The British Health Care System

From Malcolm Hutty:

On February 23, 1994, MTHORNTN(at) wrote: "One need not recount the atrocities of the British and Canadian health care systems to know that shortages of health care services results in poor health and in many cases unnecessary deaths."

... but since that's where I live, I will. The situation here proves a few basic truths. In a world of finite resources, desirable goods and services have to be rationed. This can be done by pricing or by establishing long queues. If it is done by pricing, desperately urgent cases can jump the queue by paying a premium, having a whip-round amongst friends or appealing to charity, institutional or personal. If it is done by queues, urgent cases simply die.

If the government assumes responsibility for the health of the nation, every death is seen as the fault of the government, because "just another million" would have endowed a kidney machine and operator. There is an unstoppable pressure to increase funding year on year. A slight slowdown in the rate of growth of spending is universally denounced in the media as "Draconian cuts". Whenever hospitals are moved to suit demographic trends, or unsavoury old Victorian hospitals are replaced with new, modern hi-tech ones, the TV news does an expose' on "the ward closures" and "the secret story of closing hospitals" with ne'er a word of the new ones opening. The perpetual message is "spend more, spend now."

When election time comes around patient histories are used as campaign fodder. The scandal of Jennifer's ear dominated the 1992 General Election, in which the parents of a 4? year old girl used her failure to be treated for an ear infection as material for the Labour TV ads, damning Conservative "cuts". Spending on the NHS has actually risen every year in real terms under the Conservatives since they took office in 1979 (and undoubtable, before that too).

If you can afford it you get private health insurance, and private treatment when you need it. But because this doesn't relieve you of one penny of your liability to pay taxes towards the NHS, a lot of people cannot afford it.

Horror stories of incompetent doctors, negligent hospitals and unapproved drugs waiting idle for the bureaucrats to give them their blessing do not help; I'm sure you have those stories too. But in a country where anything short of criminal negligence is acceptable, where gross incompetance leads only to transfer to another region, where the doctor gets paid according to the number of patients in his area not the amount of work he does, you can imagine that while people say "the NHS is the greatest part of the Welfare State and the great success of post-war socialism," they also say that the system is in crisis, that it cannot go on like this.