Frank Young is editorial director at the Civitas think tank.
The most tediously hackneyed non-debate in British politics is over the future of “our” NHS. Voters are constantly told that their only choice is massive waiting lists and absent GPs or the Wild West American system.
Plenty of sensible-minded Brits can perform the cognitive dissonance required to clap for NHS workers but question the system that brings them to the brink of exhaustion. Our political masters are not so intellectually dexterous.
It turns out that when you put our health system side by side with other countries we don’t do so well.
Tim Knox, a former think tank boss and veteran of the policy world, has published a new index which ranks the British health system against 18 other comparable nations. Knox uses gold-standard OECD data to compare health outcomes, such as cancer, heart attacks, and diabetes.
The NHS compares badly with other countries as the table above shows. We’re among the worst for most cancers, strokes and treatable diseases. We only top the table for helping diabetics avoid amputations.
The choice often presented to the Great British public – America or the NHS – is a false one. Tellingly, of the countries analysed by Knox almost all have universal health coverage. Questioning the NHS does not mean selling the health service to American bankers, a claim made by Jeremy Corbyn not so long ago.
We are mid-table dwellers for health care spending. It’s on outcomes where we bomb.
Take strokes and heart attacks: this new index shows the UK has the worst survival rate. The news is little better for cancer, across five different types of cancer measured by the OECD the NHS comes 16th out of 18.
One worrying statistic shows that for treatable diseases the UK is second to bottom, with only America beating use to last place. If we matched the average of other countries, we would save over 6,500 lives every year.
We badly need to break the NHS taboo that suffocates discussion. Why is it that our political class is so frit and unwilling to question a health system that compares so badly by comparison?
In the final years of the last Labour government, Conservative HQ commissioned extensive polling of public attitudes to the Conservative Party and NHS. I was in the room when the results came in.
The public viewed Conservative support for the NHS as a proxy for understanding the challenges faced by ordinary families; it had a direct and positive impact on the overall popularity of the party. In simple terms, ‘backing the NHS’ was the secret to electoral success for a party that had been in opposition for more than a decade.
Party strategists soon latched on and the decree went out that questioning the NHS was an unspeakable electoral heresy. A code of silence has been imposed on the Conservative Party ever since.
Breaking the NHS taboo is long overdue. A new set of stats will be published by the OECD later this year covering the pandemic period, and it’s hard to imagine the NHS will do anything other than continue to bump along the bottom. Knox will re-run the numbers to find out.
This isn’t a part of a secret plot to “privatise” the NHS. It’s a simple attempt to crunch complex data to put our health outcomes side by side with other countries. Our political class should welcome this.
Only a few weeks ago new British Social Attitudes data pointed to a sharp decline in faith in the NHS. It is likely we have reached peak NHS adulation. Void of a killer virus, the public are starting to ask questions.
It’s a strange form of healthcare jingoism that says ours is the best healthcare system in the world without more critical reflection. This newly published league table tells another story.
The French delicacy of ortolan is eaten by diners with a napkin placed over their head to hide the shame of eating such a beautiful songbird. Politicians who dare question the sanctity of the NHS might observe a similar practice.
We need some few brave men and women sitting on the green benches willing to speak out and ask our leaders to ask why we do so badly across dozens of different outcomes.
The NHS as a brand has huge cut through – not something to be lightly tossed away – but the pandemic might well be the point at which the public grew tired of being told it was their job to protect the NHS and not the other way round. Forensic, international comparison is the next step in asking questions about how well the NHS does at keeping us alive or treating illness.
The beatification of the NHS has to end well before future chancellors do nothing more than spend money on health care. The day is coming and the public can sense it. When will our politicians catch up?