British politicians used to boast that the National Health Service was — and some left-wing holdouts maintain it still is — “the envy of the world.”
These days, beset by scandal after scandal and facing spiraling costs, the NHS would be lucky to attract a covetous glance from an accident-prone Somali, and any U.S. conservative who doubts the urgency of stopping Obamacare before it can be fully implemented would do well to pay attention to the disaster unfolding across the pond.
A report released last week revealed that as many as 13,000 patients may have died unnecessarily in NHS hospitals between 2005 and 2012.
The investigation discovered appalling standards of care, with patients being left without food and water, forced to lie in soiled beds, and left in ambulances because there were no beds available. The report further accused hospital staff of being more focused on meeting government-imposed targets than on patient care.
To make matters worse, standards were allowed to slip so dramatically because the watchdog tasked with monitoring the performance of NHS hospitals — the Care Quality Commission — covered up incidents of its employees failing to spot problems or to investigate complaints; they even used gagging orders to silence potential whistleblowers.
Ministers of the last Labour government, which set up the CQC, have also been accused of ignoring warnings about high death rates and other problems.
In a separate development, a controversial “end of life” care program for elderly and terminally ill patients known as the Liverpool Care Pathway is to be phased out, after it emerged that hospitals were abusing the system to hasten the death of patients by withdrawing food and drink.
This is arguably the greatest scandal: patients were starved and neglected not because of staff shortages or bad management, but as a result of deliberate policies aimed at freeing up hospital beds and saving money. Staff even received financial incentives for placing patients on the program.
Against this backdrop of widespread failure, malpractice, and cover-ups, another report revealed that the NHS nevertheless faces a funding shortfall of £30B ($45B) by 2020 unless radical changes are made to the way the service is organized and run.
Not only is Britain’s socialized healthcare system broken, it’s well on the way to going broke, and neither the present Conservative-led government nor Labour seems capable of carrying out the reforms necessary to prevent standards from further deteriorating.
Some of the financial pressures on the NHS can be attributed to factors beyond the control of managers or politicians, such as a growing and aging population (although mass immigration policies under Labour didn’t help matters) and the high costs of new technology and treatments. But many of the most serious failings can be laid squarely at the door of Labour’s health policies, which fostered a culture of box-ticking, obsession with targets, and secrecy at the expense of patient care.
Successive governments have tinkered with reforming the NHS, both by promoting competition within the organization and by allowing hospitals to buy services from private health care firms, but the best opportunity for change came with the election of Tony Blair’s “New Labour” government in 1997. The NHS was set up by Labour in 1948 and the party has always portrayed itself as its “guardian.” Opinion polls have consistently shown Labour as more trusted to safeguard the NHS than the Conservatives, thanks largely to a decades-long strategy by Labour of denouncing every attempt at reform by Tory governments as being designed to “wreck” the service or to privatize it by stealth.
So, in the sense of Nixon going to China, Labour was in a strong position to force through the changes needed to bring the NHS into the 21st century, but the opportunity was squandered. While Labour doubled spending on the NHS during its 13 years in office, productivity actually fell, and the seeds of the recent scandals were sown. While Blair was initially serious about reforming the NHS while preserving its free-at-the-point-of-use character, he was frustrated both by ever-increasing costs and by bureaucrats, unions, and other vested interests within what is Britain’s last real nationalized industry.
When Gordon Brown replaced Blair as Labour leader and prime minister, he abandoned genuine reform in favor of more top-down control and a target-driven culture, with each new (often fiddled) reduction in waiting times heralded like monthly output figures from a Soviet tractor factory. Staff were bought off with huge pay rises, and family doctors were allowed to refuse to provide out-of-hours cover, causing patients with minor symptoms to clog up hospital emergency rooms. Blair’s first health secretary, Frank Dobson, said of his successors:
They preferred to take the advice of management consultants to medical consultants. Huge sums were diverted away from nurses, doctors, and patients to lawyers, accountants and PR men.