Changes to the NHS are often shunned and met with harsh criticism. When privatisation and the NHS are mentioned in the same sentence, many people fear that healthcare will no longer be a good for everyone but a luxury preserved for the rich. However, many countries around the world have a privately run health care services and operate, in some ways, better than the NHS. A survey by OECD in 2015 said the U.K. could avoid at least 14 unnecessary deaths per 100,000 citizens if it adopted SHI, one form of a privatised health care system. Having a market based system can improve satisfaction, waiting times and overall efficiency within health care and could be a viable alternative to our current model.
A privatised health system is often associated with America’s system. America, in regards to health, is unique amongst developed countries, as access to health care is less than 100%. Many countries have an insurance based health care scheme and still ensure 100% of citizens have access to healthcare. It is a myth that people will not receive health care if it becomes privatised. Privatised health care systems can work in tandem with universality.
Whilst private companies would still require payment from people who are unemployed or who are on low incomes, countries such as Switzerland and Norway both offer demand based subsidies to these people. This system still gives poorer people the choice of insurance providers and, fundamentally, the right to health care. The two countries mentioned spend more of their GDP on health care than the UK does and both, according to the 2014 European Health Consumer Index, perform better in various measures when compared to the UK. Having demand based subsidies rather than supplying health ensures the government is an arbitrator rather than a provider.
This allows health care to be focused on health policies and competition rather than a system being influenced by politicians and bureaucrats, who are disconnected with the end user. The current negotiations further exemplify how the NHS is susceptible to governmental policies which do not benefit the doctors or the end user. Due to the public funding of the NHS, decisions are ultimately political.
“You cannot sensibly advocate a system which vests politicians with so much power, and then be constantly outraged when those politicians do not use that power in the way you want them to use it.” Kristian Niemietz
Privatisation will allow for consumer choice and make the insurance companies more accountable to the end consumer. This feature is absent within our current state run system.
Privatisation does not mean that profits will precede patient care. Many countries ensure that insurance companies cannot ‘cherry pick’ clients and ensure a compensation scheme where insurers with a large amount of ‘high risk’ clients are compensated through insurers with a high amount of ‘low risk’ clients. Effectively, this allows insurers to compete through services rather than choosing the clients who have the lowest risks. Such systems also benefit from not having a gate-keeper. This allows people to see any specialist when and how often they like, further improving competition and allowing for consumer choice within healthcare.
The NHS can learn from some of these examples to improve the current service. Whilst such models only service as a guide, the alternatives to the NHS are not as bleak as people initially think. There is no consensus as to what the best model is; but should the government continue to face opposition from doctors and patients, a market based system would be a strong alternative.