A letter from 900 NHS doctors to the Prime Minister today makes the case for ending the ‘free at the point of delivery’ mantra that has been with the Health Service since its inception.
“Rationing of services and bigger financial deficits were the inevitable result of preserving the status quo, they said.” (The Guardian)
What we see here is the continual failure to understand ‘rationing’. There is always rationing of services, in any system, and always will be. Unless, of course, we discover Socialist Utopia World* (TM) with unlimited resources, then clearly there will always be rationing!
In the NHS, services are not rationed by price but by time (‘waiting lists’) and a limit to how far the service will go (i.e. the NHS will prioritise younger patients with a greater chance of survival, and pay for the drugs with the highest success rate.) In other systems, price simply becomes another form of rationing – along with more bureaucracy, more waste and greater inequality.
To increase your ‘rations’, you have to increase supply. Hence more money going into the NHS, reform of its structure to make it more effective, etc etc. (Argue about how well this has been done till dawn if you want to.) Of course demand is also rising – an ageing population, greater demand for ever more expensive health services and so on. I think the obvious conclusion is that the NHS will always have a limit to what it provides – but just like any other system on the planet.
The public agree. “Two-thirds said the NHS in its present form was unlikely ever to meet public demands, however much was spent on it.” But there is no magic replacement system, and the NHS is the fairest and most equitable way of delivering healthcare – free at the point of delivery, regardless of the ability to pay. So perhaps those 900 NHS doctors should get back to work, on their increased pay packets.
Oh and there is one piece of good news – “Three-quarters of the sample said politicians should be removed from day-to-day management of the health service.”
*(Socialist Utopia World does sounds like a great name for a theme park. In the leaflet: How do I get to Socialist Utopia World? Keep turning left.)
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