The Failure of the Centralised Healthcare System in the United Kingdom

This is an article that I wrote originally in Bulgarian, but translated later on due to high demand. The editing was done by the amazing @brentssanders , where you can find my article, as well as a lot of fantastic and diverse content. Check him out! Enjoy my work and share!

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The National Health Service in the UK was created after the end of WWII as the crown jewel of Labour. Although among the most developed countries, UK has its fair share of problems with regards to healthcare. They are far bigger than what the politicians are willing to debate over or act upon. Lately their actions have worsened the system, and their proposal to lift the pay cap would only enlarge the black hole that is the NHS. It is suffering from chronic problems which are typical of a centralised and ineffective system.

Free Service at a Steep Price

Although, at first glance, it appears almost completely free at the point of use — except for NHS Scotland where even prescriptions are free of charge — reports show that the health service is taking a heavy toll on the taxpayer. In 2016/17, the budget for the entire system is a staggering £122.6 billion, and while that sum might seem like a lot, it is highly insufficient in its current state. According to the Office for Budget Responsibility, NHS’s budget must be increased by 4% above inflation every year to help it cope with population increases, patient demand, and medical advances. This increase will inevitably be covered by a surge in National Insurance rates, which even now consume about 8% of the mean income in the UK.

Social Scotland Approaching Labour’s Dream

NHS Scotland totally covers the expenses for healthcare users’ needs and partly those for other services. Due to the structure of NHS funding in the UK, the Scottish NHS receives £1200 per capita above the national average. Even so, this system is far from the utopia it is dreamed to be. As far as GPs are concerned, the service is poor, even in comparison with the poorest EU member state (which also happens to be my home) — Bulgaria. After scheduling an appointment, the wait usually takes between 1 and 2 weeks. The alternative is to call early in the morning on the same day, often unsuccessfully. Furthermore, patients are frequently limited by their GPs to discuss only 1-2 of their medicals problems at a time, leaving other complaints for another visit.

Failed Digital Reform

The attempt to create a digital patient record system came to a crashing end 4 years ago. The total amount wasted was nearly £10 billion, which was several times more expensive than expected. This failure is one of the biggest and most expensive ones in the history of public procurement spending. The mistakes of the ruling class are that they 1) tried to create a unified centralised system and 2) vastly underestimated the considerable amount of funding it would take to create and maintain such an overextended system. Digitalisation of the healthcare system would have been much easier and cheaper had private companies been allowed to create their own decentralised systems, which would have worked much more efficiently.

Price Negligence

One of the main reasons that taxpayers are willing to pay such high prices is that they have no idea how much of their taxes the government uses to pay for certain goods and services. For example, it costs the NHS a staggering 20 times more to get a pack of ibuprofen than at high street shops. The NHS spends £3.83 per pack of prescribed ibuprofen. In comparison, in most shops, ibuprofen can be found for 20-40p. In England in 2016, the NHS prescribed 22,900,000 packs of ibuprofen, resulting in a £87,600,000 cost to the system. This example is but one of many, but it is indicative of pretty much everything within the system and clearly supports the argument for decentralisation. A centralised healthcare system is more expensive than a private one because, when someone else is financing such a system directly (government, NHS, etc.), it becomes very difficult to estimate how much it would cost the user — and the taxpayers themselves rarely have the stimulus to do so. However, when the user is faced with the end price, it is in his best interest to search for alternatives (hospitals, clinics, medication, etc.) and to weigh out the price/quality ratio according to his preferences. This mechanism by itself will force the private companies to rearrange their business models to the liking of their customers or face the risk of losing money. After all, the client has the final say in a completely market based system.

My opinion about the NHS in the UK is that it is like a religion with overzealous followers.

That religion is statism. It prevents most people from seeing the facts because they cannot or simply do not wish to see the system’s problems, which obviously obstruct its effectiveness and fail to reduce preventable deaths. At the end of the day, it is a matter of human lives vs. statism, and the bureaucrats’ negligence stands in the way of effective healthcare.