In 1948 Labour founded the NHS with the best of intentions. Today it is the epicentre of its faith. A benign State looks after you from cradle to grave not contaminated by profiteering, by American capitalism exemplified by Donald Trump. And money to fund it is simply where it needs to be.
Socialism works despite considerable evidence over the years that elsewhere it doesn’t.
It is not a criticism of its founders if I urge new thinking, not just tinkering, to enable the NHS TO confront today’s totally different challenges. The founders of the NHS could not have anticipated the escalating cost of its success.
Remember in 1948 its first budget was £431million. Today’s money – £9 billion. The budget today £139billion.
It is dealing with its success. We are living much longer. In 1948 life expectancy was 66 for men shortly after they retired, 71 for women. Today 79 for men and 83 for women.
Then no one talked of dementia. Today 850,000 diagnosed with dementia anticipated to grow to 1.6million in twenty years’ time, an average of £100,000 needed to care for each one. The new phenomenon, Bed-blocking. Trolley waits in A & E.
Post-war obesity with rationing was non-existent. This year on 11 November the Times reported that for the first-time obesity-linked hospital admissions topped one million.
The Independent reported that 7.8million admitted to binge drinking on their heaviest drinking day and in 2016 the death of 7327 from alcohol specific causes.
170,993 casualties of all severities in reported road traffic accidents in 2017, 18,477 cyclists injured and 3,499 killed or seriously injured. Meanwhile the UK population has grown from 50million to 66million.
Today NHS offers heart and kidney transplants, kidney dialysis, replacement hips, knees and shoulders, cataract surgery, scanners, new cancer drugs all unknown in 1948.
It must be a mistake to believe that the State has sole responsibility to deliver all this. There must surely a good working partnership between the State, the Universities and the private sector, with all deriving satisfaction contributing to the whole. Please do not tell me that the private sector makes no contribution to dealing with this.
Often the research, the innovation, the manufacture of drugs, scanners, prostheses &c. all come from companies driven and rewarded by the quest for profit.
Don’t sneer at profit. Profit and on the other side the coin loss are the spur in a competitive capitalist system. Profit the measure of success, loss the measure of failure. Profit stemming from venture capital and risk, innovation and efficiency, loss caused by inefficiency, overmanning, and failing to meet people’s needs. Profit generates the rewards and helps to pay for the public sector. Bankruptcy is the price of failure.
Meanwhile the public sector has the motivation but needs public accountability to accommodate failure. Its absence its major weakness. As I write elsewhere – if lawyers will let me publish it and not threaten libel suits to shelter them and others from criticism – the cover-up of State blunders and the deliberate disabling of checks and balances ratchet mistakes and miscalculations into national policy.
Again, I illustrate this with Grenfell Tower Inferno now sadly replicated in a student block in Bolton. Killer tiles were legitimised in building regs amended in 2006 when Labour was in Government to provide low-cost energy saving cladding to tower blocks without adequate testing when they should have known better.
If you want to understand the dynamic of 21st Century capitalism I would urge you not to rely on Das Kapital first published in 1867. You would learn much more by studying in detail just one website I came across recently https://www.brucewinkler.com – I call it the Winkler factor. It capitalises on human endeavour and initiative in a way that socialism doesn’t. Hence the word capitalism. But it needs to be competitive not oligopolist, and with some State regulation to head off its abuse.
And don’t sneer at America either. One person’s story can say a lot. Bruce Winkler’s wife is a psycho-therapist in prisons to help long-stay prisoners. For the big picture, look at America’s contribution to cancer research. Today, of course, this is global. America pours billions of dollars into it every year, more than Europe.
In recent times the National Cancer Institute has spent some $90 billion on research and treatment. Some 260 non-profit organizations in the United States have dedicated themselves to cancer — more than the number established for heart disease, AIDS, Alzheimer’s disease, and stroke combined.
For an illustration of American business philanthropy, after her mother in law, Estee Lauder of the Lauder family business was diagnosed with the disease in 1989, she formed the Breast Cancer Research Foundation.
The US National Institutes of Health spends around $30 billion every year on pharmaceutical and biotechnology research and is responsible for 75 per cent of the most innovative new drugs annually
Not just cancer research. The future includes nanotechnology, artificial intelligence, genetic engineering. Good news can travel fast today in a global world.
The most important new thought, however, relates to us. We need to be encouraged, not just exhorted, to take some responsibility for our own health, to share it with the State. Money talks. It does not need to compromise free at the point of delivery.
I am talking about the Insurance principle in funding.
We run away from this because America is making heavy weather of it. Health is expensive there for many reasons and this explains their difficulty. Look, on the other hand, at Europe, Israel and beyond. The premiums can discourage binge drinking that swamps A & E on Friday and Saturday nights. It can discourage getting too fat – use the word! It can reward taking steps to keep fit and well, there are plenty of steps on the ladder. Think new. Do other countries that utilise statutory insurance have the same crises the NHS has every Xmas?
Camilla Cavendish writes in the Financial Times on 16 November “I am a fan of the sophisticated social care insurance funds in Germany and Japan, which pools risks and share the burdens across society.”
Social care is an outstanding problem because dealing with it is expensive. Insure the risk and do a deal. Raise inheritance tax thresholds so people can keep more of their wealth but charge their homes with the cost of health care before they die if they can’t afford to pay for it at the time.
And get away from the equality principle – that if everyone can’t have something, no one should have it. Why? People have should have a choice. Alcohol, drugs, gambling, or paying a bit extra on your health insurance.
The NHS is brilliant when it comes to major health issues such as cancer, stroke and heart attacks, when speed of response really matters. Extra cover with private hospitals can help with lesser issues to fine tune care without prejudicing other patients. As I keep saying, fair play not equality should apply. When it comes to health, you shouldn’t prejudge where people should spend their money.
As Camilla Cavendish writes in the FT, “Take the political heat out of a question which goes to the root of who we are as a society.”
This is not just about more money – I’ll spend more than you, YA. Nero stuff, fiddling while Rome burns.
It is about humanitarian values and, for many, faith in God. In one word, Love. I have seen it, and it is there.