The Corner


Decade-Long Backlog in U.K.’s National Health Service

A message reading “Thank you NHS” displayed on the outside of Wembley Stadium as the spread of the COVID-19 coronavirus continues. London, England, March 20, 2020. (Matthew Childs/Reuters)

A few days ago Robin Swann, the Health Minister for Northern Ireland (where I sit as I write this) announced that it will likely take ten years to sort through the backlog in elective care here. No, that’s not a typo. Ten years. 

There are men, women, and children currently scheduled for screenings and elective treatments here in Northern Ireland who are expected to receive neither until 2031 a.d. Several oncologists have given interviews to various British media outlets over the past week basically conceding the likelihood that many of my neighbors here in Ulster will die of cancer and other fatal diseases in the coming years without ever having been diagnosed. More and more are turning to crowdfunding in an attempt to access private treatment in a timely manner. 

Such is the result of the pressures put upon the NHS by the pandemic, and not just in Northern Ireland, either. At the end of March, 4.95 million people across the United Kingdom were waiting for NHS hospital treatment. The latest government figures from Wales show that an astonishing 18 percent of the entire Welsh population waiting for planned treatments. The Royal College of Surgeons has asked the government to construct emergency surgical hubs across the country in order to start reducing the backlog. 

This crisis has been decades in the making. As I noted back in January, the NHS is one of the most dysfunctional health-care systems in the developed world. It was never prepared to handle the pandemic. For evidence of this, we have only to look at a few headlines in the pro-NHS Guardian newspaper from the past few years: 

“Hospital beds at record low in England as NHS struggles with demand” (2019)

“NHS bosses sound alarm over hospitals already running at 99% capacity” (2017)

“Sick children moved as NHS intensive care units run out of beds” (2016)

“Hospital bed occupancy rates hit record high risking care” (2015)

Progressives often argue that the NHS’s struggles are a product of insufficient funding, but it’s a stubborn fact that countries such as Switzerland, Germany, Belgium, the Netherlands, and Israel all boast health-care systems that are quantum leaps ahead of the NHS by every available metric and they haven’t achieved their superior outcomes by vastly outspending the Exchequer. Importantly, each of these nations also provides universal access to health care, frequently cited as evidence of the NHS’s exalted moral status. They simply do it by integrating community ratings, means-tested insurance premium subsidies, and risk structure compensation.

 It’s true that the NHS is less expensive on average than the medical regimes in many of these countries, but this is mostly due to the kind of wartime rationing by which the National Health Service allocates resources. As the economist Kristian Niemietz notes:

Innovative medicines and therapies that are routinely available in other high-income countries are often hard to come by in the UK. Any country could keep healthcare spending in check by simply refusing to adopt medical innovation. In more sophisticated estimates of health system efficiency, the NHS ranks, once again, in the bottom third.

Once again, the British citizenry’s insistence on the sacrosanct inviolability of the single-payer model is costing lives. Even before the pandemic struck, the NHS already had a grisly body count. Niemietz points out in his research that 

If the UK’s breast cancer, prostate cancer, lung cancer and bowel cancer patients were treated in the Netherlands rather than on the NHS, more than 9,000 lives would be saved every year. If they were treated in Germany, more than 12,000 lives would be saved, and if they were treated in Belgium, more than 14,000 lives would be saved.

He further points out that the U.K. has one of the highest avoidable death rates in Europe. If British patients were treated in Belgium, 10,000 lives would be saved each year. 13,000 would be saved were they treated in the Netherlands. 

It’s important for the United States to reform its health-care system so as to rid itself of the moral scandal of uninsured Americans, but this reform must avoid anything approaching the innovation-proof single-payer catastrophe of Britain’s National Health Service. For satisfactory health-care models to emulate, Americans need to look further East to continental Europe and beyond.  


The Latest