Five years ago, an expert for the British government prepared a report to recommend a plan for Britain’s National Health Service (NHS). The report was recently released to assess what has happened since.
Spending has grown by 50 percent in real terms, with an additional investment of £43 billion ($85 billion). A major portion of the funds has gone into large pay increases of about 25 percent for doctors and nurses. General practitioners now make about $200,000 a year. That does not necessarily mean that British doctors and nurses are overpaid. It does mean that the doctors take better advantage of spending increases than British patients.
Many more doctors and nurses have been hired. Unfortunately their productivity has declined, as the number of patients seen by each physician has declined over the same period. Britain has imported more than 20,000 physicians from Third World countries in the last three years, as after sixty years of experience the NHS has failed to attract and retain British physicians. Most of them are undoubtedly well qualified, even those few who blow up cars and airports in their spare time.
More essential problems remain. When the British government announced earlier this year the goal of reducing waiting times to fewer than 18 weeks for surgery and to see specialists, the Minister of Health admitted that one in eight patients still wait for one year or more. There is less access to high-tech diagnostic equipment, and cancer recovery rates are lower than in the United States.
Rationing takes many forms. Women weighing more than 180 pounds and men more than 218 pounds have been denied knee and hip replacement surgery because the outcomes are better for thinner patients. Smokers have been denied heart bypass surgery because their outcomes are not as good as those for non-smokers. Patients 80 years of age or older have been denied treatment for stroke, because after all, what is the point?
In a charming new development in cost control, a hospital recently instructed staff not to change linen when a new patient is placed in a bed but to instead just turn the linen over. Recently the NHS has announced measures to control an increase in the spread of staph and other infections within hospitals. Perhaps they should consider changing the sheets.
Fortunately Britain has always permitted private insurance and private clinics to operate. Even though services of the NHS are “free,” more than six million people purchase private insurance. Curiously, more than one third of the physicians working for the NHS purchase private insurance. Does that not tell us anything?
British patients have been the foundation of the growth of the medical tourist industry. They combine vacations with surgery in countries like India, rather than endure long waits for “free” surgery in Britain. Many of these Third World facilities are excellent and operate profitably. In fact, some Americans and their employers now take advantage of this industry in order to save money. Free markets can work if permitted to do so.
The British government has been making an effort in recent years to reintroduce a modest measure of reform in the NHS by providing some choices and allowing some private providers to serve NHS patients. In other words, although the government would definitely not put it this way, they are trying to copy some of the remaining private elements of American medical care. Imagine that.
Nonetheless, a veneer of socialist “compassion” is steadfastly maintained throughout the British system. When financially challenged patients are placed on a long waiting list to commence radiology or chemotherapy treatment for their cancer, they are given bus fare when sent home.
The NHS is hardly some model of benevolent socialist efficiency that America should follow. Rather, British health care should become more like American health care, and to a modest extent it is trying to do so. It would be wildly ridiculous for America to emulate Britain’s inferior system–particularly when the British themselves recognize they need to emulate ours.
