How to fix the NHS: a doctor’s prescription

I’m a doctor, and I don’t care about the NHS. In this country, that’s an almost heretical statement — but it’s true. What I mean is that I have absolutely no interest in ensuring its survival simply because it’s a great national treasure. What I care about is making sure that we have the best possible and most cost-effective healthcare system. And as it happens, despite the strikes, panic and doom-mongering, I think the NHS — by which I mean a nationalised healthcare model — is the best option available, if only someone were brave enough to make the right changes in the right way.

Don’t expect this government to try. Senior cabinet ministers said this week that their attempt to reform the NHS (which culminated in the 2012 NHS Health and Social Care Act) was their ‘biggest mistake since coming to power’. As angry, beleaguered nurses and frontline staff begin striking, there is a cross-party consensus that the NHS can’t be touched: it’s just too toxic politically. So instead of making amends for the former health secretary Andrew Lansley’s botched attempts at reform, Cameron decided he’d rather ‘park’ the issue. That’s like a surgeon splaying open the patient, then realising he’s made a mistake and just walking away from the operation with a nonchalant shrug. The NHS has been left haemorrhaging on the table. Sorry, but that’s not good enough — there’s lots that could and should be done.

The Commonwealth Fund survey, which uses a range of measures to analyse healthcare systems around the world, has consistently found that the NHS is one of the best. But the attempts — first by the Labour government and then subsequently the coalition — to introduce more efficiency through competition have in fact meant an explosion of expensive bureaucracy. It’s quite clear that the more providers of healthcare there are in the system, the less efficient it becomes, and the risk of duplication, confusion and misunderstanding grows.