Will we ever get a grown up debate about the NHS?

As the NHS takes centre stage in the general election campaign one despairs of the quality of debate. Why oh why can Britons not accept that there's a reason the UK's state-dominated health service is emphatically not the envy of the world?

The real emergency is that the NHS is a broken system
the commentator
On 7 January 2015 08:10

Never mind Labour's crocodile tears about the state of a National Health Service whose core funding has been compromised by the legacy of their ruinous mismanagement of the British economy, the most depressing intervention on the NHS since the beginning of the week came from Conservative Health Secretary Jeremy Hunt.

Answering criticism that Accident and Emergency waiting times are now the worst for a decade -- when, by the way, Labour was in power -- he droned on in typically British-politico speak about the NHS as the best health care provider in the world.

Not for the first time -- and in keeping with the line pushed hard by the political Left -- he offered as evidence a study conducted by the Commonwealth Fund last year.

It makes you want to weep. The study in question was an ideologically charged piece of propaganda with methodological flaws that would be embarrassing to a 12 year old.

Essentially, the Commonwealth Fund looked at issues such as value for money and inputs, while outcomes were totally disregarded. Pause and think about that. In order to con you into NHS-is-the-best-in-the-world mode, they had to ignore the question of whether the NHS is actually any good at making you better.

Cancer survival rates? Forget it. If they'd included them, the NHS ends up being one of the worst health care providers among comparable countries, and even among countries which most Britons would not want to be compared with -- many former communist countries in central and eastern Europe have now overtaken Britain in several key areas, particularly cancer.

As Kristian Niemietz from the Institute of Economic Affairs put it an a withering piece last June:

"I got a little sceptical when I saw somebody tweet the following quote from [a Guardian piece on the report]: ‘The only serious black mark against the NHS was its poor record on keeping people alive.’ This is mildly irritating. What would you make of a customer review for a coffee machine on Amazon, which awarded five stars, praised the machine to the skies, and then ended by saying ‘The machine has just one minor downside: it has a poor record on making coffee. But otherwise, it’s fantastic, and highly recommended.’

The other issue that should be, but never is, raised whenever anyone in Britain starts getting all misty eyed about the NHS is this: if it really is the envy of the world, why has no-one actually emulated it?

Obama may have come in for criticism from Republicans for his reforms to the American health system, but he still stuck with a largely insurance based approach. Canada doesn't have a system like the NHS, neither does Australia, nor do countries in continental Europe. Goodness, how do they manage? Pretty well actually.

The only countries that envy the NHS are those that are relatively poor and underdeveloped. The NHS isn't the envy of the world, but it may well be the envy of the third world.

But one despairs of even raising these points. It seems to be programmed into Britain's political DNA that a mature discussion about healthcare is disallowed.

And what that means is that the latest focus on the disastrous state of A&E is just another episode in a fruitless pseudo-debate that is destined to be repeated again, and again, and again.

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