The Deadly Failures of Britain’s National Health Service

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Britain’s single-payer system remains entrenched despite mountains of evidence that it doesn’t work. Americans should heed its cautionary tale.

The United Kingdom’s National Health Service is in rough shape. Even the Guardian, Britain’s foremost left-leaning newspaper and editorial defender of the NHS, has admitted as much:

This week it emerged that the NHS is facing the most intense strain on its resources in decades. . . . In Portsmouth yesterday a hospital said it would investigate after an 88-year-old woman died following a seven-hour wait for a bed. And earlier this week an 81-year-old woman was found dead in her house after waiting almost four hours for an ambulance.

You could be forgiven for thinking this reporting refers to the stress the NHS is under right now on account of the coronavirus. But it doesn’t. It was published by the Guardian on January 6, 2018, almost two years ago to the day. In fact, the NHS’s current winter crisis is nothing new; winter crises are something of an annual NHS tradition. Here are a few other Guardian headlines from years past:

“Hospital beds at record low in England as NHS struggles with demand” (2019)

“NHS bosses sound alarm over hospitals already running at 99% capacity” (2017)

“Sick children moved as NHS intensive care units run out of beds” (2016)

“Hospital bed occupancy rates hit record high risking care” (2015)

“More patients, overstretched doctors – is the NHS facing a winter crisis?” (2014)

“Hospital’s scramble to prevent crisis in NHS’s ‘toughest ever’ winter” (2013)

You get the gist. The NHS has proven itself comprehensively and consistently incapable of dealing with a regular flu season, something that crops up at the same predictable time of year in every country north of the equator. It has long been obvious that Britain’s single-payer health-care system isn’t fit for purpose even in normal times, much less during a global pandemic. Yet the NHS’s failures are systematically ignored.

Kristian Niemietz, the head of political economy at the Institute for Economic affairs, documents the system’s shortcomings in his book Universal Healthcare without the NHS:

In international comparisons of health system performance, the NHS almost always ranks in the bottom third, on a par with the Czech Republic and Slovenia. In a ‘blind test’, in which we look at health outcome data, and guess which data point represents which country, the UK could easily be mistaken for an Eastern European country. We would certainly never mistake the UK for Switzerland or Belgium.

Niemietz also points out that age-standardized survival rates in the U.K. for the most common kinds of cancer are well below those of other developed countries, which translates into thousands of needless deaths: “If the UK’s breast cancer, prostate cancer, lung cancer and bowel cancer patients were treated in the Netherlands rather than on the NHS, more than 9,000 lives would be saved every year. If they were treated in Germany, more than 12,000 lives would be saved, and if they were treated in Belgium, more than 14,000 lives would be saved.”

Britain’s irrational attachment to this failed system becomes intelligible in light of Nigel Lawson’s observation that “the NHS is the closest thing the English people have now to a religion.” The idea of health care provided free at the point of access has become grafted onto the vine of British national identity to such an extent that no amassing of data or evidence can persuade the public to abandon it.

The United Kingdom has changed at such a fundamental level over the past century that the old markers of identity no longer arouse any sense of affinity or self-recognition in the hearts and minds of the people. The older national inheritance exemplified by treasures such as Magna Carta, Lincoln Cathedral, and the language of the King James Bible have lost all of their cultural adhesiveness. At this point, almost the only thing that unites British people beyond their common language is the state to which they all involuntarily belong. And since the administration of health care is nothing more than the action of the state at its highest point of moral elevation, it makes sense that the NHS would be politically impregnable.

The excess deaths that the U.K. is suffering this winter along with the crushing physical and mental burdens borne by British doctors and nurses ultimately redound to this long-term failure of British culture. By transforming a medical institution into a cultural institution for the sake of forging a new, progressive national identity, Britons have underwritten decades of deadly failure. The U.K. is unlikely to change course at this point for all the reasons stated above, but there is still time for American progressives to pre-emptively end their irresponsible love affair with single-payer health care. American policymakers of both parties should see the NHS for the failure that it is, and look elsewhere for inspiration when seeking to reform the nation’s health-care system. Countless lives will be saved if they do.

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