“Patients dying in hospital corridors.”
So went the headline which appeared on the BBC’s website
last week, detailing the newest outrages which have emerged from Britain’s
crisis-beset healthcare system. This most recent revelation came as a result of
an open letter sent to the prime minister by 68 senior doctors, offering
details of the inhuman conditions which have become common in the National
Health Service’s hospitals.
The letter, which collected statistics
from NHS hospitals in England and Wales, found that in December alone over
300,000 patients were
made to wait in emergency rooms for
more than four hours before being seen, with thousands more suffering long
waits in ambulances before even being allowed into the emergency room. The
letter further noted that it had become “routine” for patients to be left on gurneys
in corridors for as long as 12 hours before being offered proper beds, with
many of them eventually being put into makeshift wards hastily constructed in
side-rooms. In addition to this, it was revealed that around 120 patients per
day are being attended to in corridors and waiting rooms, with many being made
to undergo humiliating treatments in the public areas of hospitals, and some
even dying prematurely as a result. One patient reported that, having gone to
the emergency room with a gynecological problem which had left her in severe
pain and bleeding, a lack of treatment rooms led hospital staff to examine her
in a busy corridor, in full view of other patients.
While it’s tempting to believe that
these extreme cases must be a rare occurrence, the fact is that such horror
stories have become increasingly the norm for a socialised healthcare system
that seems to be in a permanent state of crisis. Indeed, as the NHS entered the
first week of 2018, over 97% of its trusts in England were reporting levels of
overcrowding so severe as to be “unsafe.”
Almost as predictable as the regular
emergence of new stories of this kind is the equally unwavering refusal of
British commentators to consider that the state-run monopoly structure of the
system itself might be to blame. Many, including the prime minister herself,
have pointed to the spike in seasonal illnesses such as the flu at this time of
year, to distract from the more fundamental flaws of the system. However,
officials from Public Health England recently went so far as to openly dismiss
this as a major cause of the current healthcare crisis, clarifying that current
levels of hospital admissions due to the flu are “certainly not unprecedented.”
The aging of the population, and local councils’ failure to provide more
non-hospital care have also been blamed.
By far the most commonly suggested
remedy, however, is simply to inject more taxpayers’ money into this failing
system. Indeed, the belief that Britain’s perpetual healthcare crisis is solely
the result of funding cuts by miserly Conservative politicians is so widespread
that it is almost never challenged, least of all by the trusted experts within
the system itself, many of whom stand to benefit from increased funding.
However, the popular caricature of the
NHS as suffering from chronic underfunding is simply a myth. In fact, even when
adjusting for inflation, it is clear that government funding to the NHS has
been increasing at
an extraordinary rate since the turn of the millennium, much
more quickly than during the early years which its supporters look back on so
fondly.
Indeed, under the Conservative
government of 2015–16, almost 30% of Britain’s public services budget was spent
on its monopoly healthcare system, compared with around 11% in the NHS’s first
decade.
One commonly heard soundbite from
supporters of the current system is that the Conservatives have allowed
healthcare spending to slump to historically low levels; all it would take to
return the NHS to the levels of success it supposedly previously enjoyed would
be to increase its funding back to the same level it previously enjoyed, or so
they say. However, to believe such a statement one would have to make two separate
misinterpretations of the statistics, both so basic that they would strike
shame into even the dullest high school math students: firstly, it is not the
absolute amount of spending on the NHS which has fallen under the
Conservative-led governments of 2010–18, but merely the rate at which spending
is continuing to increase, even when adjusting for inflation. Second, the only
reason that the rate of increase seems to have fallen is because of how
disproportionately high it had been been under the infamously spendthrift
Labour governments of 1997–2010.
Not only is the NHS not underfunded,
but it suffers from dismally low efficiency in terms of healthcare bang per
buck compared with similarly developed countries. This suggests that no matter
how much its funding is increased, the current set-up is prone to chronically
waste that money away.
To overcome these problems, reforms to
the fundamental nature of the system itself are desperately needed, to increase
the economic freedom of healthcare providers in the UK as well as the freedom
of choice of consumers. In short, as long as British healthcare is organised as
a taxpayer-funded state monopoly it will continue to fail, just as the other
nationalised monopolies of the 1970s failed. To get to a point where the
British public would even consider reforms of that kind, however, would require
the breaking of a taboo that has defined the past 70 years of British politics.
George Pickering is the Almoayyad Fellow in
Residence at the Mises Institute this summer, and is a student
of economic history at the London School of Economics.
