By The ET Editor: There is a shocking piece of new analysis from the Financial Times about the NHS healthcare system that prevails in the United Kingdom.
But before getting into that – some of our own analysis. The NHS patient waiting list for patients waiting more than 18 weeks (referral to treatment) fell from 45 per cent in 2007 to 8 per cent in 2010 (LINK). At the time, there were numerous reports and articles about just how bad things were but to be fair to Labour, they poured the right amount of financial and management resources into the NHS and everything got a lot better.
Today, the same NHS patient list is now sitting at 63 per cent (LINK) and it is difficult to see how this is going to get better.
The number of patients waiting to start treatment at the end of January 2022 was 6.1 million. Of those, 311,528 patients were waiting more than 52 weeks and 23,778 patients were waiting more than 104 weeks. It is easy to blame the pandemic – and to be fair, it is a large part of the problem, but there is more to this alone.
The gradual decline of performance started in March 2015 and then when the pandemic hit, there was a steep fall in March 2020 when the NHS valiantly fought the Covid pandemic. But as the FT article points out, the Tories really have to be blamed for the damage done to the NHS in the years they have been in power.
In the meantime, three other numbers stand out. The first is that YouGov polling found that 17% of people would go private if they knew they were going to have to wait longer than 18 weeks. The second is that there are roughly 8 million people in the UK with active private health insurance policies, which is around 13% of the British population. And finally, between the years 2000 and 2015, the percentage of the population who had private healthcare fell from 11.4 per cent to 10.5 per cent.
This means that more and more people had faith in the UK’s NHS back in 2015 than they did five years earlier and now the exact opposite has occurred.
And because analysis of healthcare is difficult (due to the pandemic) one method of looking at how the NHS is performing is from a completely different angle and that is private healthcare. But it’s not what you think.
From the FT – “If I told you that in the US, with its notoriously expensive healthcare system, the number resorting to crowdfunding campaigns to pay exorbitant private medical expenses has risen 20-fold in the past five years, I’m sure you wouldn’t be surprised. But those statistics don’t refer to the US, they refer to the UK.”
What we can see from the numbers is that a significant shift is happening – one that the Tories may well rejoice in knowing. It is that those least able to afford private healthcare are being forced away from the NHS in the first place.
The FT gives a few of heart-rending examples of individuals or families attempting to solve serious health problems where the NHS is no longer able to help.
Hundreds of Britons have launched GoFundMe campaigns in the first few weeks of this year to raise money for private medical expenses. Many have spent months or even years on NHS waiting lists.
As the FT points out though, it is easy to paint the US healthcare system as an awful system designed to profit from the misery of ill-health and the NHS that stands head and shoulder above it – but sadly, this is no longer the truth.
In 1990, out-of-pocket spending by Britons on medical expenses was equivalent to 1 per cent of GDP, while across the Atlantic, uninsured Americans forked out more than twice as much, at 2.2 per cent. Thirty years on, that gap has all but disappeared. Americans’ non-reimbursable spending now stands at 1.9 per cent, and Britons’ has doubled to 1.8 per cent.
It is an awful admission to think that the UK’s most cherished organisation is where it is.
The numbers don’t look good. The bulk of the increase in spending in private healthcare between 2010 and 2020 (bearing in mind that the portion of UK spending that went on hospital treatments increased by 60 per cent overall), more than doubled among the lowest-earning fifth of the population.
It is the poorest in Britain who are now spending as much on private medical care as the wealthiest, in relative terms.
The FT’s numbers again – “One in 14 of Britain’s poorest households now incurs “catastrophic healthcare costs” in a typical year — where costs exceed 40 per cent of the capacity to pay. This is up from one in 30 a decade ago, coinciding with a period in which the share of the poorest who feel their healthcare needs are going unmet has risen from 1 per cent to 5 per cent.”
For decades, it was practically the badge of middle-class Britons to have private medical healthcare cover. In the past, this has reflected their ability to pay. But now we are seeing desperate people, and thousands of them, on low incomes who now feel forced to raise money from strangers to circumvent a struggling healthcare system, in order to get back to work or be an active member of their household.
If ever there was a signal that the NHS is now unable to cope, it would be that the most vulnerable or worst off feel the need to go to private healthcare. As the FT says – this is the creeping Americanisation of the healthcare system that more reflects the strains on the NHS than anything.
To solve this problem, the government has increased taxes but not much else. NHS England has produced a report about how it intends to tackle the problem of long waiting lists. But it doesn’t help if you are suffering right now. Its report makes these target pledges:
“Waits of longer than a year in the NHS for elective care are eliminated by March 2025. Within this, by July 2022, no one will wait longer than two years, we will aim to eliminate waits of over 18 months by April 2023, and of over 65 weeks by March 2024. Long-waiting patients will be offered a further choice about their care, and over time, as the NHS brings down the longest waits from over two years to under one year, this will be offered sooner.”