!

The idea behind the NHS was to provide health care to all regardless of ability to pay, but it is by no means free. The NHS costs every man, woman and child around £1300 a year. Of course, an awful lot of men, women and child actually pay nothing towards that because their money, one way or the other, comes from the state. But even assuming an average of £1300 per person per year - that buys an awful lot of health insurance for people. For an average family of four that equates to £5200 every year!

I actually have private health insurance for my family which covers pretty much everything the NHS does (and some that it doesn't). It doesn't cost nearly as much as the NHS costs me - even theoretically - but it does provide very high quality health care which is free at the point of delivery - for me, my wife and my kids. I haven't had much cause to use either the private system or the NHS over the last few years, but when I have, the experience of the private health provision was far superior to that of the NHS.

A lot of people will tell you that we spend a lot less on our health service than other nations and that the NHS delivers - in comparison - very good value for money. This is nonsense for 2 reasons. First of all, they are not comparing like with like and secondly they only consider the attributed NHS costs.

Other nations who spend (allegedly) far more on health care than Britain does don't have one big employer, but many different little bits and pieces that make up their health care provision. But when it comes to estimating how much they spend on health care they bundle all costs associated with those bits and pieces of health care into one pot and call it "health care spending".

We do not do this. We have the one big employer called the NHS, but there are many other bits and pieces associated with health care which are not part of the NHS but nevertheless cost an awful lot of money - money which is not rolled up into that NHS spending pot. We actually do what we can to make it appear that we are spending less on health care than we really are! (And that means the £1300 a year we are all paying is actually far higher than that).

The NHS is far more successful in meeting the criteria of (b) than it is (a). It provides a million or more people with jobs and a degree of security and benefits far better than it provides high quality health care which is free at the point of delivery for British people.

If what was important was that the health service provided high quality health care for British people free at the point of delivery then would it really matter if that came from the public or the private sector?

3 comments:

DAVID VANCE said...

The NHS is a monster, and it is mangled by Statism. Sadly. They key is to remove Government from any role, the politicians have destroyed it, as they destroy everything,

DAVID VANCE said...

PS. Stan,

Drop me a mail over at ATW using the Email the Editor button. I want to discuss something with you..

xoggoth said...

The figures are frightening. A recent study from the states put the lifetime cost of an HIV sufferer at £200k. There are nearly 16 thousand HIV positive Africans in the UK, you can work it out for yourself. Yet finding a few hundred k pa for citizens with breast or prostate cancer or alzheimers always seems to be something the NHS cannot afford.