Emily Carver is Head of Media at the Institute of Economic Affairs.
Customers are more demanding than ever. We expect instant gratification in most things, not least when it comes to our precious goods and services.
(I can’t be the only one who’s found myself unreasonably disgruntled when an Uber has taken more than ten minutes(!) to arrive.)
It takes a moment to book an appointment, make a reservation, or plan a trip. Now, at least for those of us living in major cities, we’ve even got the power to summon groceries to our homes, in less than ten minutes, and at all hours, through apps like Zapp and Jiffy.
This may sound rather extravagant, and perhaps it’s making us lazy, but capitalism has afforded us this level of convenience, and most of us are taking advantage of it in one way or another.
But not when it comes to ‘our NHS’, a health service that is looking staler and more antiquated by the day. With waiting lists at a record high (and growing) and face-to-face GP appointments as rare as gold dust, it’s unsurprising public satisfaction is at a 25-year-low.
We’re beginning to fall out of love with the NHS, and there are signs that the debate is beginning to shift too.
If people are waiting months and years for routine operations, can it really be said that the NHS is still universal? Universally inadequate, perhaps. Unless you happen to have won the postcode lottery.
More of us than ever are giving up altogether and deciding to forgo the bureaucracy and waiting lists. Polling this week showed that close to a third (29 per cent) of 18 to 34-year-olds said they would consider funding their own care.
For a generation accustomed to Netflix and next-day delivery, waiting days or even weeks for a GP appointment is intolerable.
Indeed, even before the pandemic shut GP surgeries, I gave in and downloaded a private GP app. Having struggled to get an appointment within a reasonable time scale, for me the small fee was worth the convenience of seeing a professional quickly.
Another recent survey showed 85 per cent of patients on NHS waiting lists have paid for or are considering private medical treatment, with 68 per cent ending up in debt as a result.
In a country that prides itself on having a health service free at the point of use and accessible to all, it is simply unacceptable for people to have to find the money or wait until it’s too late, due to the inadequacies of our system.
I think it’s fair to say that the NHS has pretty much gone from hero to (close to) zero over the course of the pandemic. The maternity scandal has revealed considerable structural and cultural problems within the Service, with half of our maternity wards revealed to be unsafe, potentially putting mothers and babies at risk.
Shockingly, research published last week claimed that a third of cancer cases in the UK are only diagnosed after the patient went to A&E with cancer-related symptoms.
At the same time, NHS trusts have issued guidance telling patients not to turn up at A&E unless you have “genuine, life-threatening situations”.
We are frequently told that the NHS is dangerously understaffed; data from between January and March of last year shows there were around 76,500 full-time equivalent advertised vacancies in hospital and community services alone – a shortfall of six per cent.
Yet, over the last decade, it’s been senior NHS managers who have seen their wages rise – and by significantly more than those on the front-line. Their pay packets have risen 65 per cent in the last ten years, while nurses’ wages have received a relatively meagre 35 per cent bump.
One might reasonably ask why it is bureaucrats and managers who are receiving inflated salaries at time when the service is struggling to recruit much-needed doctors and nurses.
Predictably, some commentators claim that the Tories created this crisis in the NHS. That it is all part of an elaborate plan to privatise the NHS by stealth and end free universal healthcare.
This would be convincing were it not for the small fact that they’ve continued to pour record amounts into a broken system. Sir Keir Starmer may like to further this untruth on social media, last year accusing the Government of cutting £30bn in day-to-day health spending.
Of course, he fails to mention that this is no such cut, but rather an ending of emergency Covid funding, which, presumably most sensible people would accept could only ever be temporary.
Even so, healthcare spending is set to reach 39 per cent of total day-to-day departmental spending this year and has been going up consistently year-on-year, and in real terms. Not a very effective way to end the NHS, I would argue.
As more people turn to private healthcare, unable to risk their lives on waiting lists any longer, and the NHS can’t even get the basics like GP appointments right, the narrative is shifting.
The penny is starting to drop that we’re not getting value for money, particularly when we compare our often woeful health outcomes to countries which spend similar amounts on their healthcare systems.
The use of private healthcare may return to more normal levels once the Covid backlog is more manageable, but it may also pave the way to a more sensible discussion around market-based reforms.
We need to accept our NHS isn’t working properly, rethink the infantile NHS adoration, and admit it’s time to redress its shortcomings. Without this, the dream of universal healthcare may be well and truly over.