The National Health Service celebrated its 65th birthday this month, but is far from being retired. It is constantly ranked among the best health care systems in the world. Its success stands out despite health spending per capita being among the lowest in high income countries and less than half spent per head in the US.
Like free education for all, the NHS was founded in the aftermath of the horrors of World War Two where there was a growing mood for social change, determined that there should be no return to poverty, squalor and sickness. The fear was that if the government did not accede to real improvement, it would lead to demands and protests for even more basic rights.
As a result, Labour won a landslide victory in 1945 and Health Minister, Aneurin Bevan, a former Welsh miner, set forth his famous plan, involving the nationalisation of 3,000 voluntary and municipal hospitals with free treatment for all. GPs became salaried, allowing everyone to register at surgeries.
It proved to be a win-win situation with even industry benefiting from a fitter workforce. The NHS has since grown to become the world’s largest publicly funded health service, employing 1.7 million people, just under half of whom are clinically qualified. Only the Chinese People’s Liberation Army, Wal-Mart supermarket chain and Indian Railways directly employ more people. In the UK, it is also the single largest employer of black and minority ethnic (BME) people and has been heavily dependent upon the services of professionals from all parts of the globe since its inception.
In 2011, the Commonwealth Fund found that people in Britain have among the fastest access to GPs, the best co-ordinated care, and suffer from among the fewest medical errors, in a survey of 11 high income countries surveyed. “The success of the NHS stands out despite the fact that per capita health spending in the UK is the third lowest of the 11, at £2,170 per head, compared with £3,200 in Switzerland and £4,950 in the US,” it said.
Yet despite the success, the NHS is continually being chipped away by successive governments. The late Prime Minister, Margaret Thatcher, set the wheels in motion towards privatisation over 20 years ago by creating an artificial internal market and disastrously selling off cleaning, laundry and catering services. Labour’s Tony Blair and Gordon Brown accelerated the process. Their biggest tragedy was to extend the Private Finance Initiative, originally unveiled by John Major’s Government. The shocking long-term cost to the public purse is that the NHS would end up paying £65bn to private contractors for hospital building, even though completion cost just £11.3bn.
Reforms have been based upon an artificial market structure, with the setting up of trusts that allowed health authorities to “purchase” care from hospitals which had to compete with others to provide it. The latest changes effected in April include the abolition of primary care trusts and strategic health authorities and the introduction of clinical commissioning groups and Healthwatch England.
During his election campaign, David Cameron sought to reassure voters that the NHS was safe in his hands and promised to cut the deficit, not the NHS. But such promises have proven to be worthless. The appointment last year of Jeremy Hunt as Secretary of State for Health was seen sending a signal of intent, given his previous call for the NHS to be denationalised and replaced with a national insurance model.
It is true that Britain’s National Health Service is not perfect and can always benefit from streamlining, becoming more efficient and cutting out waste. But it is second to none in providing front-line healthcare free at the point of use for all, which any modern country should supply as a basic right. Arguments that it is expensive and that a private insurance system is better, are seriouslyflawed as highlighted no better than in the US.
The NHS is continually providing better service and better access than ever before, despite Government interference. The current worrying factor is that it is being hit by dramatic cuts and a tendency towards supplementary private insurance schemes. But private services could not exist without the structure and back-up support of NHS facilities and would be better if they were abolished to give a further injection of needed funds instead.
Privatisation of the healthcare is a step too far in an era of failed free-market fundamentalism. It must be remembered that it was New Labour that took the unforgivable step of ending free education and has led to huge university fees. The same must not happen with the NHS and is time not only for the Conservatives but for Ed Milband to clarify his party’s position.