Let’s not pretend that the NHS, however much voters love it, is the envy of the world

Today the NHS is 72, which is another way of saying that on July 5 1948 the Government nationalised the 480,000 beds previously managed by some 1,400 voluntary and about 1,500 municipal hospitals. Every other European country chose not to centralise control  and maintained diverse ownership of hospitals.

Fast forward to 2020 and we find that the most respected international comparisons show how far the NHS falls below the best systems. The OECD produces Health Care Quality Indicators covering 27 measures in 15 advanced countries. The UK is “better than most” on eight measures, similar on five, and “worse than most” on 14 measures, including breast and cervical cancer survival, stroke mortality, and deaths within 30 days of a heart attack.

The NHS has consistently lagged behind countries like Germany and France. In recent years some hospitals have been found guilty of extreme negligence. We all remember Mid Staffs, the Alder Hey scandal involving the unauthorized taking of body parts from children, and avoidable deaths of mothers and babies at the Morecambe Bay NHS Trust, and at the Shrewsbury and Telford NHS Trust.

The National Audit Office has consistently drawn attention to such failings. It looked at accident and emergency care in 2010 and found that “despite repeated reports identifying poor practice”, NHS trusts had “taken very little action to improve major trauma care”. A Royal College of Surgeons report spelt out the problems decades ago, but little had been done in the years since.

The Healthcare Commission’s report in 2009 found complete failure at “virtually every stage” in the care of emergency admissions at Stafford Hospital. The investigation found that there were too few doctors and nurses and that vital equipment was not available. Wards  were filthy, and nurses did not know how to operate cardiac monitors or intravenous drips. The final report from the public inquiry into Mid Staffs in 2013 found “appalling suffering” by many patients primarily caused by a serious failure of the Trust Board that tolerated poor standards. Its failure was in part the result of focusing on meeting national targets at the expense of patient care.

A few years earlier in 2005 Tony Blair appeared aware of the problem when he declared war on the “forces of conservatism and reaction” in the public sector. Creating a “Patient-Led” NHS said in 2005, he said: “At its worst, the NHS has a very hierarchical tradition with professional divides and bureaucratic systems and inflexible processes. These can get in the way of good patient care”.

As a result there was a big push for so-called “contestability” and patients were told that they were now consumers with choices that put them “in the driving seat”.  According to the NHS Improvement Plan of 2004, giving people greater personal choice would give them “control… allowing patients to call the shots about the time and place of their care, and empowering them to personalise their care to ensure the quality and convenience that they want.”

GPs notoriously seized on Mr Blair’s reforms to advance their own narrow interests. In the first year of their new pay deal, they increased their average pay by about 30 per cent and in many cases stopped providing an out-of-hours service. So much for giving patients choice and convenience, let alone allowing them to call the shots.

Every independent researcher who studies the NHS knows that it is second-class compared with most other European countries, but comforting delusions overwhelm inconvenient facts. We have just spent 10 weeks clapping for the NHS. Hopefully many people felt like me and went into the street as an act of solidarity and goodwill with neighbours, not because we were taken in by NHS propaganda.

Just over 25,000 patients were moved from hospitals to care homes between March 17 and April 16 this year, at a time when few coronavirus tests were being carried out and care homes were being starved of PPE by the NHS. The Office for National Statistics reports that nearly 20,000 care home residents in England and Wales have died with coronavirus.

That is quite apart from the patients who have died or suffered prolonged pain because their treatments have been cancelled. Professor Karol Sikora, a former NHS consultant, has estimated that a six-month lockdown could cause 50,000 cancer deaths.

Every civilized country shares our ideal of guaranteeing health care for all. But there is more than one way to achieve it, and the NHS is far from the best at doing so.


David Green is CEO of Civitas

Source Article