Annals of Government Medicine

At the Telegraph, Simon Heffer reviews the condition of Britain’s National Health Service after 68 years and finds: “The NHS will simply collapse unless politicians have the courage to reform it.”

According to Government figures, the £437 million spent in the first year of the NHS’s existence in 1948-49 is equivalent to £15 billion today. Yet the UK total spent on the NHS is now £116.4 billion, £101.3 billion of which is spent in England.

I believe this is similar to our experience with Medicare, which currently costs something like ten times as much as was projected when the law was passed.

The population is nearly a third larger than in 1948-49; we are 64 million people against the 50 million at the 1951 census, thanks not least to the last Labour government’s mass immigration policies and the EU’s refusal to let us control our borders.

Yet this population growth cannot account for such an enormous real increase in spending. The problem is that the NHS is doing things its founders never envisaged.

It also suffers from grotesque overmanning in non-medical staff, a lack of strategic planning to cope with demographic change, and many of the failures associated with the absence of an effective price mechanism.

A fundamental problem of socialized medicine, and socialism in all contexts.

Without rethinking its whole purpose and method of operation, it will, within a decade or two, simply collapse.

Whether that would be bad or good is in the eye of the beholder. The NHS has become a behemoth institution on Britain’s Left:

Labour wouldn’t touch it because of the mythology it has sedulously created: that the NHS, free at point of use and controlled on the shop floor by comrades in the trades unions, for whom it represents a considerable employment opportunity, is “safe” only in Labour’s hands.

“Safe” in this context equates to eating up a sixth of public spending without worrying too much about how and where that money is spent. The NHS now employs 1.5 million people. As its website proudly proclaims, only McDonalds, Walmart, the US Defence Department and the Chinese People’s Liberation Army have larger payrolls. It may not have occurred to the NHS that this is not necessarily something to be proud of.

Mr. Heffer points out some of the bloated salaries earned by NHS bureaucrats. The largest belongs to Steve Leivers, Turnaround Director–whatever that means–of the Kings College Hospital Foundation Trust, at £59,500, around $90,000. Well, that doesn’t seem so bad. No, wait–that is £59,500 per month!

Hefner offers a number of suggestions for what the NHS can do to remain solvent, including, most significantly, transferring a substantial part of the health care industry to the private sector:

The Government needs to encourage private medicine and especially private GP services, if necessary through tax breaks: our European neighbours spend far more in the private sector than we do, which is one reason why their health services are not collapsing.

He argues that the current collapse of the Labour Party offers an opportunity for the Conservative government to make bold efforts to reform the NHS. Will that happen? Maybe, but I doubt it. As long as people believe someone else is paying their bills, reform is difficult, short of the point of complete collapse.

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