Monday 26 January 2015

Monday, January 26, 2015 Posted by Hari 2 comments Labels: , , , , ,
Posted by Hari on Monday, January 26, 2015 with 2 comments | Labels: , , , , ,

We're told we'd need to find an extra £5bn every year to be able to afford an NHS that maintains standards, free at the point of delivery.

We're told it's only possible if we allow the private sector to take on more of our healthcare delivery.

We're told that other countries, including the progressive lefty ones, use a mix of public and private to be able to afford modern healthcare.

But a look at the data from other countries shows...
  • Our system is the most efficient and cost effective.
  • We’re spending less than almost everyone else – i.e. not enough.
  • If we spent more, it should be on the system that is the most efficient and cost effective. Ours.

First, here’s the graph from a report by NHS England, showing how funding is falling behind spending requirements.

Now take a look at the costs, per head, of all the OECD countries. You’ll see that every nation has a mix of public and private provision, to varying degrees. What it shows is that the UK spends less than almost any nation comparable to ours.

What else does it tell us? If we had almost any of the other comparable nations’ public-private mix, we’d be spending more than that £5bn extra already. 
  • Any other system we choose that costs approximately $125/head (=£83/head) more than ours, will end up costing us more than that £5bn the NHS needs.
  • 60m people in the UK
  • 60m X £83 = £5bn

Let’s now dig a little deeper into the performance of each country: quality, accessibility, efficiency, and results. The Commonwealth Fund, a healthcare think tank based in the US, ranks a range of comparable countries, by different criteria. The UK came top in most, and overall.

You’ll note that the UK comes almost bottom in one, very important criteria: Healthy Lives.

Compared to these other nations, our overall mortality rates, infant mortality, and life expectancy figures are indeed among the worst. But isn’t that because we’re spending less than the others, rather than because we don’t have enough private provision?

There is no doubt one big advocate for spending that extra £83 per head: the private healthcare companies and their friends in government, on condition none of it is spent on the NHS.

Looking forward, our healthcare system will need to find extra billions not just for one year, but for every year due to ageing populations and more expensive yet better treatments. But so will every other nation, whatever their mix of public-private delivery.


  1. It's also worth noting that in figure 4 (Overall benchmark ranking), that attributing a slightly higher mortality amendable to healthcare as a failure to the NHS is a flawed way of looking the strengths and weaknesses of our NHS (or any countries' health system). Firstly, the ballpark for what kind of diseases and "age limit" where if someone dies below the age limit, it's a death which contributes to "mortality amendable to healthcare" is an ever-shifted goalpost (Nolte and McKee 2008), with no universal literature consensus (Wheller, Baker, Griffiths and Rooney 2007; Nolte and McKee 2004). A study comparing the literature argues effectively why mortality amendable to healthcare shouldn't be a measure of the countries' healthcare system success/failure; I'll cite here for anybody interested. Kararudeen, S., 2010 "Amendable Mortality as an Indicator of Healthcare Quality" found file:///C:/Users/User-pc/Downloads/Amenable-Mortality_tcm77-168576.pdf

  2. Remember that every £1 invested in health care or education, generates £3 in the economy, as quoted from The Body Economic by David Stuckler and Sanjay Basu.


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