The NHS was once seen as heroic. Now it's a national embarrassment - by James Bartholomew -22.08.22

Of all our public institutions none is more in need of urgent reform than the NHS. An organisation responsible for the health of millions is itself in A&E and in need of vital surgery before it collapses completely.


The important difference this time, argues James Bartholomew, is that support for change is coming from the public itself:


Now the failings of the NHS are in focus again and this time I believe there is a modest but distinct shift in attitudes. More people have reached the point where they feel, “This just isn’t working”. The change has come about because of millions of bad personal experiences.

And with the NHS now buckling under the strain post-Covid, the time has surely come to look to alternative models of healthcare provision.


“The Netherlands once had a healthcare system comparable to ours and suffering from the same sort of problems. The waiting times were bad and there were instances of waste and mismanagement. In 1986, a commission was appointed to report on the system.


It recommended a compulsory health insurance system with less central government control and more competition between private suppliers. The report was hugely controversial and did not lead to any immediate reform. Yet it remained as a big fat elephant in the room which could not be ignored indefinitely.


Eventually, after many years of debate and a great deal of consultation with the medical profession, a new system of health insurance was created in stages. It might not be the best health insurance system in Europe – the German and Swiss models are probably superior – but it is a great improvement.”


So why not try something similar over here?


If we tried the Dutch model – starting off with a major report on the performance of our healthcare system, perhaps even a Royal Commission – the same process of debate and eventual realism could take place here, too.”


Operationally, the sensible approach to reform might be through incremental change.


“These changes could include copying techniques that are already in place in other countries. In Australia, higher rate taxpayers are required to pay a special surcharge if they do not take out private health insurance.


The idea is that high earners can surely afford to pay for their own healthcare and should do so, freeing up the capacity of the public healthcare system to serve everybody else.


Another idea deployed in Australia and elsewhere is to allow patients to go to see any General Practitioner they want – not just the one they are registered with. If you can’t get a timely appointment at your usual surgery, you can get one elsewhere. We could do the same and simultaneously remove any remaining restrictions on GP practices being set up in competition with each other.”


In just the same way that welfare reform was designed around the needs of those trying to get back into work,


“Similarly, the reform of our healthcare system should be framed as finding ways to reduce suffering and prevent unnecessary deaths. We are a caring country. The way to show we care now, is to reform our healthcare.”


The full article can be read below with a link to the original here:



Article for the Telegraph by James Bartholemew - The NHS was once seen as heroic
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