Monday, November 12, 2007

What does the NHS need? More money

You know how some people go on about how much money Gordon Brown has spent on the health service, and how the fact that there are still problems, such as a 'postcode lottery' when it comes to providing new medicines, shows that the money has been wasted?

Here's another take, from an American health expert arguing the pros and cons of the USA moving to a universal health care system. He rejects the arguments that this would reduce innovation and stop people getting the best possible cutting-edge healthcare (which is the argument of the Republican Party), but adds the following caution:

"None of which is to say a universal coverage system couldn't have a chilling effect on innovation while severely pinching access to medical care that is expensive but, arguably, worth it. All it would take was a system that had both a rigid budget and very low funding. The British have such a system, or something approximating it. Even after some recent spending increases, they still devote just 9 percent of the gross domestic product to health care, less than many European nations and a little more than half of what the United States spends. And that shows up in the availability of cutting-edge care. Relative to other highly developed countries, Britain is one of the last to get the latest cancer drugs to its patients. And that probably helps explain why British cancer survival rates generally lag, too.

But few of the plans under discussion in this country would create such a strict budget. And nobody in this country seriously proposes reducing U.S. spending to British levels." (my emphasis)

The American healthcare system comes in for a lot of justified criticism, but it's worth remembering that they, along with European countries which offer the very best in innovative healthcare with the latest drugs, spend much more per person on healthcare than we in Britain have chosen to do.

There's a debate about how to change the structures of the NHS, and what to prioritise, and getting those things right is far from unimportant. But if we want the very best healthcare in this country, then we have to pay for it. The people who are saying that all the extra money has been wasted are the same ones who ran down health spending so that it lagged so far behind that of countries like France or Switzerland. Compared to the inefficient American healthcare system, the NHS gives vastly better value for each pound spent. The problem is not enough pounds, not that the money we spend is wasted.


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