The charts that show the NHS should be privatised

Report after report has declared the NHS unequipped and unable to keep Britain fit and healthy.

Last week, a review by Lord Darzi found the health service was doing less despite having more money, while a cross-party commission by the Institute for Public Policy Research (IPPR) said Britain’s poor health would increase worklessness by 50 per cent in five years.

Today two new reports have called for the NHS to be overhauled to varying degrees, with the most drastic proposing it be scrapped altogether.

Sir Keir Starmer said the NHS must “reform or die”. The Institute of Economic Affairs (IEA) has set out why it should be the latter.

Its report calls for a social health insurance system to replace the NHS and highlights other countries with such models that are doing far better.

Avoidable deaths

More people are dying from treatable conditions in the UK than any other country in western Europe except for Greece.

The UK’s “avoidable mortality rate” of 71 per 100,000 people is higher than Australia, New Zealand, Canada and South Korea, albeit lower than the US, according to data for 2019 from the Organisation for Economic Co-operation and Development (OECD).

The figure is the lowest it has ever been for the UK, but the country’s international ranking has remained relatively unchanged in 20 years.

It is one example of the NHS consistently ranking poorly against comparable countries.

The report calls on the Government to follow in the footsteps of the Netherlands, Czech Republic, Slovakia, and former East Germany, in reforming NHS-ype systems into social health insurance systems.

Dutch courage

The report, called The Denationalisation of Healthcare, spotlights the Netherlands as an example of what could be achieved.

Less than 20 years ago, the Netherlands introduced the 2006 Health Insurance Act, merging a national health system with private insurance markets to create a universal social health insurance program.

It continues to provide universal coverage but has integrated a competitive, market-based insurance system.

Dr Kristian Niemietz, the report author, said the Netherlands’s transition was “instructive”.

He said the examples show “that a transition from one healthcare system to another need not be especially disruptive. It can be done in an orderly fashion, and it has been successfully done.”

Waiting times were shorter for the majority of treatments and procedures in the Netherlands while recovering from the Covid pandemic than they were in the UK before it hit.

The Dutch offered faster access in 2023 for various surgeries as well as hip and knee replacements than the NHS did in 2019. Since then waiting times have soared in Britain.

And while NHS waits have got worse since 2010, the IEA says they were still twice as long as the Netherlands, so even “the NHS’ golden age would not have seemed especially golden to a Dutch citizen living in the UK”.

And it costs the same

What’s more, is that the UK is spending a greater proportion of its GDP on healthcare than several other countries performing better.

The UK spent 11 per cent of its GDP on healthcare in 2023 is slightly more than the Netherlands and similar to other countries such as Belgium, Sweden and Austria.

The IEA said some “criticisms levelled against the NHS are… unfair”. In particular unfavourable comparisons to France, Germany and Switzerland, which “have long been among the world’s top spenders”.

But it said it would be one thing if the NHS was “an austere but efficient system” that got the basics rights without “bells and whistles”, and was akin to “the Ryanair of the healthcare systems”.

“The problem is that the NHS is very much not like that. It struggles with the basics, and it is not particularly cheap either,” it said.

Prof Gwyn Bevan, emeritus professor of policy analysis at the London School of Economics, said: “Lord Darzi was shocked by what he found in his investigation in the NHS and the state of the nation’s health. This paper by Kristian Niemietz offers the radical solution to that crisis of changing to a social health insurance system with a choice between competing insurers.”

He added: “Even if that change were desirable, would England’s political system ever maintain a consistent direction for NHS reform for 20 years?”

Low rankings

The NHS continues to consistently rank poorly in international comparisons.

The Commonwealth Fund – whose studies praise the NHS system more than any others – ranked the UK second-to-last on “healthcare outcomes” between 2007 and 2017.

It moved ahead of Canada to ninth out of 11 in 2021.

Globally the UK also ranks 23 out of 40 countries on the Healthcare Access and Quality Index, which looks at preventable deaths by country.

The report said the UK was “above the North American average, but below the averages for Western Europe, Australasia, and the high-income Asia-Pacific countries”

The UK also has high mortality rates for heart attacks and strokes compared to other Western European nations. The mortality rate for haemorrhagic strokes in the UK is the second highest in Western Europe, and for ischemic strokes, it is the third highest.

Cancer care

The UK’s cancer survival rates are among the lowest in Western Europe and are typically not far ahead of the Czech Republic and Slovenia.

While they are the highest they have ever been, improving since the 2000s according to OECD data, the NHS continues to lag behind international peers.

“This is not new,” the report declares. “It is not the result of a recent deterioration.”

Lord Darzi’s report found that “no progress whatsoever” was made in improving early diagnosis of cancer between 2013 and 2021, with a slight improvement since.

Death rates from cancer are “substantially higher” in the UK than in other western European and Nordic countries, as well as the US, Canada, Australia and New Zealand, it said.

More people die from cancer per 100,000 in the UK than any other G7 country.

Professor Karol Sikora, ex-director of the World Health Organisation Cancer programme and founding Dean of the University of Buckingham Medical School, said: “We all know the NHS is in the graveyard. Even the Labour Party are saying it’s broken and needs reform.

“Labour just can’t go on blaming the Tories for the mess Britain is in - we need some action to change policy. Where better to start than the NHS and with this proposal.”