The NHS is attacked on a variety of spurious grounds. Negative statements often being repeated uncritically and ad nauseam by some sections of the media until they become ‘common knowledge’. Here, John Puntis examines some of the most prominent, considers the evidence, and offers some counterarguments (part 1 of 2).
“If the NHS is so good, why has no one else copied it?”
This question is meant to imply that the NHS is outdated and that a social insurance model or other form of funding would lead to better outcomes. Nigel Edwards of the Nuffield Trust pointed out that if we look at countries that have health systems funded largely out of tax, that are mostly free, comprehensive and have a provider sector that is substantially publicly owned (i.e. like the NHS), there are actually quite a few. Scandinavian countries have systems where the majority of the revenue is collected by tax and providers are owned by local government. The current Portuguese Health Care System was created in 1979 and based on the Bevanite National Health Service model; Italy, Spain and Malta also have health systems in many ways close to the NHS.
Of course, these countries do not replicate our NHS model in every detail but nevertheless have much in common, including now being the objects of ideological attack, and undermining of their public aspects through the growth of financialization and the promotion of the unevidenced view that privatisation brings efficiency. On the contrary, recent evidence from England suggests that outsourcing clinical services is associated with increased mortality. Where profit-hungry private equity firms have taken over hospitals in the US, there has been a 25% increase in complication rate (principally infections) observed among patients. The deficiencies of some social insurance-based European and other high-income country systems have been outlined by John Lister and include higher overall administration costs and transfer of cost of care to individuals, often disproportionately affecting those on lower incomes.
Full story in The Lowdown, 12 January 2024