Why Should the NHS Be Broken Up?
Last week we read about why the NHS should be broken up. This week, we will explore what proponents of the NHS argue are the merits of the NHS.
All the above data may be fine and good, but the ground reality right now seems to paint a putrid portrait of this prominent organization. The internet has enabled the free reign of horror stories related to patient treatment inside the NHS with stories ranging from the ones accounting how the understaffed and underfunded NHS refused to scan an elderly citizen’s head during a headache only for doctors to realize a year later that had signalled the onset of an aggressive brain tumour that could have been treated with minimal cost a year back but was now terminal to patients being found caked in blood and soaked in putrefactive urine unattended in a solitary confinement room (All having been reported by the Guardian). Should these just be considered as the wild rantings of families who recently lost their loved ones and now vent out their frustration through the medium of over-exaggerated stories? Or could this just be a symptom of the long-dreaded, festering condition of “becoming too big”? What does the data suggest?
1) Although funding for the NHS has ballooned by 12 times since the founding of the NHS, the actual spending on projects by the NHS has decelerated rapidly. Today, the UK spends $4192 per head on healthcare, which is far behind nations like the United States (US), Germany, France, and Japan who spend as much as $9892 on the same area. Additionally, while spending on public health has plateaued recently in the UK, it has accelerated elsewhere in countries like the US as illustrated in the graphs below. Would spending on public health be greater if the NHS was broken up and privatised? Keynesian Economics posits that private companies seek to maximize profit. Profit would be maximized only if current services are improved which would only be possible if spending on public health increased. Hence, such an interpretation would encourage the breaking up of a privatisation of the NHS.
2) The NHS employs 1.4 million people. Is it too just too massive to be managed effectively? A report by McKinsey Management Consultants found that 45,000 NHS staff are absent from work at any day; that is more than the size of the workforce of Britain’s largest manufacturing company. McKinsey recommended decreasing the size of the NHS by 137,000 people: few firms even employ so many people in the first place. The NHS is comprised of semi-autonomous units like hospital trusts and primary care trusts (PCTs) and GPs that also have their own management structure and boards. With so many managers onboard (31,000 according to the Warwick Trust and 77,000 according to King’s Fund) an estimated 14% (£15.4billion) of the NHS’s budget is spent on managing alone. What is shocking is how the McKinsey report recommended spending only about half this percentage (8%) on management. If the NHS was broken up, the number of managers could be trimmed as well as the establishment itself would undergo restructuring as elaborated upon by Ricardian Economics. Would the loss of the surplus managerial jobs and cutting down of the associated red-tape prove beneficial to the provision of health for the NHS? Of course!
3) Do better modes of providing affordable and quality healthcare exist? The Swiss Health Care system, touted by the Health Innovation Index as being the best in the world, uses a system of universal compulsory private health insurance. Swiss private insurers provide basic coverage ( GP Services, Medicines, Psychiatric Care) to everyone with all Swiss citizens being required to take out basic insurance schemes as well wherein they receive additional services like private hospital rooms and dental coverage. Over 80 such private insurance companies exist that are tightly regulated by the Swiss Government. The combination of the strict regulation alongside the huge competition available in the marketplace means that prices for private insurance remain affordable for all Swiss citizens at no additional cost to the Swiss Government saving the Swiss Government millions of pounds every year. Why can’t a similar system be implemented in the UK?
Conclusion and Conclusion
Having read about all the benefits and criticisms of the monopolistic nature of the NHS, the onus is now on you. The end of each of the sections on disadvantages includes a question: Consider the question and answer the question posed to you in the title of this essay- Should the NHS be broken up?
Send your responses to the comments section of this article. I look forward to hearing what you think about this issue!
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