Delusions on the NHS

Sadly, one of the reasons that the political conversation about health care in the UK is so difficult is that a number of people taking part in it simply do not know of what they speak. And example here in the Guardian:

Four flawed beliefs have dominated the actions of UK governments on healthcare over the past 25 years: personal responsibility for health supersedes government responsibility; markets drive efficiency; universal healthcare is ultimately unaffordable; and it is entirely legitimate to view healthcare as a business.

Responsibility is a moral argument and not really our point here: no one at all says that universal health care is unaffordable, only that all healthcare that everyone would conceivably like to get is unaffordable. But of course it is legitimate to regard healthcare as a business: there're inputs, there're outputs, there are people in the middle doing the transformation, that's a business. But that point about markets not driving efficiency is drivel: because this is the same NHS which is now separate organisations, NHS England, NHS Wales and NHS Scotland. And NHS England has had rather more of that market stuff applied to it. And NHS England has been getting more efficient more quickly than NHS Wales and Scotland too. The very subject under discussion disproves that assertion about markets.

But there's more too:

The 2014 Commonwealth Fund report on 11 wealthy countries shows that the UK spends least but ranks first in healthcare performance; the US spends most but ranks bottom.

Actually, no. Healthcare performance was only one of the things measured. Things like equitable access and so on were also measured and the NHS did very well on some of those measures (that the Commonwealth Fund agitates for single payer health care in the US is not a result of such studies, it is the cause of their measurement methods). On actual healthcare performance, mortality amenable to healthcare, it came near last. And oddly, we do think that how well a healthcare system is able to treat things that healthcare systems can treat is a pretty good measure of how good that healthcare system is. Or, for the NHS, not very.

In the US, one in six citizens has no health cover and inability to pay healthcare bills is the primary cause for personal bankruptcies, yet we are witnessing extraordinary, deliberate moves towards a failed US-style healthcare model.

Absolutely no one at all (and we are ourselves one of those voices shouting loudly for NHS reform) is calling for a US-like system. Instead we're calling for a system rather more like that of France, or Switzerland, or Singapore, all of whom have rather better healthcare systems than either we or the Americans do.

So why is this a problem if piffle like this appears in The Guardian?

Neena Modi is professor of neonatal medicine at Imperial College London, and president of the Royal College of Paediatrics and Child Health

Because this piffle is being spouted by people who really should know better.