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Is the NHS the world’s best healthcare system?

From our ever popular series, headlines in The Guardian we can answer:


Is the NHS the world’s best healthcare system?

As the article itself points out:

Is the NHS the world’s best health service?
The US-based Commonwealth Fund, a respected global health thinktank, last year ranked the British health system as the best of 11 well-off countries. The NHS performed better than its counterparts on fairness, ease of access and administrative efficiency, although the study acknowledged that outcomes for people with potentially fatal diseases fell short of those in western Europe and Australia.

And we really should acknowledge the Commonwealth Fund’s bias here. It’s nothing at all to do with what we call the Commonwealth. It’s a private American foundation. Whose mission is to: “promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable and the elderly.” Something they pretty much define as government paid for health care for all.

They’re predisposed to like a system like the NHS. And their ranking system reflects that. The vast majority of the points leading to the rankings being about equity, not effectiveness nor efficiency. Well, it’s a point of view but it’s hardly objective.

This is absolutely fascinating:

Spending as a share of GDP is lower than in many western European peers: the government has spent just over 7 percent of GDP on public health each year over the past decade. Including private healthcare spending, the 2016 total was 9.7% of GDP – slightly higher than the OECD average.

A more recent report by the King’s Fund thinktank, which analysed health data from 21 OECD countries, said the UK was falling behind other countries, with among the lowest per capita numbers for doctors, nurses and hospital beds in the western world.

“If the 21 countries were a football league then the UK would be in the relegation zone in terms of the resources we put into our healthcare system, as measured by staff, equipment and beds in which to care for patients,” said the King’s Fund’s chief analyst, Siva Anandaciva.

We spend more and get less. That’s not really efficiency, is it? And effectiveness is pretty bad too, given that low ranking in mortality amenable to treatment. As I’ve said elsewhere recently:

Just in time for the NHS 70th birthday celebrations we get the news that our hallowed health service isn’t all that it’s cracked up to be. According to a substantial new report by the King’s Fund, the UK is the third worst out of 18 rich countries at curing people of things that can be cured, or more technically speaking “preventing avoidable deaths”. The authors note that the NHS is also highly equitable in the sense that treatment is entirely divorced from any personal economic factors.

This is not new information, by the way. The Commonwealth Fund has run a ranking system for years, showing the same results. The World Health Organisation’s now discontinued rankings also told us the same thing. Equitable but not very good at its actual job, that’s our NHS.

Is that the world’s best health care system?

No, no it isn’t.

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Quentin Vole
Quentin Vole
5 years ago

The NHS may well be the best health care system in the world for delivering benefits to those working within it. For efficient health outcomes, not so much.

5 years ago

Every year, my town’s government school system is claimed to deliver better value than the school systems of the surrounding towns. And my postmaster is sure the USPS is “better” than other nations’ letter-delivery rackets. To let this question be asked without challenging it is to lose any resulting argument, although Tim not only challenges it but points out how it measures nothing but success at being the NHS, much like how my state gets “high marks” on a “report card” compiled by a group of gadflies. This is naked advocacy, dressed up to resemble science! There are ways to… Read more »

5 years ago

Spending less is not automatically a bad thing, spending less can often be the solution. If you get the same or more for less money, that’s a good. As I keep reminding people, I’ve just had an operation. 20 years ago I spent three days in hospital for something similar, last week I and five other people were done as a single batch of day cases, and spent a total of 11 hours in hospital. So far, my experience of the NHS where I live is spending less and getting more. Yes, it meant a five month wait from assessment… Read more »

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