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BUSINESS DAY For all its virtues, England's National Health Service (NHS) is far from perfect. After paying £600 for the privilege of accessing the publicly funded health care system for the next three years, I have been waiting to see a specialist for about five months since being referred by a GP. Since mine is not a medical emergency, appointments have been moved out by a month on more than one occasion. My experience is not unique (waiting times for nonurgent treatments can be up to 18 weeks), but it provides a small insight into the challenge of providing universal health care – a challenge that is deepening in the face of an ageing population increasingly afflicted by costly ills of lifestyle such as diabetes and heart disease. For all its achievements in improving life expectancy and infant mortality since it was established in 1948, the NHS lags behind many European countries in key health outcomes, such as child health and cancer survival. Yet, despite this and serious doubts whether the funding model is sustainable given demographic changes over the past 70 years, the NHS remains a British sacred cow. It is so entrenched in British culture that alternative approaches are given little to no thought. Until the money runs out (if it ever does), reforming the NHS is off the table. This was clearly evident at a recent Cambridge Union debate: "This house regrets the NHS's status as a national religion." The Cambridge Union, a central part of Cambridge University, it is the oldest debating society in the world, launched in 1815 and still hosts weekly debates and talks, featuring student speakers and high profile outsiders. Recent speakers have included Baroness Brenda Hale, the president of the UK's supreme court (and the only woman to have held the position), and Farrah Storr, editor of British Cosmopolitan. Celebrities such as Pamela Anderson, Robert Downey jnr, Russell Brand and James Blunt have graced the union, which has also hosted Winston Churchill, Theodore Roosevelt and the Dalai Lama. In other words, this is no mickey mouse debating society. It was disappointing, then, that the speakers participating in the debate on the NHS did not suggest much by way of alternative approaches to providing universal health care. That the state should provide it and should do so centrally – despite evidence that this may no longer be affordable or even desirable – was the assumption of underlying arguments made by both the proposition and the opposition. The word "private" was spoken as if a swear word. The opposition seemed to be labouring under the common misconception that the only conceivable alternative to the NHS is the US system, which is not universally accessible. To his credit, the student speaker for the proposition suggested that reform of the NHS could take the shape of recent changes applied to the social care system, where the amount you contribute depends on the level of need and your existing assets. Under the Social Care Act, local councils assess income, savings and property to establish how much an individual should contribute towards their own care. Still, the debate was largely inward-looking. Those debating had clearly grown up in a society predicated on state-centric social welfare. So shaped had their worldviews been by the welfare state that they scarcely considered how the private sector might help solve society's greatest needs. In SA, that type of thinking has given birth to companies such as Curro and Discovery. While these companies do not cater for the poorest, they go some way towards alleviating the burden on Pretoria. Let's hope that when it comes to National Health Insurance the NHS is not used as a blueprint, and private sector expertise and innovation are brought to bear. Ziady writes from Cambridge in the UK.
Created at 2019/03/25 02:33 PM by Mediclinic
Last modified at 2019/03/25 02:33 PM by Mediclinic