How much would the NHS cost to use if it was a private, commercial service?

21 November

In the US, healthcare is essentially an insurance-based, private sector industry. The US spends almost 17% of its GDP on health care. We spend less than half of that, around 7% of the GDP. Under a US-style system I think we’d end up spending at least double the amount we do now. We’d end up spending another £115bn to go to a privatised system.

 But the beauty is, outcomes are still a lot better in our system than in the US. In the Commonwealth Fund healthcare survey for 2013/14 we came out top for efficiency and cost-effective health care. The NHS was named the best.

 So the NHS is a world leader. You are given healthcare according to your need, not according to the size of your pocket, or your colour, gender, sex or race. It’s a unique system as far as I’m concerned, and I’ve travelled extensively, in Asia, in America, across Europe. Being a doctor, you always want to see how those systems work there and I’ve looked at them. I might moan and groan about the NHS, but in my experience, it is still the best system. 

But tragically, it’s being changed to the kind of system they have in the US.

“The Conservatives’ reforms are already leading us down the road to a US-style insurance-based system.”

All of [former health secretary] Andrew Lansley’s reforms, and what Jeremy Hunt is now doing  to healthcare, is leading us down the road where it’s going to become insurance-based like the US.

It will lead us to a two-tier system. We might have some people who can top up or who can give a lot more money for insurance. They might have a better quality service.  But by and large, for the rest of the country healthcare will become more like the kind of service you see in a third world country. We don’t want that. 

I hope the NHS is saveable – I always use Aneurin Bevan’s quote: “The NHS will last as long as there are folk left with faith to fight for it.”

I will qualify that however. Though I am so proud of the NHS, what we have really developed with the NHS, so brilliantly and beautifully, is a National Disease Service. If we want the NHS to be sustainable and healthy, then we have to look into the preventative bit of it, the public health bit of it, the lifestyle side of it. That’s the real elephant in the room. It’s such a shame. As a GP I can safely say that 70-80% of my consultations would disappear if people were able to look after their lifestyle, nutrition and exercise. It’s as simple as that. 

“I am so proud of the NHS but we don’t do enough on preventative healthcare. Really, what we have developed here is a National Disease Service.”

This kind of thing needs to be taught from the nursery, from school. As soon as people have kids, they need to realise how important nutrition, exercise and lifestyle are if they want to really live. People are living longer, but are they really living healthier? That’s the big question. You look at the diabetes and heart disease epidemics we’re getting, it’s alarming. Everybody’s got to contribute, whether it’s local authorities, schools, politicians. We’ve all got to understand this – we’ve got to get this right.

 The money spent on public health measures is only around 2-4%. We have to spend more money to address these things rather than having these structural reforms, or having ideological fights between left and right. Let’s take politics out of it. Let’s make it a real national health service where no political parties own it – we all own it.

 Let’s stick to what it has delivered for us for the last 70 years, and then we won’t have to pay for it at the point of use. The NHS is still one of the best – let’s not kill it.

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