Rory Sutherland Rory Sutherland

A nice, cuddly NHS would be bad for us

We can have an efficient health service or one no one complains about. We can’t have both

issue 20 January 2018

Recently the NHS postponed a large number of non-urgent operations to cope with what is known as the ‘annual winter crisis’. Naturally, this outcome was treated as a scandal in the press, and there were predictable calls for Jeremy Hunt to resign. But the fact that non-urgent operations are postponed is not by definition bad. It might be evidence that the NHS is working well. Or at least that it is doing what it is supposed to do, which is to deploy necessarily finite resources on the basis of patient need, rather than some other criterion — such as profitability or ability to pay. Making people wait for less urgent operations isn’t a bug of the NHS; it’s a feature.

People can and do distinguish between a common-pool resource and a private good, and judge them differently. For instance you won’t often hear me say, ‘Sorry I’m late: some bastard in an ambulance needed to get to a car accident.’

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