Covid-19 has exposed folly of a one-size-fits-all health service

The news that the Prime Minister is being treated on an ordinary NHS ward, rather than at a top private hospital, doubtless came as a shock to Donald Trump. The president, quite sincerely, offered experimental treatments from American drug companies to aid the PM’S recovery. Unsurprisingly, in a country whose citizens tend to view both Mr Trump and any mention of private healthcare with suspicion, Downing Street quickly declined his overtures.

It may seem trivial, but the decision to treat the PM on a public ward, despite his obvious importance, reflects the core ethos of British healthcare

– an uncompromising commitment to fairness which, though noble in theory, often proves a punishing straitjacket in practice. The spread of coronavirus has sadly exposed the destructive power of this ideology on our collective health.

So far, only a few thousand of the 500,000 frontline NHS workers have been tested for Covid-19, though the Government has pledged to boost this number dramatically. Absurdly, internal caps on the numbers of NHS staff who could be tested remained in place until just a few days ago. The fact that one in four doctors is now thought to be off sick or self-isolating – many will not be infected – shows the folly of this strategy. They, like the PM, are vital to the national effort. The case for preferential treatment could not be stronger.

The NHS has responded brilliantly in some ways; particularly in ramping up intensive care capacity. Yet the combination of a centralised structure with a one-size-fits-all mentality has crowded out non-state bodies, to potentially lethal effect. A damning report from the Adam Smith Institute accuses the UK of lagging on testing due to the refusal of Public Health England to sanction private-sector outsourcing. In one example, a group of researchers volunteered to run testing equipment, yet were spurned amid legal concerns about manning NHS facilities. Meanwhile, countries that immediately sought private-sector assistance, such as South Korea and Germany, with its decentralised healthcare structure, are now testing on a mass scale.

Many hospitals report shortages of protective equipment, even though the Government says there is enough to go around. Who is responsible? Though NHS managers must take some of the logistical flak, it also points to the perils of complex bureaucracy and the difficulty of creating a top-down service that can react nimbly to local demand. Alarming reports of hospitals discontinuing cancer treatments in order to focus on Covid-19 reflect this fundamental inflexibility, too. NHS defenders may argue that hospitals cannot and should not operate like businesses, yet when comparing how supermarkets have grappled with this crisis, it no longer sounds like such a terrible proposition.

Every Thursday, I have applauded the bravery of NHS workers who are putting themselves at great risk on the nation’s behalf. But I refuse to clap for a health service that demands uncritical respect and obedience. For too long, mindless adulation has silenced vital discussions of systemic failure. In its recent woes, the NHS has come to embody the Nietzschean adage: “Madness is something rare in individuals – but in groups, parties, peoples, and ages, it is the rule.”

follow Madeline Grant on Twitter @Madz_grant; read more at telegraph.co.uk/opinion