Junior doctors are killing the NHS they claim to love

The system is broken, with many patients forced to go private in order to receive any treatment at all

As junior doctors walk out on strike again today in pursuit of a 35 per cent pay increase, they will surely be aware that their decision to stop work for the next six days could cost lives.

In 2023, at almost 53,000, there were more excess deaths in the UK than in any non-pandemic year since the Second World War. Undiagnosed cancers, untreated heart attacks and delayed operations took a heavy toll, as nurses, paramedics and finally junior doctors all took part in strike action.

With more than seven million people already on waiting lists for treatment from the NHS, the situation can only get worse in the week ahead, as consultants cover the work of striking doctors on top of their existing duties.

The Government no doubt hoped that replacing Steve Barclay with a new Health Secretary might enable the impasse with the junior doctors to be broken, and for a brief while there were signs that negotiations might make progress. But the doctors’ union’s demands were too ambitious and the Government is unlikely to concede them for fear that meeting their claim in full will provoke other workers to demand more.

With this bleak outlook ahead for 2024, must the sick go on dying for want of treatment? Tragically, this seems inevitable, and it’s hard not to conclude that the health service is broken beyond repair. As Britain’s excess deaths outpace those of many other comparable developed nations, can any government really persist in believing that the NHS is the best healthcare model available?

The British people no longer seem to think so; last year public confidence in the NHS dropped to its lowest ever level, with fewer than a third of people satisfied with the service.

More and more of us are deciding that the only way to get prompt treatment is to pay for it. Last year saw a record number of people opting for private treatment, not just through health insurers but also, increasingly, by paying to see a private GP and for tests and operations.

In contrast to previous generations, this includes many in their 20s and 30s, who lack confidence in a service that does not respond to demand. Research published in the autumn found that 18-24 year olds were the most likely of all age groups to have used private healthcare, and the vast majority of under-34s would consider going private.

Clearly they do not share the quasi-religious belief in the NHS that has been ascribed to previous generations. What good is a “free” health service if you can’t see a doctor? Or if you can’t get a test to find out if your symptoms are those of a life-threatening cancer?

Meanwhile, older generations are increasingly being forced to choose between paying for an expensive operation or putting up with a life of pain and restricted mobility. Tens of thousands of people are now paying for cataract removal, at around £3,000 a time, or hip replacement surgeries costing £15,000. The increase in upfront payments is in addition to a rise in membership of private health insurance schemes to cover such surgery, as well as cancer tests and treatments.

The Government should be grateful to the hundreds of thousands of British people of all ages now taking the private health option – if only because it reduces the pressure on NHS waiting lists.

Yet the idea of making private health insurance more affordable – for example by making it taxdeductible – is still regarded as unthinkable among even many Conservative politicians.

Sooner or later this Government – or its successor – will have to face up to reality and decide how best to implement a system of universal health insurance or means-tested co-payments. There are abundant successful examples from other countries, notably Australia. Our antipodean friends succeed in providing better care with more doctors per head, more treatment facilities, and notably better diagnosis and survival rates, at a lower level of expenditure relative to GDP.

Britain currently has the worst of all worlds, its people being forced to pay heavily through their taxes for a health service that doesn’t treat them adequately, and then having to pay for private services on top of that.

In the meantime, junior doctors are putting the final nail in the coffin of the health service that they profess to love.