The NHS is once again in a state of crisis with all non-urgent operations in England postponed, yet public debate remains heavily constricted. Healthcare provision is deeply contentious but public discourse on our health service is severely lacking. We all want a sustainable, universal service fit for the future, and building such a service begins with an open mind and a willingness to consider radical action. The National Health Service was conceived over 70 years ago across party lines. Clamour for universal healthcare accelerated during the turmoil of the Second World War. The Liberal Party’s William Beveridge recommended the provision of universal healthcare in his famous 1942 report and in 1944 the Conservative Health Minister Henry Willink published the White Paper which would form the foundation of the NHS launched under Labour in 1948.
The principle of free delivery at the point of use was Britain’s great invention. Other developed nations, aside from the US, recognised the value of the principle but decided to implement it differently. Comparative studies of different systems reveal why. The Lancet ranked the NHS just 30th globally last year behind Germany, Spain, and Italy among others. The much-cited Commonwealth Fund study, also from 2017, ranked the UK 10th out of 11 for health outcomes, particularly for cancer. An open and honest collective spirit devoid of party political sniping must be harnessed again to create a system that can keep up with evolving needs. The principle of universal healthcare free at the point of use exists across most of the developed world. One might get the impression from some, however, that only two healthcare systems were ever devised: the NHS and the American model. One of the great fallacies of the health debate is that to be critical of the current NHS model is to endorse the American one. We all recognise that NHS staff work hard; to be critical of the NHS model is not to be personally critical of health professionals too. Even the best doctors and nurses have limited potential within a tired system. This is echoed in figures released this past week, showing that the NHS is haemorrhaging thousands of staff who no longer trust that they can work under the current strained resources, and fear providing an inadequate quality of care.
Funding is crucial, but the problem goes beyond that. The NHS was not designed to cope with our ageing and expanding population. Everybody wants to keep the NHS free at the point of use, but we should not fear looking to other systems on the continent or farther abroad who abide by that same principle but opted to adopt different models. To cling to a sacred cow is to let down patients. I am not going to advocate any specific other system for Britain to adopt. It is simply crucial to recognise that the NHS has been experiencing the same problems for decades under all governments in Westminster or in the devolved assemblies. We must be open as a nation to the notion that a model devised in the 1940s might be unfit for 2018, and simply indebting future generations by borrowing ever more money might not be enough.
All options that maintain the universal principle should, of course, be considered. Insurance-based schemes subsidised by the government, which ensures protection for all, are the standard in most of the developed world. It is also necessary to look at preventative measures and strengthening social care. Only with an integrated approach can we find the best solution to this most pressing of issues. By being more open to our own fallibility we can secure the future of universal healthcare.