Criticising the NHS and promoting private health care as the answer has been in the news recently. According to the chair of the Royal College of GPs in Northern Ireland there has been a “significant rise” in patients having their “health needs met in the private sector”. Considering how bad the queues are for some treatments by the NHS, this is not surprising. When you see a relative in significant pain for well over a year with no end in sight, you will find a way to speed things up – if you can afford it.

Two Tier System

Unfortunately, if those of us with more money are using private care, we will not experience the queues, we may not be aware of them and certainly will have little incentive to pay more in tax to allow the NHS to employ the doctors and nurses needed to reduce the queues. There is an increased danger that we will leave much of the population with a declining service that fails to meet their health needs. This is not a criticism of those who pay for private health care (doing the best for your family is natural) but it is important to warn of the pitfalls for society of moving away from the NHS.

There is a real danger that anti-private sector think-tanks who want to reduce tax as much as possible will cultivate a very negative attitude toward the NHS as a way of reducing support for tax increases. Right wing publications such as the Spectator run stories with headlines such as ‘The NHS is failing us all’ (27 April 2022) or ‘The data that proves the NHS is failing Britain’ in the Telegraph (15 April 2022) and I fear that we are not looking at NHS funding rationally.

But are the failings of the NHS due to an existential inability of the NHS model to work or has it been run down with under-investment, fewer healthcare training places and creeping privatisation, resulting in staff choosing better pay and conditions in the private sector?

Alternatives

Alternative methods for paying for health care will always be under consideration but we should remember that private companies provide a service for a fee because they expect to make a profit – it would be naïve to expect them to put our welfare before their profit. (Look at the number of private health scandals in the USA – insulin for diabetics is just one example. A vial of insulin that costs $12 will cost you $98.70 in the USA. People die trying to use less insulin. President Biden is currently trying to bring the price down to $35 across the USA.)

The chart above shows the expenditure of a range of countries we should note that several countries like Sweden, France, Norway and Germany pay more per person for their health care systems, so perhaps we should not be surprised if they have better outcomes and shorter queues.

It is possible that the problem is not just with funding, but also that changes in how the NHS is structured could allow the money to be better spent. I hear that separating acute/emergency surgery from elective surgery is under discussion and of course the Bengoa Report of 2016 still needs to be implemented.

Private Health Insurance

Today I heard a speaker from one of the private hospitals indicate on Radio Ulster that private insurance would cost approximately your age + £15 per month up until the age of 45, when you would pay roughly £60 per month. He did not deal with insurance for older people, but the MyTribe insurance website gives an estimate of £112.90 per month for someone in their 60s.

It should be remembered that this does not cover all your health needs – you still need the NHS for chronic conditions such as diabetes or cancer, and if you have an existing health problem your insurance will not cover it. Private health is more profitable if you exclude those most likely to get ill.

The question must be asked:

Is there much difference between paying an extra £112 in tax, or as an insurance premium?

Flawed and underfunded as it is, the NHS delivers when it matters.

Much of what the NHS provides is not glamorous but really matter to our health, we are offered a range of free screenings as we age. I have had my first prostate exam and second bowel cancer screening – both negative. Women are offered a free mammogram (breast cancer scan) every 3 years once they reach 50. No woman looks forward to the scans and even though the cost is not high (approx. £150) if these were not free people would be tempted to put them off, to save the cost

On Friday 3^rd Feb 2023 my wife had her scheduled mammogram screening but this time changes in the breast were discovered and she was called back for a second scan and then a biopsy on Tues 21^st March. We had a meeting with a surgeon on 1^st of March, with surgery to remove the tumour on 14^th March. She was home again on 17^th March.

Within a 6-week period my wife had

• been called for a scan,
• had cancer detected,
• was operated on and
• returned safely and is recovering at home.

The free NHS mammogram saved her life.

The NHS still delivers where it matters, we undermine it at our peril.