Actually, what is the only interesting NHS question:
The NHS was “on its knees” even before winter had begun, health service bosses have said as figures showed it missed key waiting-time targets for A&E care, operations and cancer treatment.
The performance of the NHS in England in November was yet again its worst ever, prompting concern that it cannot keep up with a relentless rise in the number of people needing care.
Doctors’ leaders called for Boris Johnson’s government to take urgent action to boost staffing, hospital bed numbers and GP services.
NHS England is run in a different manner frm NHS Wales and NHS Scotalnd. There’s much more outsourcing, private provision, in hte English version.
OK, great. So, we can now test the three against each other. Is NHS England producing more health care from the inputs available to it than NHS Wales and or NHS Scotland? Or, obviously, less?
Whichever system is producing that more output from its inputs is the one we should be using for all three, obviously enough. So, what is the answer?
The reason we’re not told this answer is, perhaps, because it’s the English method that does best, a politically inconvenient result there.
But this is indeed the only interesting NHS question. Which version is the most efficient?
The different structures of the three NHSs deliver one of the benefits of the free market: innovation. Adopting innovations another NHS found efficacious is a good idea. The more important thing is motivating the three to innovate further. They lack the bigger benefit of free markets, competition, as I assume each Brit is limited to using exactly one of them. Perhaps domains could change according to quality of service (as salesmen’s territories sometimes do) and the others could risk being gobbled up by the more efficient NHS England.
As with folks who live near a state border, I know of people in the Welsh marches who will drive into England for A&E, or even register with an English GP.
One wonders what percentage of the A&E patients served were actually emergencies. Probably well below 10%…
But since it’s almost impossible to see a GP in any reasonable amount of time, it’s either A&E or self-medicate. (Many of them should just be tucked up in bed with a Lemsip and a hot-water bottle, of course.)
But that’s why the US system is so much worse! It’s often a 2-24 hour wait over here (to see a gp)
Oh, wait..
The original Beveridge proposal, supported by Conservatives and Liberals, was for a NHS, free at the point of treatment, with powers delegated to local boards with the resultant ability to observe which methods worked best before applying them across the board. Bevan et al refused that lest the rich areas spend more on health than the poor ones. You point out that this has had the obvious consequence that the dirigiste Health Services in Wales and scotland have performed worse. BUT how much worse has the NHS performed for 70 years because it never tested alternative ideas before deciding what… Read more »