Why I won’t sing ‘Happy Birthday’ to the NHS
Second rate cancer treatment on the NHS has left us the sick man of Europe
You’ve probably noticed that the National Health Service is celebrating its 70th birthday. Tomorrow, a service of thanksgiving will be held at Westminster Abbey to mark the founding of the NHS. Do you suppose countries like France and Germany hold quasi-religious ceremonies to honour the creation of their health services? Services that the public in a developed country ought to be able to take for granted, not get down on bended knee and give thanks for.
You are much safer in a French or German hospital, and they have far better cancer survival rates. In fact, according to the largest study of cancer survival rates ever undertaken, published in The Lancet in January, thousands of British cancer patients are dying early because NHS survival rates continue to languish towards the bottom of global league tables. The data, from 2010 to 2014, showed that only 6.8per cent of British pancreatic cancer patients survive for five years after diagnosis, putting the UK 47th out of 56 countries. Our marvellous NHS is outperformed by Latvia and Argentina.
For stomach cancer, we come 46th out of 60, lagging behind such medical titans as Romania and Turkey. And for ovarian cancer, we are 45th out of 59, with some countries achieving nearly double our survival rate.
Forgive me for being a party-pooper, but slow diagnosis and second-rate cancer treatment in the NHS make us the sick man of Europe and pretty poorly by standards elsewhere, too. It’s estimated that 10,000 deaths could be prevented each year if the UK merely hit the European average. As it is, we are left trailing by developing nations such as Ecuador and Algeria. It’s appalling. A national embarrassment.
So what exactly are we celebrating? Why this act of national genuflection before a behemoth that supporters continue to claim is “the envy of the world” in the face of so much damning evidence to the contrary?
Nigel Lawson once said that the NHS “is the closest thing the English have to a religion”. He had a point. We put our faith in the goodly men and women who dedicate their lives to making us better. And so they do, thousands of them, and many endure terrible things on our behalf for often modest pay and go out of their way to do right by the vulnerable people in their care. I have just reviewed Christie Watson’s The Language of Kindness: A Nurse’s Story.
Never have I felt so humbled upon finishing a book.
On the wards for 20 years, Watson ended up in paediatric intensive care. One day, a little girl who had been in a fire was brought in and tragically died. The child still stank of smoke and, thinking it would add to the distress for her relatives, Christie and another nurse gently washed her hair, getting out all the filth and ash, talking all the while to the girl, as if she were alive.
Such sweet acts move us, and so they should. But the devotion of staff should not blind us to the grievous faults of a bloated NHS managerial culture and a funding system that regards patients as pesky costs, not valued customers.
The mixed funding systems (combining state and private contributions) in other countries make more treatments available when demand increases, rather than rationing them. Because the patient, not the Treasury, is the customer. By contrast, look at what happens here. Despite Theresa May promising an injection of £20billion a year, Steve Powis, medical director of NHS England, said he hoped to save £200million a year by stopping or drastically cutting back on “unnecessary or risky procedures”. Alarmingly, the discontinued list includes knee arthroscopies for arthritis, while grommets for glue ear and haemorrhoid surgery will “be restricted to exceptional cases”.
How about my friend Amy, whose two-year-old son had 21 ear infections, but kept being sent away by the doctor until he had suffered sufficiently to deserve grommets? (Unbelievably, there’s a threshold you have to pass.) Fred’s speech development was badly affected, but once the grommets were put in, he was a different child.
How dare the NHS, which pays £5billion a year to settle medical negligence claims, and squanders an outrageous amount on management consultants, tell parents they can’t have grommets for their screaming toddler because “he’ll probably grow out of it”. Yes, after four years of constant infections, agonising earache and speech impediments, he just might grow out of it, Mr Powis.
In what other circumstances would you hand over money and then let your supplier decide what you can have? And I can’t help noticing the first stage of “weeding out” doesn’t include getting rid of managers and redirecting the money to the infantry in A&E. As for cutting haemorrhoid surgery, a head of a CCG (clinical commissioning group), on £395,000 a year when a brilliant matron I know can’t afford a deposit on a flat, is, I’m sure you’ll agree, a total pain in the arse.
In countries with high-functioning health systems, the state doesn’t run the service. It insures the patients, who can top up if they so choose. Doctors see patients as an income, not a burden. There are more doctors, a higher nurse-patient ratio, better standards of care, advanced diagnostics, reduced waiting time and better survival rates.
Spending more money on the NHS won’t improve it, not so long as the management gravy train rolls on and patients are seen as a cost and nuisance.
Perhaps over the next 70 years, the NHS could finally adopt a model of funding that would enable it to deliver world-class standards of care. The men and women who work there deserve that. So do the people who pay for it. That really would call for a service of thanksgiving.