How much longer can we go on with our obviously failing health service? The Government is valiantly searching for technological improvements to the NHS and seeking to link pay rises from this April to a move away from outdated working practices, but all of this merely amounts to tweaks that won’t change the fundamental equation.
As populations age, spending on health (not just social care) must rise, and the resources allocated must be used as wisely as possible. This can’t happen if all the cash has to be raised through taxes. It is partly because Australia has a better universal health care model than us that they can poach British doctors and pay them more, and also levy lower taxes than Britain’s.
The Conservatives have long been terrified of seeking to reform the NHS: it is a national religion, they insist, and any genuine reform proposal would immediately trigger a toxic row about “privatisation” and “American-style healthcare”. Seeking to shift the NHS towards a more continental (or, in fact, global) model where healthcare remains universal but insurance, co-payment and the private sector work hand-in-hand with the state could only lead to political annihilation – or so the Tory thinking went.
But the NHS collapsed anyway – the trigger was Covid – and with it the Conservative poll ratings: they were too scared to reform it, and face destruction regardless. What have they to lose now? Why can’t they announce a Royal Commission to investigate new funding and ownership models?
The Dutch system used to have similar problems; in the mid 1980s, a commission suggested a compulsory health insurance system, reduced central control and competition between providers. Its recommendations weren’t picked up immediately, but a new system of health insurance was gradually rolled out.
Patricia Hewitt, the former Labour health secretary, is working on a review of how the NHS works – so the precedent is there for a British, bipartisan discussion about the future of healthcare. Royal Commissions are an ideal method. Incredibly, none have been held since Lords reform in 1999: the Tories pledged one in criminal justice reform but this, too, was put on hold by Covid.
A different way is possible. In Australia, higher-rate tax payers are nudged to purchase insurance; people can visit whichever GP they wish. The Tories thought they could hide from the NHS, but delaying what they should’ve done years ago has hurt their reputation for good management. More importantly, it has tolerated avoidable misery.
Tories have put off NHS reform for far too long
The Conservatives have let fear deter improvements to Britain's health service. But delaying any further will only make things worse