Britain’s NHS nightmare: a warning to America

The pioneers of Britain’s welfare state may have had good intentions. By founding the National Health Service (NHS) in 1948, they hoped to improve access to treatment for the poor. But, more than sixty years on, it has become a bureaucratic monster that ranks among the worst-performing health care systems in the developed world.

Socialist central planning failed in the Soviet Union, and it has failed again in the NHS. In the absence of market prices, resources must be rationed by state officials. And as Russian housewives once queued for bread, British patients now queue for health care. Winston Churchill once defined socialism as “Queuetopia”.

Today the NHS has many hundreds of thousands of people on waiting lists. Despite years of reform and tens of billions of pounds of extra funding, it is still common for patients to wait several months for routine procedures such as hip replacements.

Even those with potentially fatal conditions may face long delays, while life saving treatments are often denied by bureaucrats on grounds of cost.

One deadly result is that cancer patients in Britain are far more likely to die than those in the United States. Cancer survival rates compare very badly with those of other rich nations.

But the NHS can’t even get the basics right – such as providing patients with adequate food. In 2007, there were almost 30,000 incidents of malnutrition, and a large proportion of patients are undernourished in NHS hospitals.

It is important to emphasise that these problems are not due to a lack of money. Expenditure on health in Britain is not low by international standards. In the absence of market prices and profits, health expenditure is allocated inefficiently by government officials. The system is further hampered by powerful unions that have thrived since nationalisation. It has been estimated that the NHS employs more than four times as many managers and support staff per nurse than a typical British private hospital.

Perhaps the most damning indictment of the NHS, however, is that it has failed in its original objective of eliminating health inequality. In practice, as with all socialist systems, those with the best connections and the loudest voices get better treatment and greater choice.

Yet despite such abject failure, the NHS has proved highly resilient to change. A key lesson from the British experience is that once people perceive health care as “free”, they will fiercely resist reform. Once socialist entitlements are introduced, it becomes almost impossible to roll them back.

America’s existing health care system is far from perfect – it is over-regulated and producer interests are too powerful. But as the Democrats prepare to push reforms through Congress, US policymakers should examine closely the disastrous experiment in collectivised medicine across the Atlantic. Britain’s NHS nightmare suggests that President Obama’s faith in government is misplaced.

4 thoughts on “Britain’s NHS nightmare: a warning to America”

  1. Posted 10/02/2010 at 16:11 | Permalink

    As with the notorious European Union ‘ratchet’, Richard is quite right to point out the extreme political difficulty of rolling back ‘free’ services, whether in health, schooling, or anything else.

    I know this personally. As someone over 60 years old living in London, I am ‘entitled’ to a free pass for travelling on buses and tubes. At one time (it may have changed now) these passes didn’t work in the rush hour. And even I, a lifelong libertarian and opponent of big government, felt cross that my pass — which I’d done nothing whatever to deserve — was (temporarily) being taken away.

    If someone like me experiences such an emotion, it’s not hard to imagine what most people would feel.

  2. Posted 10/02/2010 at 19:56 | Permalink

    On Monday my dog managed to grab a plastic clothes peg from my laundry basket. By the time I’d caught him and removed it from his mouth, he’d crunched it into several bits.I could not find all the bits, including the metal spring.
    So I rang my vet.A receptionist answered immediately, I explained what had happened, was given an appointment for about an hours time. I took the dog in,left him there to be sedated and x-rayed.After lunch I had a phone call to say nothing had been found. They kept him until I was able to pick him up in the evening (they were still going strong at 6pm).
    I paid £195, which will be covered by my pet insurance (£75 excess).
    Why cannot I get similar service on the NHS?

  3. Posted 11/02/2010 at 11:49 | Permalink

    The day after Arthur Seldon died I read in one of his obituaries that he said “the state produces thousand upon thousands of goods stamped ‘take it or leave’”. The following day, I was telephoned by the hospital who said that they had a date for a (fairly) major operation. I said, “I’ll just get my diary.” They said, “there’s no point, it’s either take it or leave it.” Leaving it meant starting again with a GP’s appointment – I had to be removed altogether from the process or I would have counted as having gone over the government’s max waiting time. To cap it all, the day of my release I had to sit for 7 hours in a plastic chair with no food. Maybe I should have asked a vet to do the op.

  4. Posted 01/01/2016 at 23:37 | Permalink

    I completely disagree with the above article. The NHS in Britain is not run down because it is a socialist- type system. The way it has ended up is what the tory government, along with neo-liberal Blair, and now Cameron, have always wanted- the political right have made the NHS like it is. It has had business rules leached in by the back door. When I was a child, about 20 years ago, all prescriptions were free to everyone in the country. Now they cost more than the hourly minimum wage. In the last 10 to 15 years, news articles have started to be included, then the number of them increased, telling us how much NHS services cost, and how many people fail to attend, and what this costs. The money from front line staff, money for much needed treatments, and research is being fed up to these managers, and private clinics, while well-intentioned charities are feeding the capitalist scheme of de-centralisation and privatisation. Nurses are working ridiculous hours and waiting lists are causing suffering and death. But to blame this on socialism? Pull the other one.

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