Arguments about why the NHS is faltering are as well-rehearsed as they are divisive: the left complain about lack of funding, while the right cry about the inefficiencies of the public sector. It is not my intention to be partisan in approach but rather to convey a fairly balanced view of the current state of things. No doubt there are people more qualified to analyse the failures and issues of the NHS, but I will give a few thoughts and observations on this highly controversial issue.
The first is a problem associated with public discourse. Understandably, the NHS is seen by many as a quasi-religion; an institution celebrating the best of British society. While it is certainly a fantastic organisation and there is no doubt that universal healthcare must be seen as an essential right of any citizen, such zealous devotion to the NHS can have its disadvantages.
For example, arguments for NHS reform can sometimes be unadvisedly shouted down by allegations that a US-style privatisation is in the offing. This happens to Labour politicians as well as Conservatives (evidenced by Wes Streeting’s very public disagreement with the BMA). It is without question that civilised debate about the right course of action for healthcare outcomes can only happen when episodes of privatisation mania stop.
It is highly unlikely that any changes in the structure of healthcare would lead to an ill-fated US system. Rather, the health system would take the form of a German or Dutch approach of subsidised health insurance – which still guarantees universal healthcare.
Secondly, the problem that the NHS is currently experiencing not only concerns healthcare, but public service provision in general. Indeed, one of the reasons for lack of beds is that elderly patients who need to be discharged cannot be sent home – a problem associated with social care policy. Similarly, health outcomes are still too often determined by region, background, or class, which is primarily due to poorer education, social services, and opportunities in less well-off regions of the UK. Meanwhile, nurse and doctor shortages have been exacerbated by Brexit and the termination of freedom of movement.
When debating the NHS and healthcare provision, we need to be mindful of two crucial factors. The first is that we have to be honest about our healthcare system. We must look at the facts and come to conclusions that will improve its ability to provide, leaving partisanship at the door. The second is that in order to fix the problems associated with healthcare and the NHS, it is essential that public services and provisions outside of immediate healthcare be looked at. Reform to these might just hold the key to maintaining a critical British institution.