The National Health Service: A Cultural U-Turn

Contemporary Britain has redefined and extended the roles of the National Health Service from simply treating illness to its prevention, educating the masses and extending life. In its plight to meet all of these criteria, or face torrents of criticism, the NHS has reached a stalemate on its 70th anniversary. Despite receiving £116.4bn in funding (2015/16), it is under fire for shortages of staff and beds as well as prolonged waiting times.

Now, there are calls to modify the NHS from the likes of Mark Pearson (the OECD’s Deputy Director of Employment, Labour and Social Affairs). Others, such as Dr Kristian Niemietz of the Institute of Economic Affairs, have advocated the complete discontinuation of the NHS and its replacement with universal healthcare. The latter may not be necessary if significant changes are made to British attitudes towards health and the norms and practices within medicine.

Increasing the accountability of British citizens by adopting an insurance-based healthcare system is a possible solution to the high demand hospitals face, especially the pressures felt during the winter months. If people have to make insurance payments to receive treatment, the financial commitment is likely to cause a shift in British attitudes towards health, i.e. people will be more compelled to maintain their health without professional medical intervention.

Lifestyle-related illnesses in particular would see a significant decrease. Giving people more personal responsibility for their health could be the key to increasing general health by establishing a more health-conscious culture in Britain, reducing long-term costs to the NHS.

Switzerland exemplifies this: each individual pays insurance premiums worth up to 8% of their annual income. As of 2014, Swiss people are spending an average of 6% of their income on healthcare (this is predicted to increase to 11% by 2030) compared to 5.7% of taxable income in the UK. The system is aimed at promoting health, reducing costs, and encouraging each individual to be responsible for their own health.

Right now the NHS is hampered by the mantra that it is truly “the envy of the world” and any reform from its current model would amount to dismantling Nye Bevan’s legacy.  If this idea is maintained, an insurance-based system will be politically infeasible.

This is not to say that paid healthcare, co-pay or insurance systems would result in a utopian society in which nobody is sick - for instance, diabetes is equally prevalent in Switzerland and the UK (approximately 6%).

But sustaining life is arguably the most vital function of health services, and it appears to be a greater strength of insurance-based healthcare. Switzerland has one of the highest life expectancies in the world and one of the lowest mortality rates in Europe. Notably, the 2015 Euro Health Consumer Index described Swiss healthcare as excellent.