What to Learn from the United Kingdom’s Universal Healthcare System

By Clare Burgess (CMC ’20), Foreign Correspondent Spring 2018

Universal healthcare has been proposed by numerous politicians and is used by most developed countries. Universal healthcare is basic healthcare funded by government taxes to provide comprehensive medical care in order to incorporate those who could not otherwise afford private insurance. President Trump and the Republican Party have pointed to the United Kingdom’s “failing” healthcare system as a reason to steer clear of universal healthcare. Trump claims that the United Kingdom’s system is “going broke and not working.” However, before entirely dismissing or promoting universal healthcare, it is necessary to understand its shortcomings and successes.

Trump was specifically criticizing the United Kingdom’s National Health Service (NHS), which is the U.K.’s publicly funded healthcare system. The United Kingdom introduced the National Health Service (NHS) in 1948. Even in 1911, the U.K. offered a range of healthcare services for British citizens in exchange for a small deduction from their income. However, this excluded unemployed individuals and has since been reformed to the NHS. Since its founding, the NHS has expanded its services including mental health care, dental services and sexual health services. In 1958, the NHS established a mass vaccination program, which established the precedent of the NHS providing regular access to vaccinations, after the discovery of the polio vaccine in 1953. In 1961, contraceptive pills were made available to married women; it has since become available to all women. The United Kingdom’s NHS has seemingly moved with the times.

Despite this history of progression, the NHS is breaking at the seams due to massive debt and an inability to adjust to the demand for its services. Earlier this year, there have been several cases of patients waiting several hours for an ambulance to be dispatched to their homes. In fact, the ambulance services have since requested over 160 new vehicles by 2020 due to the unprecedented increase in patients. Although this is only one region, cities throughout the U.K. are experiencing a similar lack of resources. Additionally, the number of patients having to wait over an hour in the back of an ambulance at the hospital have doubled in the last two years. There have even been increased reports of deaths in ambulances due to the unavailability of hospital beds. A leading health care think tank, The King’s Fund, has further reported the NHS’ inability to comply with their maximum wait time standards. For elective treatments, the NHS has promised no more than 18 weeks from the patient’s referral; however, this standard was not met in 2016 nor in 2017. In other words, people may wait for over four months to receive treatment for surgeries such as cataract surgery, angioplasties, hysterectomies, biopsies, or hip replacement surgeries. The King’s Fund also notes that the NHS has surpassed their four hour maximum wait time for Accidents and Emergencies (A&E). Arguably, the most consequential impact of the U.K.’s fracturing healthcare system is the cancellation of thousands of surgeries. British hospitals were forced to prioritize flu patients over patients in need of urgent surgery. The U.K. had one of the worst flu outbreaks in nearly ten years; its climbing mortality rate caused panic throughout the country. Although their prioritization is understandable, hospitals argue that they should receive enough resources and have enough beds to accommodate all immediate procedures and treatments.

Regardless of these obvious failures, the United Kingdom adores the NHS. Unlike the United States, there is not a disagreement between the parties about their healthcare system. According to the King’s Fund, neither party advocates for privatizing health care. However, the British Labour Party blames England’s conservative government for the NHS’ lack of funding. While the Labour Party claims that the NHS is underfunded, the funding for the U.K.’s Department of Health is actually £124.7 billion, the equivalent of $174.7 billion. Conservatives continue to increase funding for this resource-straining institution. Recently, the British government gave the NHS £335 million and an extra £1.6 billion to cover this year. However, this is still not enough, as analysts find that this is less than half of what the NHS needs due to the demand increase.

Funding is not the NHS’s only problem, however. The European Union is incredibly involved in British healthcare. Brexit poses several problems for the NHS. Firstly, many British citizens living in other EU countries could lose their healthcare. Secondly, nearly 30% of health and social professionals in London are not British, but from other member countries. Therefore, their citizenship and ability to remain in England threatens the already understaffed NHS. Thirdly, the U.K. will have to come up with their own regulations regarding clinical trials, pharmaceuticals, health, safety, food safety and communicable diseases considering their current regulations are enforced by EU law. On a similar note, the United Kingdom has incorporated EU competition laws into the country code. So, if there is a desire to repeal these laws, it is not enough to simply leave the EU, but these laws must be formally appealed and modified. The King’s Fund also points out that many Britons living in other European Union states are likely to return to the United Kingdom, thereby intensifying the already existing pressure on the healthcare system. Another important issue the U.K. faces is the amount of money they have received for research, development, and innovation. Between 2007 and 2013, the U.K. received 8.8 billion euros. In general, these are all issues that the United Kingdom will have to contemplate when considering the impact of Brexit on the NHS and their healthcare system as a whole.

The United Kingdom’s current healthcare system seems obviously flawed; however, it is not necessarily fundamentally broken. Many experts have given suggestions for ways to improve the NHS. Alan Milburn, the U.K.’s former health secretary, emphasized the importance of technology in the advancement of healthcare. He even goes as far to say that predicting and preventing illnesses will soon be possible through technological advancements. Chris Ham, the CEO of the King’s Fund, suggests broadening the scope of care. Instead of merely relying on emergency care to take care of the sick and elderly, the U.K. should invest in social care that will relieve the pressure on hospitals. This will not only solve the problem that the U.K.’s ageing population poses, but this also will allow patients to be discharged from the hospital more quickly. Doctors will trust that their patients are receiving sufficient non-urgent care within the proposed social care structures. Shirley Cramer, the chief executive of the Royal Society for Public Health, also emphasized the need for prevention in lieu of simply treatment. While the NHS clearly faces enormous obstacles, the public is still largely in favor of this institution. Nearly 77% of Britons believe that the NHS should be preserved in its current form, and 66% are willing to pay higher taxes to maintain this system. Clearly, the NHS is not going anywhere.

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