Britain is often a strange and eccentric country. Of course, all nations have their foibles that baffle people, and by thinking us Britons particularly odd I’m probably indulging in a bit of good old British exceptionalism. Undeniably though, if you just sit back and observe certain elements of our culture, one can only conclude that this is a mad country full of mad people.
The 70th birthday celebrations of the National Health Service are a prime example of this. Westminster Abbey is holding a service to celebrate. Every radio station is gushing over it. The NHS choir has released another single. Turn on the TV and you will find shows such as ‘The Big NHS Singalong’. We have made a national religion worthy of the Soviet Union out of a relatively poor public service which is generally managed badly.
We are staging a bizarre birthday party which further feeds the mythology of the ‘envy of the world’. It’s a ludicrous circle jerk, an orgy of unwarranted self-satisfaction and a form of deluded exceptionalism that completely warps the debate about healthcare in this country. How many NHS worshippers would otherwise criticise British exceptionalism when applied to other parts of our culture? The cult of 1948 and the post-war settlement is right up there with imperial nostalgia in hampering national debate, preventing a more forward-thinking attitude and leading to poor policy making.
I am of course extremely grateful for the fact that if I get injured or ill, I have access to free healthcare. From many unlucky and/or poorer parts of the world, this is indeed something to envy. The principle of healthcare being ‘free at the point of use’ is something to cherish and celebrate, but it is literally the only element of the system which should be considered sacrosanct. All developed countries except the USA – which has its own bizarre and baffling national hang up with healthcare – has universal healthcare free at the point of use. Few of these use the same model as the NHS and many of them are evidently superior. On a range of important outcomes the NHS ranks poorly. Considering this, it makes no sense that we refuse to look to the rest of Europe for ways in which our own system could improve.
Far from being the ‘envy of the world’, it has a lamentable reputation in Europe and its performance is poor on global comparisons. Our overall life expectancy is middle ranking in Europe. Amongst comparable countries we are falling behind and linger in the bottom third for cancer survival rates and middling for heart attacks and strokes. So, yes, lets be thankful for not having to suffer the fear of not being able to afford healthcare, but while we slap ourselves on the back for a 70-year-old achievement our healthcare system languishes behind in Western Europe and people suffer because of it.
Amidst this festival of self-congratulation, one could be forgiven for assuming that people in Germany, Switzerland, Spain and France don’t have their own successful healthcare systems and are looking at us enviously, but they aren’t. Across Europe, standards of healthcare has improved hugely over recent decades, in many cases beyond what has been achieved in the UK, so there is nothing unique about the benefits of the NHS. A sufferer of brain cancer is better off in Croatia than the UK, where they have double the chance of surviving five years than they do under our NHS.
Of course, millions of people will have tales to tell of the excellent care they received, for which they will be eternally grateful, but all of this over emotional gushing ignores the multitude of stories of patients being treated horrifically. For every great story of personal care by one of the thousands of fantastic individuals who work for the NHS, there are many more of people being treated coldly and impersonally in a disorganised, disjointed and dysfunctional system with overworked, stressed out staff simply unable to give the level of care they should.
I have had good experiences with our health service, but many bad ones. Just try getting my nana in a hospital now after the two times she went in, was left ignored in a corridor for days before getting a bed and then contracted pneumonia. Envy of the world? The third world perhaps.
Being bundled into a tiny, stuffy and sweltering room with my ill wife suffering from an awful infection shortly after childbirth was a low point. She was in a lot of pain and distress and we were made to wait, with our new-born baby, for seven hours before anyone saw us. Over and over I tried to find out what was going on, I was continually fobbed off, or ignored. No one seemed to know what was going on, the right hand hadn’t a clue what the left hand was doing. I felt like I was in some rusty socialist republic.
We all know about the major scandals, many of us have seen the elderly side-lined and ignored in our hospitals, hear about the delayed operations, the maltreated and humiliated patients falling through the cracks, and we have seen some of our dirty, disorganised and run-down hospitals. We must stop kidding ourselves, there is huge room for improvement and it can’t truly begin until we stop this masturbatory celebration of a decrepit state institution.
The NHS is just a healthcare system. Why must we treat it with the same awe and wonder as Catholics do with the True Cross? It isn’t perfect, and it may need to change in order to improve, this is common sense, not heresy. We need rationality injected into this debate, so a future government can look at the fact that the NHS is struggling in the European league of healthcare outcomes and take the necessary policy decisions to rectify it.
The situation will only improve when we stop worshipping at the altar as if the NHS were a deity, admonishing anyone who dares to criticise it and stop deluding ourselves that it’s the best in the world or based on unique principles. Then, and only then, can we begin to look around the world and see how it can be made better. Drop the weird national chauvinism and understand that other countries are also very compassionate and do healthcare rather well and, in many cases, better.
I am not an advocate of any particular reform or system, I simply want to conserve the principle of healthcare being universally accessible and free at the point of use. Beyond that, I simply want the system to achieve the best outcomes. Why does it matter if healthcare is delivered via health insurance and private funding if its free at the point of use and high quality?
Although it’s clear the NHS needs more money, it’s obvious that a dysfunctional system will not simply be fixed by throwing money at it. In-fact a bureaucracy with so many inefficiencies is bound to waste much of the extra funding that comes its way. Anyone who has ever been involved in delivering services to the NHS will be aware that there are huge amounts of waste and bad practise.
Am I simply an ingrate? I don’t think so. I know that there are thousands of brilliant, compassionate people working in the NHS. They are some of the most dedicated and hardworking people in this country and they bust a gut everyday to make the NHS better and improve the lives of patients. However, I also know that the same is true for health services all over the world, because many great people go into health to make a positive difference. Again, this isn’t unique to the NHS; the NHS didn’t make these people who they are. I thank them, not the system.
It’s time we freed ourselves from the national religion of modern Britain.
