26 May 2021

If we really loved ‘Our NHS’, we’d see its faults

By Hannah Ord

One could be forgiven for thinking that the British public are in love with the NHS. 

Over the last year this sentiment has been written on signs, heard in applause and branded on clothing. We treat the NHS like a first crush, sticking up posters and worshipping it with blinding intensity. 

But true love is much more serious than that. A long-term relationship means growing together and understanding each other’s defects. 

Truly loving the NHS would mean accepting what is wrong and trying to improve it, developing a system that truly delivers quality healthcare for all, not one that merely survives. For this, our attitude towards the NHS must change. 

The pandemic has granted us this opportunity. It has tested the institution’s many strengths and weaknesses, and shown that it is in critical condition. We now have a unique opportunity not just to recover from our losses but to reform and create a stronger healthcare system. 

This must start with recognising the insidious role that rationing currently plays within our healthcare system: explored in the Adam Smith Institute’s latest paper ‘The doctor might see you now’ by Dr Robert Sutton, a junior doctor in Wales. It is an uncomfortable truth, but the NHS can’t possibly ever fulfil the promise of “a comprehensive service, available to all,” which is also “free to all at the point of care”. We simply do not have unlimited resources for the infinite possible demands for healthcare. It is the quintessential economics problem – limited resources vs unlimited demand.  As our population continues to grow and age, resources are stretched further and demand expands. 

Rationing is unfortunately inevitable, and yet the NHS and politicians consistently deny this fact to protect the brand. This cover up only results in opaque and indirect rationing in the form of never ending waiting lists and an ever-growing backlog of cases: effectively denying patients the right to care. It is a growing problem as the Government’s focus on treating Covid-19 patients has sadly come at the expense of other health services.

It is easy to believe that this issue can be solved by simply throwing more money at it. But the UK has above average spending levels on medical training and yet has fewer practising physicians per 100,000 population than 26 of the 27 EU member states. The volume of staff shortages reveal that it will take more than money… it will take reform. 

Just as radiographers use X-rays to identify the location and size of an injury in our bodies, so too do we need a way to quantify and make transparent the extent of rationing within the NHS. 

We must look outward and learn from places such as Australia, Israel, Germany, Denmark: countries with similar per-capita health spending who consistently outperform us in patient outcomes and waiting times. They consistently save more lives. We need to make changes that increase competition, productivity and efficient allocation of resources to reduce the need for rationing and provide greater care and support for the British public. 

As the old cliché goes if you love something, let it go. If we truly want to show that we love the NHS it is time to let go of the pretence that it’s better than it is, and work to create a stronger, healthier institution. 

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Hannah Ord is a Research Associate at the Adam Smith Institute.

Columns are the author's own opinion and do not necessarily reflect the views of CapX.