Jake Bugg at Brighton Dome
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Jake Bugg at Brighton Dome

Matthew Nicholls - April 19, 2018
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The Big Debate: We need to privatise the NHS

In Favor

Fraser Coppin

When the words “privatization” and “NHS” are uttered in the same sentence, it’s not uncommon to see a look of horror and disgust on the faces of everyone present. Its founding principle, providing universal healthcare to all citizens based on need rather than an ability to pay, has rightly been applauded.

This rose-tinted idealism has become so ingrained within the public consciousness, though, that to even suggest reforming our healthcare system these days has become political suicide. The NHS is a much celebrated British institution, undoubtedly. However, there is one problem with it: it doesn’t work very well.

Many like to think that our NHS is the “envy of the world”, but this is far from the case. In international comparisons including from the WHO, OECD and the Commonwealth Fund, it almost always ranks in the bottom third of developed countries, on par with the Czech Republic and Slovenia. The Commonwealth fund study is by far the most generous, and thus is the one that its defenders most often site. However, even in this study, in the health outcomes category it ranks second to last. The Guardian in 2014 stated that “The only black mark against the NHS was its poor record of keeping people alive.”

A report by the Institute of Economic Affairs takes a closer look at some of these outcomes. If the UK’s breast cancer, prostate cancer, lung cancer and bowel cancer patients were treated in The Netherlands instead of the UK, more than 9,000 extra lives would be saved every year. If they were treated in Germany more than 12,000 lives would be saved, and if they were treated in Belgium, more than 14,000. If you’re lucky enough to actually receive treatment in the UK, don’t be surprised to find that there isn’t a hospital bed for you, as there is a huge shortage of those as well.

Whichever way you try and spin it, the NHS is systematically failing patients on multiple levels. When confronted with these issues, the NHS defender will usually argue that things would be much better if there was extra funding available. Well, it’s as though the money has dried up- quite the opposite in fact. From 2000 and the 11 years succeeding that, spending in the NHS has more than doubled from £68bn to £143bn, and this continues to rise year upon year. While it’s true that the UK spends less on healthcare than many other countries, this doesn’t necessarily mean that is it more efficient. Clinical failure, waste and mismanagement are commonplace across the entire system.

The country cannot continue pumping money into something which doesn’t work. And as nobody seems willing to properly discuss how to improve it, millions upon millions in taxpayer’s money is poured away on this failing system every week, supported by those on both the left and right of British politics. This needs to stop. So how would more privatization make this any better, if we go down that road, won’t we end up like America?

Not at all. A much better solution would be a social health insurance system, the model used by many social democracies. They combine the universality of a public system with the consumer choice, competetiveness and innovation of a market system. With SHI, everyone in the country, no matter their level of income, has universal access to quality healthcare, just like the system we know and love! And in terms of patient outcomes, quality and efficiency, these systems beat the NHS on almost nearly every single measure. The NHS may be a beloved national icon, but the reality is that it is failing. Our out-dated, bureaucratic, fully state-controlled healthcare system is badly in need of reform.

Privatization isn’t a bad word- it can work very well, as we learn from our European neighbours. Instead of clinging to what we’ve got, we should be exploring these alternatives. Healthcare policy should reject the ideological quagmire it’s currently stuck in and focus on what really matters: the patient.

Against

Jessica Hubbard

The National Health Service is a keystone of British Society. Founded in 1948, its principles include free and universal healthcare for Britons. We must remember that the NHS was a consequence of the Beveridge Report. Published in the early 1940s, it revealed poor care and living conditions for the public. We would not want to return to such a state- but some may argue that we already have.

The fact that the NHS has traditionally been free for non-residents in emergencies and similar cases portrays us as a caring nation. I was deeply saddened that the Department for Health feels the need to think about charging these people, despite the fact that ‘health tourism’ accounts for just 0.3% of the NHS’ annual budget. If the NHS were to be privatised, I feel as if there would be a ‘crackdown’ on ‘health tourism’ and a lack of decent healthcare for those who can’t afford it.

What many do not realise is that the NHS IS being privatised. It’s happening as I write. One NHS employee has told me that different parts of their hospital are being sold off to different companies. With Virgin running the physio department and other companies swallowing up other departments, I very much doubt they will communicate with one another.

Competition is more precious to them than how quickly a patient is seen to or whether they are seen at all. I believe in the testimonies of NHS workers as they are at the ‘front line’, so to speak, of delivering NHS care. The aforementioned employee states that privatization leads to job losses, funding gaps and ultimately bad service.

Privatisation of the railways has led to the exact consequences that the NHS is facing and could be up against in the future: low wages, long hours, workers strikes, low safety for users, and a poorer service. The NHS may be perceived as expensive, but the investment is necessary. It needs more reform and more funding, not to be sold off to the highest bidder. Privatisation costs. Private companies will, naturally, demand funding to run the NHS. Funding is being wasted on ‘marketing’ the NHS as it is being privatised.

‘1 in 10 NHS pounds is now spent on non-clinical expenses’, says the popular blog ‘NHSpace’. This is because NHS contracts with private firms take staff and funding to administer; get rid of them altogether and you eliminate these costs. That such a high number of NHS trusts across the country are experiencing a funding deficit or debt is very telling. This shows that there is a problem with funding in general and not necessarily with efficiency. If this were the case, a handful of trusts would be in debt and crisis, not the majority of them.

‘Sustainability and Transformation Plans’ introduced by the government force NHS trusts to cut spending wherever possible. They are highly unpopular as they lead to unnecessary cuts. The NHS wasn’t in crisis previously- such plans are merely an unwelcome cost cutting measure from the Tory government. The blog NHSpace suspects that privatisation of the NHS has been encouraged by Tory Party donors who have shares in healthcare.

What I want to know is why on earth the Government feels it necessary to spend so much on unnecessary goods like our dilapidated and dangerous nuclear weapons system. This costs billions to maintain ‘just in case’ a nuclear power decides to get shirty with us. Let’s get rid of this bloated ‘defense’ spending and invest it where it is really needed. After all, I can say with certainty that the NHS has prevented more deaths than Trident ever has.

We must fund nursing courses and other training in healthcare, plugging up this spending on agency staff. This will also increase safety, as NHS workers have a more reasonable number of patients to attend to, and won’t be forced to work inhuman hours and make mistakes due to a lack of staff.

Hopefully we are on our way towards kicking out private companies, but I doubt it.

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3 Comments

  1. The NHS has achieved the status of a religion, far beyond that of a Holy Cow.
    It was a good achievement in 1947 when launched ( I was born under the old system in 1946, private nursing home etc)
    But can an institution this ancient be fit for the fast moving modern world?

    The Socialists want to keep it as as the vast number of employees vote for them Their Union pay masters are likewise culpable. The BBC is the Pontiff overseeing the organisation.

    At least the GP must become independent as must Surgeons, who must choose between Private and public work. Hotel charges must be levied for food and lodging at a hospital
    Tax breaks to be given to private health patients
    Surgeries open all day with a consulting fee for those who want to pay
    Cost of surgery to be told to patients
    Pharmacists to be given more consulting and prescription power.
    Self inflicted attendances to be charged for.

    But overall there must be a system of Government backed, private health insurance that would offer lower Nat Ins. payments yet deliver enhanced outcomes. Private enterprise management must be put in place.

    Reply
    • The USA, where health outcomes for many conditions like cancers are better than in the UK, and where pharmaceuticals are much cheaper and more readily available? God help us indeed…

      Reply

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