Sector wars will not help Health

As I have two retained clients in the Health Sector, I don’t like to write much about it.

However, with Health as with anything else, I get frustrated by “Sector Wars”. The absolute assumption on the part of some that private provision is to be excluded at all costs (literally, it turns out) will actually have the very opposite outcome from that intended – such an exclusion would destroy the “NHS” (i.e. state-funded provision of health services free at point of access).

From the very outset, the NHS has been necessarily dependent on private provision – of medicines most obviously, but also of hospital/health centre construction/maintenance and other specialist services. It is worth noting: the basic principle is state-funded provision free at point of access, not public provision.

It is in fact impossible to provide state-funded provision free at point of access without using private health services. Most obviously, it would be impossible for the State to fund all research into pharmaceuticals, not least because this is necessarily international. So are other services. Those services may well include certain treatments, certain services and products to do with diagnosis of certain conditions, and indeed a certain range of care services. Not all of these will be on a profitable basis, of course – but some necessarily will (after all, if someone has taken a risk with research into a new drug, or a new treatment, or a diagnosis technique, it is not unreasonable for them to expect a return on that risk if it works out – a return they may well reinvest in further, useful research).

This pretence that all state-funded provision must necessarily be public provision is already moving us towards collapse of the “NHS” (i.e. the free at point of access system). In Belfast, the waiting list for diagnosis of certain conditions “on the NHS” is now approaching two years. Go private, and this is four days. If “the NHS” were to pay for access to the private system, this could be equalised – meaning that wealth would make no difference to how quickly you were diagnosed; but the refusal to go this route now means that wealthy people are diagnosed within a week, whereas poor people can expect to wait over 18 months. This is grossly unfair and a breach of the spirit of the NHS – but it is caused by the very insistence that the NHS should not use private services.

“The NHS” does not exist to employ people and guarantee pensions. It exists to provide a system of health care which is free at point of access. Daft sector wars aimed at protecting the former actually inhibit the latter – and with an ageing population, a lower working-age tax base and more complex conditions, this will only become even more markedly the case.

It is time we stood up for the basic principles of the NHS – and recognised what that really means.

[Strictly, Northern Ireland does not have an “NHS”, hence the quotation marks – but its integrated Health and Social Care service operates under the same basic founding principles.]


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