A horror short: if the UK lost the NHS and looked like the US

I and others have written at length about Health Secretary Andrew Lansley’s catastrophic Health and Social Care Act and the disastrous effect it’s having on the NHS. I’ve written variously about the BBC’s near-criminal silence on the matter, the blackmail tactics the government has used on the BBC to force it to collude in this way, and on the BBC’s indolence and arrogance if anyone complains about it.

I’ve also written about the Tories’ real feelings about our National Health Service and their determination to break it up and sell it off along with the rest of the welfare state, and the origins and history of their ideological motivations for doing so.

And yet I still get a steady stream of Tweets, comments on this blog and email messages from people who’ve fallen for the government’s (and its media mates’) propaganda that the NHS is inefficient and wasteful (it isn’t!); that NHS doctors, nurses and other workers are lazy, selfish, and not worth the pay they receive especially if they live in a poorer area; that the NHS is in need of radical reform to get it working properly (the government isn’t interested in reform – ‘reform’ is simply an excuse for initiating its destruction); that the government genuinely wants to improve the NHS (its determination to cut spending by an impossible £50 billion shows the lie of that). If I had hair, I wouldn’t have hair – I’d have torn it out by now.

The Tories want to remove the NHS and even dismantle the welfare state completely. Some of them have even been caught saying so. They claim to admire the US system of private healthcare provision, and continue (in spite of G4S!) to insist that private provision is more efficient than a public system could ever be, and that this justifies opening up the NHS to ‘competition’, even though adding a profit layer can’t possibly be cheaper unless you ration care and strip the wages and conditions of health workers.

So, just in case you’re still on the fence on the matter, let me paint you a couple of very quick word-pictures based on a couple of very simple comparisons of US and UK statistics – word pictures that amount to horror stories:

Horror Story 1: Cost

The government keeps claiming (a clear example of the ‘Big Lie’ principle in action) that the NHS is inefficient and needs reform to ‘save’ it. That reform means allowing private companies to carve up the NHS (according to Eoin Clarke’s ‘Green Benches’ blog, if the latest sale of 3 hospitals in London goes through, the value of the NHS sell-off/give-away under the coalition government will reach £7 billion), with the result that in a few short years the treasured NHS principle of ‘care free and at the point of need’ will be gone (see also http://www.activequote.com/news/nhs-may-charge-patients-to-meet-costs-of-an-ageing-population-experts-warn.aspx).

But, as referred to above, the US spends more than twice as much per health per head of population as the UK does – an additional 128%! So what would it mean here if the UK followed the US pattern?

The UK currently spends about £120 billion a year on the NHS. If we were as ‘efficient’ as the US, that £120 billion would increase to a whopping £273 billion. That’s where the Tories are taking us. But because they’re destroying ‘free at the point of need’, that incredible cost would have to be borne by you, me, my loved ones, your loved ones, instead of being paid for via taxation so that nobody’s health is dependent on their ability to pay. Which leads us to horror story #2:

Horror Story 2: bankruptcy

In the US, cost of medical care accounts for an incredible 62% of bankruptcies. Figures vary each year, but in the UK as a whole, among England, Wales, Scotland (haven’t found figures for Northern Ireland yet), there are around 130,000 insolvencies every year.

If we followed the US, that 130,000 would only equate to 38% of the total. Add in another 62% for insolvency related to medical bills, and the UK would be facing – at horrendous cost both fiscally and socially – a staggering total of 342,000 insolvencies every year. When the government talks about the NHS being inefficient, what it’s really referring to is ‘inefficient for the super-rich’ – if you earn multiple millions a year, it’s much more efficient for you personally to pay for your healthcare yourself rather than through taxation. But it would be a disaster for pretty much everyone else – even if you’re pretty wealthy, you’d only be a diagnosis away from losing your job, losing your income and finding your house and your savings drained to nothing by the cost of treatment – and then finding yourself bankrupted by the cost of trying to live.

The title of this post says ‘short’, so I’ll round up now. I haven’t even mentioned the obvious horror story that under a US-style system anyone who can’t get insurance and can’t afford to pay for treatment would be turned away by the vast majority of hospitals and would be forced to hope that a charity hospital might give them some kind of basic care.

Even without that, what the two comparisons above show is that even if you don’t think the NHS is something we can be proud of, something to be saved, treasured, lauded – you should still be campaigning with every fibre of your being to save it. Unless you’re super-super-rich, pure self-interest dictates it. The alternative is a pure horror story.


  1. Reblogged this on The SKWAWKBOX Blog and commented:

    There’s so much negativity in the press, on TV and in government statements at the moment. Every imperfection of the NHS is magnified and held up for public ‘horror’ – a clear strategy to try to undermine public affection for our National Health Service.
    So it seems like a good time to re-publish this post, which shows what a real ‘horror story’ looks like, to remind us that the NHS, though imperfect, is a boon and a blessing no matter how hard those who hate it try to denigrate it.

  2. Apart from the “horror” approach and systematic
    de-professionalisation over the years, there is another problem for those trying to be positive about the NHS. At any one time, the number of people using the NHS is large in number but a small proportion (ie most people are well (hooray!) Those that are using the service know very well how valuable it is and are mostly getting a very good service or occasionally miraculous help with seemingly impossible predicaments. The rest of the population (the vast majority) only have the press and general comment/rumour to go on – hence the ignorance. Hence the problem.

    You are right that even if you lack common humanity as a reason for liking the NHS (a pretty good reason, surely), it makes huge economic sense; and if you believe in opportunity cost (as I do) then wasting public money on a project to divest HMG of the responsibility for Health Care simply because it annoys you is absurd and obscene – and a cause of having less money for other worthy projects (more swimming pools and playing fields, good personal care for the disabled and clever gismos for them etc etc)


  3. But here, on 26/03/2013 (ex Hansard) is Clegg re-affirming that he thinks the revised “Competition” regs have prevented CCG’s from having to put EVERYTHING OUT TO TENDER. The man is a liar and one day I hope that he pays for it.

    T5. [149773] Debbie Abrahams (Oldham East and Saddleworth) (Lab): Perhaps I can think of one. Ministers have said that the second set of NHS privatisation regulations due to come into effect on 1 April will not force clinical commissioning groups to put health services out to competitive tender—in spite of legal analysis showing that they are just as bad as the first such regulations. Since the warnings about the Health and Social Care Bill have turned out to be true, if NHS services are privatised, will the Deputy Prime Minister resign?

    The Deputy Prime Minister: This is typical scaremongering from the Labour party. It was the hon. Lady’s party that wasted £250 million of taxpayers’ money subsidising the private sector in a deliberate act to undermine the NHS. It is the Government who have made it illegal, directly in the Health and Social Care Act 2012, to have competition based on price rather than on quality. The hon. Lady would know, if she looked in detail at the new regulations—the so-called section 75 regulations—that they make it quite clear that clinical commissioning groups are not forced to open services to competition unless they think it is clinically justified in the interests of patients to do so.

    1. Thanks for the pointer! The only thing I’m confused by is that the senior parliamentary clerk said it couldn’t be 1/4 because days when neither House is sitting don’t count, so it should be 15/4 or thereabouts. Will check further..

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