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Monday 21st May 2018

Is the NHS modern again?

4th July 2008

The Economist explores the idea that the health service has stayed around for long enough to "look modern again".


The health service was put into place after the end of the war, on July 5th, 1948. Since that time it has often appeared old-fashioned and deeply troubled.

Now it is "looking oddly contemporary - partly because it has survived long enough for its principles to be relevant once more".

The health service has faced four main issues - two of which are nearly resolved.

The first one is the problem of how treatment should be paid for. The idea put forward in 1948 - "that demand would decline as the nation’s health improved"- proved to be wrong. The more money people had, the more treatment they desired.

The experts' view of the NHS was pessimistic - they thought the combination of longer lifespans, new technology and increased anticipation could spell the end for the health service.

However, Britain's "tax-funded health system" could stand the test of time. The US spends 15.3% of its budget on health in comparison to the UK's 8.4%, but plenty of US citizens do not have health insurance.

The idea of services being funded by taxes is solidly set in place and one which is accepted by the Conservative party.

The second issue is the idea that the government, because it funds the health service, should also manage the hospitals.

Now the government has actively encouraged the idea of competition and the future must surely see "the NHS...becoming a state-funded market rather than a creaking monopoly".

There are two remaining problems. The first is politics. This lays the NHS open to the mercy of ongoing "pointless micro-reforms and distorting central targets". It also results in skewed values.

The last problem lies with the doctors and their reliance on "lavish" pay. Organisations representing medics' interests have often held out on the employment of good concepts to further their own interests.

The numbers of patients who are satisfied with their care is increasing, Although infection rates and cancellations need to be tackled, improvements have been made. Patients wait less time for operations and more staff are available.

The British populations stubborn attachment to "a few totems of communitarianism" could, in relation to the health service, turn out to have been the right move.


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