The NHS isn't as good as what went before
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| Author: Patrick Crozier |
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Before 1948 (the year the National Health Service was created) there was some state involvement in healthcare. There were local authority hospitals but whether they were ubiquitous or not I don't know. Equally, I don't know how long they had been around for. As I understand it (ie reading between the lines of James Bartholomew's The Welfare State We're In) they were funded by means testing. According to Max Gammon (author of Gammon's Law) they weren't very good.
According to Bartholomew healthcare prior to 1948 was pretty much universal. Most people paid for their healthcare either directly or through insurance companies and friendly societies. The rest relied on charity.
Healthcare seems to be have been of a very high standard given the technology of the day.
British medical science was the most advanced in the world.
It is significant that the wartime Labour Party pamphlet that first advocated the setting up of the NHS did not criticise it for poor care. It's main criticism was the lack of a system.
Since 1948, it has been a never ending story of waiting lists and cash shortages. In recent years care has been deteriorating at a rapid rate despite (because of?) much more money. There is now a serious problem with infections caught in hospitals.
I am keeping a list of NHS horror stories divided into the following categories:
- Poor care
- Waste
Now, I accept that this isn't an entirely fair comparison - we are never going to hear new horror stories from what went before the NHS - but then again perfect comparisons don't exist.
Q&A
But, if healthcare isn't as good how come we are living longer?
- Partly, because we work fewer hours, breathe cleaner air, eat better food and because (independently of the NHS) medical science has made all sorts of advances. My beef at the NHS is not that it is in absolute terms worse than what went before. Obviously, there are all sorts of treatments that it will do that simply weren't available in 1948. It is that the system, the culture, its efficiency all seem to be much worse
How can you be so sure?
- Partly on the basis of superficialities, things like the state of the buildings, whether people are nice to you or not
- Partly because of what people within the NHS themselves say. See NHS Blog Doctor, for instance.
Superficialities, you're having us on aren't you?
- No, I am not. Sure, it is not a hard and fast rule. There are plenty of institutions that have pretty buildings and nice smiles that will fleece you and vice versa but as a rule of thumb if it looks good it usually it is. Don't believe me? Try it out for yourself. Make a list of those things that work and those things that don't. Now ask yourself which set has the best superficialities.
Ah, but if we are living longer due to better air, food and working conditions who is responsible for that if not the state?
But weren't there all sorts of gaps before the NHS came along?
- A point that this guy makes.
References
James Bartholomew (2004). The Welfare State We're In. Politico's Publishing. 1842750631.
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