A consumer healthcare revolt is brewing

When people use foreign treatments, they start to wonder why the NHS is seen as a ‘national treasure’

At some point, we’ve all been given something as a gift that we didn’t particularly like. It’s two sizes too small, clashes with the rest of the living room décor, or you already have three at home on a shelf. Nonetheless, you smile politely, acknowledge the gesture, and sometimes even proclaim that you couldn’t live without it. Such niceties are usually reserved for birthdays and Christmas; Britain is one of the few places in the world where they’re also observed when you access healthcare.

The NHS tends to rank in the bottom third of international comparisons, loses thousands more people a year to common cancers than equivalent countries, and approves of patients waiting up to 18 weeks to receive treatment for serious and physically painful ailments. Yet this institution is still celebrated as a “national treasure”. Why?

Of course we’re proud of its hard-working doctors and nurses. But reverence for the NHS stems from a far more sinister place than many would like to admit. It is the result not of a clear-headed reading of the facts, but of dependence: most of the population has no choice but to access treatment from a single monopoly giant.

But a consumer revolt is brewing. The Government has put in place new measures to tackle “health tourism” in the NHS. Far more interesting, however, are the growing numbers of Brits capitalising on their own form of health tourism in an increasingly global healthcare market – taking off to other European countries for care that the NHS cannot deliver in a timely or high-quality fashion.

The number of British patients flying overseas for medical treatment has tripled to almost 144,000 in just two years. Some of the rise is attributed to more easily accessible fertility treatments in other countries. But another factor is increasing waiting times in Britain, longer now than they have been for a decade.

It’s possible to be miserable about all this. Going abroad is only available to those who can afford the flights, the hotels and the bills, or to those savvy enough to know what costs the NHS will reimburse; proving once again that Britain’s health system isn’t as egalitarian as made out. It’s also yet more evidence that the NHS delivers much less than is promised.

But there is a more hopeful reading. This is consumer choice in action – people going elsewhere because they’re unsatisfied with what’s on offer with their existing provider. And if people are beginning to look at their healthcare through a consumer’s eyes, that’s a promising sign for the future.

First, this trend should create more pressure for fundamental reform that will deliver a better standard of care for all.

One of the problems with the NHS, as it is currently constituted, is that it is not designed to respond to consumer expectations. When airlines offend or mistreat passengers, their failures become international news stories, which often result in compensation. When supermarkets sell overpriced or poor quality food, shoppers go elsewhere. Such consumer discipline helps keep quality high and costs low.

Yet the notion that one would act as a consumer of healthcare has long been foreign in the UK, despite most other countries in Europe adopting this approach as the norm. British patients have had extremely limited control over their care and few affordable alternatives outside the NHS. If you get sick, especially with something serious, you are at the mercy of what the bureaucrats think you deserve, and most people have simply accepted that. As this changes, it will create additional pressure on politicians to stop fiddling and reform the system fundamentally.

And, second, people travelling abroad will see that there are alternatives to the NHS – and they’re better. From the social health insurance systems in Switzerland and Belgium, to Singapore’s healthcare savings accounts, patient choice and universal access to individualised care are at the heart of what make them successful. Unsurprisingly, the efficiencies that spring up when patients are treated as customers, not grovellers, translate into less waste and better health outcomes – and for everyone, not just the wealthy.