Singapore has much to admire about it. The island has the second highest GDP per capita in the world, the third lowest levels of corruption, and universal healthcare at less than half the cost of ‘Our NHS’. Those remarkable successes have been underpinned by a strong commitment to market economics. Indeed, Singapore is ranked the most pro-business nation in the world, thanks to its winning combination of taxation and economic freedom.
Britain may be a much larger economy than Singapore, but that doesn’t mean we cannot learn from their many achievements. However, as Dr Bryan Cheang argues in a new paper for the Adam Smith Institute, Singapore-on-
Nowhere is the need for reform more pronounced than in healthcare. For all its failing and inefficiencies, the NHS has long been virtually immune from criticism and subject to a quasi-religious level of devotion from public and politicians alike. Singapore, on the other hand, rejected and dismantled an NHS-style healthcare system shortly after becoming independent in 1965. In its place, they have created a far superior alternative, where consumer outcomes are the primary measure of success.
Singapore’s health system is neither a state monolith, nor a fully marketised free-for-all, but a hybrid. It features six geographic ‘clusters’ designed to drive competition, with treatment prices easily accessible online. To encourage people to take responsibility for their own health, Singapore devised an innovative scheme whereby individuals have a mandatory ‘Medisave’ account, which is automatically topped up from their paycheck. Singaporeans can tap into this account to cover healthcare costs, with the state topping up the balance for the least well off. Likewise, those below a certain income threshold are subsidised, and so not excluded from the improved quality provided by the private market.
The result of this is a highly-effective, modern healthcare sector, which ranks at the top in the world for efficiency. Given the enormous waiting lists, staff shortages, workforce burnout and myriad other problems with the NHS, we ought to have the humility to look at better healthcare systems and ask where we can learn from them.
The same contrast is equally apparent in education. While the UK has tended towards a top-down, bureaucratic approach to schooling that puts decision-making in the hands of civil servants, Singapore has built its system from the bottom up. This is achieved through a devolution of power to headteachers, who wield far more control than their British counterparts, with around a fifth of all schools holding entirely autonomous status. That approach has yielded a nation of astonishingly accomplished and capable students. Singapore ranked first in the OECD’s PISA comparative assessments in reading, maths and science, and its students account for around half of all perfect scores on the International Baccalaureate.
Of course, nowhere is perfect, and there are aspects of Singapore’s society we might not want to replicate, not least its often authoritarian style of government. Nonetheless, its culture of diligence, ambition and individual success, built on a bedrock of low taxes, high quality public services and prolonged economic success are a model for what Britain should be looking to achieve after Brexit.
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