NHS – What is it and why have it?

Image result for nhs logo

Origin and work

  • July 5 1948 – The NHS is born. When health secretary Aneurin Bevan launched the NHS at Park Hospital in Manchester (today known as Trafford General Hospital), it is the climax of a hugely ambitious plan to bring good healthcare to all.
  • Healthcare provided for free and funded by taxation, this was part of the post-war Labour Government’s ‘Cradle to the Grave’ welfare state. The idea being, that at every stage of a citizen’s life, they would have some level of safety net provided by their state.
  • The NHS allowed uniform treatment for everyone, rich poor, young, old. If you needed care, you could access it. This was hugely beneficial saving millions of lives and allowing public health programs such as vaccinations.
  • 1958 – Polio and diphtheria vaccinations for children under 15 save thousands of lives annually.
  • 1960 – An Edinburgh doctor, Michael Woodruff, performs the first UK transplant involving an identical set of twins.
  • 1968 – A 45-year-old man becomes the first Briton to have a heart transplant on 3 May.

These are just some examples of the great things achieved under a Nation Heath Service. Allowing for people to benefit from a healthier population. If a workforce is healthy they can produce wealth and pay for their treatment indirectly through taxation. Those who can pay more, do so. Those who can’t pay at all, do not. But are equally cared for.

  • The NHS employs more than 1.5 million people, putting it in the top five of the world’s largest workforces, together with the US Department of Defence, McDonalds, Walmart and the Chinese People’s Liberation Army.
  • The NHS in England is the biggest part of the system by far, catering to a population of 54.3 million and employing around 1.2 million people. Of those, the clinically qualified staff include 150,273 doctors, 40,584 general practitioners (GPs), 314,966 nurses and health visitors, 18,862 ambulance staff, and 111,127 hospital and community health service (HCHS) medical and dental staff.

Funding and cost

  • Funding for the NHS comes directly from taxation. Since the NHS transformation in 2013, the NHS payment system has become underpinned by legislation. The Health & Social Care Act 2012 moves responsibility for pricing from the Department of Health, to a shared responsibility for NHS England and NHS Improvement.
  • When the NHS was launched in 1948, it had a budget of £437 million (roughly £15 billion at today’s value).
  • For 2015/16, the overall NHS budget was around £116.4 billion. NHS England is managing £101.3 billion of this.

Is this a lot?

Diagram of % of Government spending 2016
  • This chart amounts to 85% of GDP as the remaining is surplus to pay the national debt. Taken as a % of spending. The NHS account for 18%.
  • In 2016 the UKs GDP was £1,942.6 billion
  • The NHS cost the taxpayer £142.7 billion in 2016  equivalent to just 7.34% of GDP.
  • The NHS cares for a population of 65.2 million people

Is it worth it?

  • More than 1 million patients seen on a daily basis
  • Regularly features among the top reasons people feel proud to be British
  • The NHS has been declared the best healthcare system by an international panel of experts who rated its care superior to countries which spend far more on health.
  • “The United Kingdom ranks first overall, scoring highest on quality, access and efficiency,” the fund’s researchers conclude in their 30-page report. Their findings amount to a huge endorsement of the health service, especially as it spends the second-lowest amount on healthcare among the 11 – just £2,008 per head, less than half the £5,017 in the US. Only New Zealand, with £1,876, spent less.

My sources

http://www.commonwealthfund.org/interactives-and-data/surveys/international-health-policy-surveys/2016/2016-international-survey

http://www.ukpublicspending.co.uk/year_spending_2017UKpt_16pc1n#ukgs302

http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx

http://www.nhsconfed.org/resources/key-statistics-on-the-nhs

What’s the alternative?

For this portion of my research I will look at America. The 9th richest country in the world per capita.

  • Until recently, healthcare was entirely private, funded by individuals or through group plans of companies for employees.
  • With the introduction of Obamacare in 2014, 48% of U.S. health care spending came from private funds, with 28% coming from households and 20%t coming from private businesses. The federal government accounted for 28% of spending while state and local governments accounted for 17%.
  • Spending per capita is approx £5,017 per capita, more than double our own at £2,008 per capita.
  • In 2014, 283.2 million people in the U.S., 89.6% of the U.S. population had some type of health insurance compared to 100% in the UK.
  • Medical Bankruptcy – A 2009 study by Himmelstein et al, published in The American Journal of Medicine, revealed that 62.1% of all bankruptcies in the US had a medical cause.

Here is an example of the huge costs incurred by medical procedures in private healthcare systems. [1]

The issues with privatized healthcare are numerous:

  • Health coverage in the states is often linked to employment, a company with pay for coverage as part of your employment terms. This means you may be tied to that job, if the terms of work are changed in a way that negatively effects you, you have no recourse or you may lose coverage. If you lose your job you have no coverage.
  • Companies have sway over the healthcare they wish to provide. Certain care options can be removed on Religious grounds for example. [1]
  • Essential medicines can be raised in price for personal profit, this happens all to often and can lead to deaths. Cases recently have included AIDS medication and Epi Pens. Essential, potentially life saving treatments that can be price hiked out of availability for some.

Final Thoughts

I have heard arguments on social media and in political circles tat the NHS is too expensive and unsustainable. Every statistic and piece of evidence I have found points at it as being among the best healthcare systems in the world. I worry that people are too short sighted, they simply see that their taxes are high and would like a few quid knocked off them. But in reality this is not how it would play out.

  • The security of knowing you will be cared for for free in the event of medical malady allows a person more control over their life, no money needs to be horded in preparation for an eventual illness that could cost tens of thousands.
  • The money saved by dismantling the NHS would be spent by your employer on group plans for private care and would simply be deducted from a paycheck instead of at the point of taxation. And it would cost you more, almost certainly.
  • Those who weren’t currently in decently paid employment would be left to fend for themselves. A society should care for its citizens.

 

 

 

 

 

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Author: David Rothwell

I am a Graphic Communication student at Cardiff Metropolitan School of Art and Design If you like any of my work, have feedback (good or bad) or would like to get in touch, please do

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