Hang on a moment. Hasn’t Trump got a point about the NHS’s failings?

TSo when a few days ago Donald Trump fired off a tweet about the NHS ‘going broke and not working’ everyone jumped down his throat. He could hardly have provoked greater consternation had he taken a swipe at our own dear Queen.

Downing Street declared that Theresa May was ‘proud’ of the NHS. The chief executive of NHS England said the American President had ‘got the wrong end of the stick’. Jeremy Corbyn tweeted that he was ‘wrong’.

Shaming

Silly old Trump — up a gum tree again, and passing judgment on what he doesn’t understand. That was the general tenor of the response from his politer critics.

But hang on a moment. Hasn’t it been pretty clear during the past few weeks that the NHS is in a serious crisis? And if not ‘ broke’, isn’t it widely accepted — even by the Health Secretary, Jeremy Hunt — that it is short of money?

What the trigger- happy President said was not, in fact, very far from Jeremy Corbyn’s frequent assertions that the NHS stands urgently in need of more injections of cash on top of those it has already received.

Trump is mistaken in supposing that the insurancebased, and vastly wasteful, American health system is one which this, and other, countries should emulate. He is surely right, though, to suggest that the NHS is not working as well as it should.

Last week, a deeply shaming report was published by The Lancet medical journal. It analysed the records of 37.5 million patients with 18 of the most common cancers, and compared survival rates in 71 countries. Not all of them have data for every form of cancer, so in practice the pool is smaller.

What this monumental report shockingly revealed is that British survival rates for most cancers lag behind the rest of the developed world, and in some cases behind much poorer countries.

We are 27th out of 61 when it comes to prostate cancer, 47th out of 56 for pancreatic cancer, 45th out of 59 for ovarian cancer, and 33rd out of 63 for colon cancer. Our highest position, if one can put it like that, is 7th out of 54 for acute lymphoblastic leukaemia for children.

Ah, some will say, the UK is doing so badly because it spends less on its health service than many other countries. This isn’t true. Countries with much smaller health budgets outperform us in many cancer treatments.

For example, Latvia, South Africa and Argentina have better survival rates for pancreatic cancer, though as relatively impoverished countries they spend far less on their health services than the UK.

Equally, Romania, Turkey and Malaysia (all of them far poorer than Britain) have better survival rates for stomach cancer, for which the UK is ranked 46th out of 60 countries.

Possibly — some would say probably — our cancer survival rates would improve across the board if further billions of pounds were ploughed into the NHS, whose annual budget in England alone is nearly £124 billion.

But if the health service of which we are so proud is producing markedly less good outcomes than much less well-funded health services in poorer countries, doesn’t that tell us something about the shortcomings of the NHS?

The truth is that, contrary to what the Labour Party claims, and ‘experts’ on the BBC tell us, Britain spends more on healthcare than the average of the ‘EU-15’ (the bloc which excludes the poorer accession states) and the OECD (a club of 35 developed countries).

That was the conclusion last year of researchers at the Nuffield Trust and the Health Foundation when they used a new definition of health spending adopted by the OECD. They found, in 2014, Britain devoted 9.8 per cent of its national output to healthcare, compared with an average for the EU-15 of 9.7 per cent.

I realise I am questioning a deep-seated conviction, held by the great majority of people in this country, that the NHS as a concept is not far short of perfection, and all it needs is more money.

But might it be that this vast State- run behemoth, the largest employer in Europe now that the Soviet Union’s Red Army is no more, is intrinsically less efficient than its counterparts in comparable countries?

According to Tim Briggs, a senior surgeon who has been conducting the most comprehensive clinical efficiency audit of the NHS so far undertaken, it does not yet deserve more money because it wastes so much on poor care.

He reckons the health service could save hundreds of millions, even billions, a year if the most efficient practices were applied nationwide.

The other day — I offer this as a tiny example — I read that the NHS had paid a chemist as much as £1,500 for single pots of moisturiser which others have sold for less than £2.

Discriminate

I am, of course, strongly in favour of a universal system of healthcare that doesn’t discriminate against the poorer members of society — which is why the American approach is not for us.

But mightn’t there be other models which we could study, and conceivably follow? Look across the Channel at France, where compulsory social insurance based on income is overseen by government.

It’s true that France spends on health a slightly greater proportion of its national income — some 10.9 per cent in 2013, according to the OECD — than Britain. But its outcomes, and the standard of its healthcare, are far superior.

Most French people would be aghast at the notion that a four-hour wait in Accident and Emergency is viewed in Britain as a kind of gold standard. They would be shocked to learn that patients in this country often wait months for an operation.

Indeed, my colleague Sue Reid travelled to a gleaming new hospital in Calais where, as is generally the case in France, there are no waiting lists.

A British woman, who had been told she would have to wait at least five months for knee replacement surgery at a hospital in Kent, received an immediate appointment in Calais. Under a new scheme, her operation in France will be paid for by the NHS.

Blinkered

Whether one is rich or poor, there is little doubt that medical treatment across the Channel is more efficient and more rapid, and usually has better outcomes, not just for cancer treatment. I know where I’d rather be ill.

Why do we cling so myopically to the creaking NHS, where in recent weeks sick patients have been made to wait for hours on trolleys in corridors — scenes that would be deemed incredible in France or, indeed, Germany?

Needless to say, the NHS has thousands of hard-working and long- suffering doctors and nurses. It is not their commitment I question. It’s the system.

There was a time when imaginative Tories were prepared to contemplate alternatives. No longer. Jeremy Hunt (for whom I have some respect) seems genuinely to believe that the NHS offers the best available healthcare.

He often quotes a study by the U.S.-based Commonwealth Fund which last year — unbelievably to my mind — judged that Britain has the best health service in the world.

What Mr Hunt does not mention is that when outcomes were taken into account (the most important consideration, I’d have thought) the same report ranked Britain 10th out of 11 countries.

The NHS is very far from perfect. It could be reformed and improved. And it’s not just a question of sloshing in more money. These are truths our politicians dare not discuss, and we blinkered British will not confront. HE British are convinced the NHS is the best healthcare system known to man. It is the ultimate sacred cow — to be worshipped and revered and, of course, regularly fed with great wads of cash.