No other European country has copied the NHS model in half a century. Almost all comparable countries use a mix of funding mechanisms, rather than relying on taxation alone, and most outperform the NHS in health outcomes.
UK cancer survival rates lag behind those of comparable countries, A&E delays are increasing, the number of operations being cancelled is dire, staffing rates are in freefall and the tick-box target culture is sending doctors and dentists screaming into the private sector. The UK has one doctor for 356 people, against a developed world average of one for 277.
The NHS’s archaic divisions of labour between GPs, hospital doctors, pharmacies and clinics is now indefensible. So too is the division between the NHS itself and social and domiciliary care. As any victim of these restrictive practices knows, treatment delayed is treatment denied.
Sooner or later, the pressure of demand (now from all age groups) will force the NHS to choose between rationing by some form of means-tested pricing or by further bureaucratic delay. Last year’s Guardian survey of foreign systems showed there were plenty of other ways to organise public health. Before the coming of the NHS, London’s (local) health service was regarded as the best in Europe. It is not that now.
So what are the alternatives?
In countries without the NHS what does healthcare and insurance look like for sick, older or poorer people? Are the rich able to purchase a luxury tier of healthcare and what happens if your insurer goes bankrupt in countries like the Netherlands, Switzerland, Germany, Belgium or Israel?
To discuss, the IEA’s Darren Grimes asked Dr Kristian Niemietz to join him, author of ‘Universal Healthcare without the NHS’.