NHS: National Health Service
A&E: Accident and Emergency
DOH: Department Of Health
GP: General Practitioners
TCF: The commonwealth fund
IEA: The Institute of Economic Affairs
WHO: World health organisation
BUPA: British United Provident Association
HSP: Hospital service plan
1.0 Abstract and Methodology
I firstly research and outline what the healthcare was like before the NHS was created and if it was successful in treating people. My next aim was to find out how health care changed after NHS was created and how successful it was in treating people. Thirdly, I looked to see if patients were treated better in the private sector or in the open sector and if the service it’s self is based upon how much the workers earn per year. Fourthly, I assessed the state of the current healthcare and what the governments thoughts were on it.
This dissertation is focusing on the question ‘would it be in the UK’S best interest for healthcare to go private’ and will be addressing the current state of the NHS and the health care available. I shall talk about what the NHS is and what state it is currently. Next, I will talk about the private sector, how it works and basic facts about it that willgive a better picture if healthcare did go private. Then, I will go into the main arguments where I will talk about the arguments for and against before talking about the view of the three big political parties;the conservatives, labour and democrats.
2.1 What is the NHS?
The NHS stands for the National Health service which was first launched in 1948 after World War Two as a way to give free healthcare to everyone who needs it. The services of the NHS are free to all citizens in the UK and the only expectations would be for prescriptions, dental services and optical services. The NHS offers a wide range of services that people all across the UK used constantly from A&E to end-of-life care. Every 36 hours, 1 million patients are dealt with by the NHS showing that having free non-privatized health is something that benefits every resident in the UK which need a certain service (GOV.UK, 2016)
2.2 What is the state of the NHS currently?
Currently, the NHS is non- privatized. This means that it is free to anyone UK citizen. The NHS has been public now since after WW2 where the labour government brought it in after the devastation of the second world war. During the aftermath of WW2, hardly anyone had money and the UK needed to be rebuilt after the damage caused. The NHS was brought in as a way to help the going rate of lower income class. By bringing the NHS, more and more people were able to get the medical help they desperately needed whenever they wanted without having to worrying about how much they would need to pay. Since the 20th century, people have been more than happy to have a public healthcare.
(Smith, 2017), shows a poll taken in May 17th to 18th of the year 2017 and whether the public whished for health care to go private. This figure had indicated which service believes that health care should be public, which ones say it should be private and those who don’t know or are undecided. The survey shows that most of these services have more supports that say health care should be in the public sector. There are only 3 services which have more supporters who want health care to be run by the private sector. These services are, Telephone and Internet providers (53%), Banks (53%) and Airlines (68%).
(The King’s Fund, 2016) shows the increase in how much the department of health has spent every year and some predications on what it is expected to be spend until 2021. There is a steady increase in the amount of money used which confirmations that the NHS will be needed more money in the years to come but the problem is, there is only so much the government can give the NHS and health care which has led to there being cut backs within the NHS and has caused many arguments from the hospital staff and the UK’s citizens.
The reason why the NHS is in constant need of money and extra funding is due to the fact that the population within the UK is constantly growing which means that more people are needed to go to hospitals for different reasons. The rise of the population could be due the increase in immigrates arriving in the UK who are in need of health care. This means that more money is needed on different drugs, different hospital equipment and staff, furthermore an increase in population will mean that more babies will be born, therefore making the maternity wards in constant use. Secondly, the fact that in the 21st century, people are living longer which means that they are more likely to go to a hospital more times in there lives for many different reasons. Thirdly the rising health problems that are starting to occur in people of diseases such cancer, heart problems and multiple long-term conditions means that more treatment will be needed will need to be available and most if the time, that treatment isn’t cheap (The King’s Fund, 2017).
The Telegraph Online news articles showed that the NHS in in crisis and that there had been a new record in the waiting times of A&E wards. The end 2016 to the beginning (Scott, 2017)
2.3 What would it mean for the health care to be PRIVATISED?
There are already private clinics and hospitals that are also available as well as the NHS which means that there is a variety of places that people may go to. Private clinics are typically often used for the wealthier people and this is because they simply have the money to pay for such treatment. The lower and working class however, rely on the NHS to be able to get healthcare that if free as they simply cannot afford to be private and pay for treatment, whilst the middle class and the rich class are able to pay for such things.
Already within the healthcare sector, there are some private sectors that people turn to as an alternative to the public sector. It is a choice that people sometimes make when they need treatment that the public sector cannot provide. In some NHS run hospitals, have brought in private wings or clinics in which people can use and this might also include in the patient getting that private care for a cheaper price, depending on the hospitals (Freedom health insurance, 2017).
The private sector also, already provides services for the NHS and in turn, the NHS provides the private sectors with beds for their patients. The is a sort of collaboration at this point and to change the healthcare sector completely to private might throw the balance that the healthcare sector has already established. The services that the private sector has provides for the NHS includes: long term residential care for people who need it, care of the elderly, termination of a pregnancy psychiatric care (US National Libary of Medicine, 2002).
Privatized healthcare would mean that the criticizes on the UK would have to pay for treatment that is originally paid for by the government under the NHS. This means that hospital visits, GP visits, optician visits, dentist visits will all have to be aid for the person doing this. Already, the Guardian has stated that there is a growing trend where patients from England are now paying for surgery to avoid long waiting times and this is showing that this problem that are occurring in the NHS are having a big impact on the number of people using this service (The Guardian, 2017).
3. The Private sector
Private healthcare is a sector that includes clinics and hospitals which are run by companies, charities organisations. Private healthcare is run usually separate from the NHS. When using the private sector, the fees must be paid since the NHS does not cover the cost of any type of private care available. When using the private sector, the patient is usually able to choose which hospital or clinic that they can treat for and depending on how much they pay, the time spent in the hospital can be longer than if the patient had undergone treatment through the NHS. The private sector is a place where many people often go to for a second opinion if they need it (Freedom health insurance, 2017).
3.1 How does it work?
Until 1948, before WWII, the healthcare within the UK was private. The NHS didn’t exist which meant that healthcare was set up by private medical facilities, medical services which charged a lot of money for their services. There were also charities and voluntary hospitals for those who couldn’t pay the medical fees that came from the other companies. The health insurance sector was first developed between 1940 and 1947 based on HSP/PPP Healthcare and several schemed into BUPA (US National Libary of Medicine, 2002).
In 1997, in the UK, there were 12 million people who were covered for private care and the medical expenses that came with it. This is only about 75% of the type of care that is done in the private sector. Commonly, private medical insurance occurs more among older people who start to become in need to more need to go to visit a GP or go to hospital. And of those more older people, they are usually are in a better social class as they usually are able to pay for it without too much risk of getting in dept. (US National Libary of Medicine, 2002).
3. Arguments for the Privatization of Healthcare
In this section, I will be arguing why it would be in the UK’s best interest for healthcare to go private. That would mean changing it from what it is now and bellow, there are a few reasons to why it should be done:
3.1 The wait is over
The having private health care in the UK, it could firstly reduce the waiting times for patients in the UK. Currently, on a daily basis, when arriving in a hospital there is a wait before a person gets seen by a doctor. This wait to a highly danger to a person who had a serious illness or injury could mean the difference between life saving treatment or serious problems (The Medic Portal, 2018). Currently, the waiting time in A&E should be 4 hours per patient. However, Holly Dorning, a resear4ch analyst and report author has stated that hospitals are finding it harder each day to keep to that 4 hours before a patient has become breeched. The our hour A&E target had declined from the national expectation since 2010. Even the top 10% hospitals had not beaten this target and breached it. (The Nuffield Trust, 2015)
Co-author Holly Droning, Research analyst at the Nuffield Trust said:
“The vast majority of patients are still receiving care within the target times, but our analysis shows that deteriorating access to services is starting to affect patients attending even the best-performing hospitals… We’ve known that hospitals have been struggling to meet the four-hour A&E target for a while. But the fact that we are starting to see problems in other areas, like access to planned treatment, is a real concern. As this study makes clear, warning lights are now starting to flash across the wider hospital system”.
This shows that this problem of waiting had been pointed out as a problem. This is worrying as the difference between even 5 minutes could mean the different between saving a patient’s life (The Nuffield Trust, 2015).
However, with private care, this problem is likely to decrease as it would lessen the pressure on the NHS and it will means that patients get treatment and attention needed and this might lead to problems being discovered a lot quicker.
3.2 Comparing to other countries
Reports from the IEA showed a very concerning different between the cancer treatment in the UK and other countries in the EU. It was stated that if the UK’S lung, bowel, breast and prostate cancer were treated in the Netherlands instead of being treated in the UK, more than 9,000 lives would be saved every year. This is a huge amount of people and that shows that there is clearly a flaw in the UK’s healthcare for cancer However, this is not the end, if those patients were treated in Germany, more than 12,000 lives would be saved. If those cancer patients had been treated in Belgium, more than 14,000 patients would have been saved. Theses number are too big of a difference. Theses suggesting that having public health care, whilst it might have a good idea in the respect that it means that everyone in the UK has equal opportunity and the freedom of choice in what healthcare sector they wish to choose from, this isn’t important if patients who are critically ill are dying just being there isn’t a private health care. Those lives that could have been saved could be prevented (Coppin, 2017)
According the WHO, OECD and TCF have done research other healthcare in the UK in comparison to other EU countries. It was found out that the NHS now, ranks in the bottom third of developed countries. In the heath outcome category, it is ranked as second to last. This research clearly shows the poor record that UK had in keeping people alive. This shows that the reputation the auk had of having a good healthcare system is clearly unjustified and changes are need to be made (Coppin, 2017).
3.3 People who need it get help
Another positive for the privatization of healthcare is that by having obligatory private healthcare, it would reduce the amount of ‘time wasting’ patients that hospital get. This is because people are less likely to go to the doctors and hospitals for no actual reasons as they wouldn’t want to be a hospital bill if they didn’t need to visit the hospital. With there being less encouragement to just go to the doctors, it will stop there being hospital blockages and it will mean that patients in need of actual care can get it a lot faster than it used to (The Medic Portal, 2018)
Also, by having less reason to just visit the hospital, it could mean that people will try and take better care of their health more so that when they do need to visit the doctors, go to GP’s they are well aware that they are need of help and aren’t spending money of something unimportant.
4. Arguments against the privatization of healthcare
The argument against the privatization of health care is the argument which is staying that making healthcare in the UK private wouldn’t be un the UK’s best interest. Bellow, there are a few reasons to why that is:
4.1 The moral case
An argument against the privatization of health care is the moral case. It is called the moral case as it would not be morally right for the government to send the UK back to how it used to be and hinder the development of the UK itself. It wouldn’t be morally right for the lower and working lass who struggle to pay for their daily living, to be made to pay for healthcare which they need. Being able to go to the doctors when needed is the best thing that they could be given and to have that taken away from them will only cause them to stop going it things like GP for much need annual check-ups. Missing check-up’s just to save money my cost someone’s life in the end Well know scientist Stephen Hawkins has said that the privatization of the healthcare is not the best way forwards for the UK. By following the American healthcare of the insurance systems and private companies running healthcare, we would not be able to help the nation as the working class who do not have the means for that sort of healthcare. The NHS was originally made so that everyone could be entitled to having free healthcare when they needed it and this was part of a reform to make the UK great. By privatizing healthcare, all the government would b doing is sending us back in the past where the death rate was high and the average expectance was lower than it is now (The Week Ltd, 2017).
Hawkins himself wrote in the guardian, he believed that the NHS is “the fairest wat to deliver healthcare”, and by this, he meant that it is the best way for the government to look after UK citizens from afar and is a system which doesn’t judge on the wealth or status of a person, but on their health. (The Week Ltd, 2017).
Figure 4 (ONS Digital, 2015) shows a table of life expectances from 1841 to 2001. This data was taken from ONS and it clearly shows an increase in life expectancy and this figure could continue to increase of the UK continues to do this. Although there are other factors which has contributed to ther life expectancy increasing, having public healthcare that people don’t need pay for means that people can go to hospital anytime instead of worrying about spending money in case there is something wrong. These hospital visits based on whims are also the ones who help find diseases, illnesses and conditions early enough to prevent any further damage. That could save a person’s life. However, if there was private care, then things life high blood pressure might exist more due to the stress of having to pay the fees just to get the medical attention needed.
Furthermore, the graph on figure 4 might change if healthcare is privatized. From 1841 to 2011, the life expectancy rate had doubled for both male and female and this graph is only an average up to 2011. That figure had probably increased since due to many different ideas that can be done on people for free under the NHS.
4.2 The public health is more efficient than private care
Hawking also told the Royal Society of Medicine that “International comparisons indicate that the most efficient way to provide good health care is for the service to be publicly funded and publicly run”. This suggests that other countries who run on private healthcare might not be doing as well as what we are lead to think (The Week Ltd, 2017).
The evidence for this is the 2012 study which was led by a US-Bosnian team who looked at the healthcare system of different countries. America, Germany and Canada. Data from OECD in 2000 showed that America – which runs on a privatized healthcare – had spent the most money out of the three. Whilst Germany was second and Canada was last. Germany and Canada both run off public health care and the figures show that clearly despite the fact that America is running on private healthcare, meaning that the citizens pay, they end up still paying a of money. (AVICENA, 2012)
4.3 Choices for patients
By having not only a public healthcare systm and a private sector, this allows for the UK’s citizens to be given a choice. The choices to go to the public healthcare is a decision that most working class must choose, some of them simply do not have the money to be able to choose where to go. The fact that they are even able to call an ambulance or walk into a hospital without having to worry about to pay is something that stops a lot of stress and is health for them. Stress is never good for people and the added stress of having to worry about how they will pay for the treatment might only cause more problems than solve it. Whilst some, prefer to stick to public health care, other do not and often choose to go to the private sector. This is due to the fact that the private sector is more likely to explore was difficult procedures and more experimental procedures than normal hospitals and patients have better choice to where they are being treated. For those who can afford to go private, it is a good alternative (The Week Ltd, 2017).
To be able to have a choice in where you go is a privilege that not many people around the world get to have and with this sort of power, the best thing to do would be too keep being able to choose, keeping this privilege would help many people within the UK.
5. The governments on the privatization of health care
This debate of whether health care being private is the best things for the UK all lies in the hands of the government. Whilst the public can have their say through the democratic voting system, it is the government who mostly have the power and that is dangerous
Doctors claim that the government is deliberately creating health crisis to privatize the NHS (Bodkin, 2017)
Dr Chaand Nagpaul – BMA chairman – said
“As doctors we strive to provide safe, quality care to our patients. Yet we appear set up to fail. We trail European nations. With significantly fewer doctors and hospitals beds per head and spends £10 billion less per year on out health service”
which suggests that the government are clearly not trying to help the current crisis that is beginning to arise as a result of not enough spaces in hospitals to accommodate the need of the public (Bodkin, 2017)
DOH spokeswomen said:
“This motion sadly has no relationship with reality – while of course there are pressures on the frontline, the government is now spending more that aby in history on the NHS, has left themselves to decide on use of the private sector, and public satisfaction is not the highest it has been in all but three of the last 30 years”.
This statement contradicts that one Dr Nagpaul has said, but this still doesn’t disprove the fact that there may be major shortages within the NHS government are purposefully not trying to solve (Bodkin, 2017).
5.1 The Conservatives
Currently, it is the conservatives who are in power with Theresa May being prime minister. This argument had been occurring even before May was put in power, but now that she is in power her and the government already have ideas to what the future holds.
Recent election and polls have shown that there is a large percentage of the public who wish to have public healthcare. However, the conservatives had said that the NHS and its free healthcare is too expensive to run and that it fails to work in the interest patients. May is said to have been convinced that the benefits of this change will outweigh the risks. The cutting of running costs and joining up the sectors if the best move for the UK (Vize, 2017).
The conservatives and their constant rivals are at opposite ends of the argument, however, with the conservatives being current in power, this might mean that they have a slight advantage over the labour, but this of course isn’t necessarily true. But what is true, is that both parties will face many problems as their solution both have flaws that might be hard to fix (Vize, 2017).
It was the labour party who created the NHS all those years ago and the have stated that it was their “proudest achievement, providing universal healthcare for all on the basis of need, free at the point of use”.
In this argument over whether the healthcare would be better being private, the labour party have stuck to their old policy and say that healthcare would be better if it was public. Labour have said that they plan on investing to the NS to give the citizens of the UK a modern and well-resourced service that is available whenever it is needed. The labour party wish to make the NHS into world-class quality and for all patient to receive the best care from the staff (Labour, 2018).
“By guaranteeing access to treatment within 18 weeks, we will take one million people off NHS waiting lists by the end of the next Parliament…We will ensure all NHS patients get fast access to the most effective new drugs and treatments, and insist on value-for-money agreements with pharmaceutical companies” (Labour, 2018)
They have made a lot of promises that the nation hopes to see be done and if they do, it would be one step into moving healthcare in the UK into the future. Currently, the NHS is seen to be in crisis ad many people, government and normal citizens wish to see the crisis end and for the NHS to move on and improve. Labour say that they will guarantee too meet the 4-hour A&E target, something that even the top hospitals have been struggling to do.
5.3 Liberal Democrates
The Liberal Democrats are the 3rd biggest political party and in this debate, they don’t want healthcare to turn private, however, for that to be prevented, they have said that some sacrificed must be made. The Lib Dems leader Tim Farron had told his party that conference takes would be raised to pay for healthcare in a bid to rebrand the NHS. It will become a fully “taxpayer-funded service” (Elgot, 2016)
“If the only way to fund a health service that meets the needs of everyone is to raise taxes, Liberal Democrats will raise taxes”
he said, promising to campaign to transform the NHS into the National Health and Care Service. Farron believed that over the years, the government has trying to hide this problem of the NHS failing before by putting in small term solutions and not really actually solving problems, and the government haven’t really been looking at what it will take to not only keep the NHS and its free healthcare, but also to give people the best care and treatment, which they deserve. He says that the best way to go forward is by having a National Health and Care service (Elgot, 2016).
5.4 In conclusion
In conclusion, the Conservatives wish to have a privatized healthcare. The labour party wish to have the NHS stay and for healthcare to continue to be public. And finally, the Liberal Democrats wish to have a National Health add care system. All three government want to different things and have different yet similar plans for the future of healthcare.
In this dissertation, the chosen title was ‘would it in be in the UK’s best interest for healthcare to go private?’. Within the dissertation, there have been arguments for and against that campaign, what the different political parties say and what it would mean to turn the public sector into a private sector
The arguments for the privatization of healthcare had shown that having private healthcare would solve many problems that the NHS currently had. The first argument was that waiting times would decrease. Secondly, people who need it will get the medical help needed and thirdly, when comparing it to other countries in general, it was shown that the UK’s pubic healthcare is clearly one of the worst healthcare’s in developed countries. This then showed that there was obvious need for change in order for lives to be saved.
The arguments against the privatization of healthcare have shown that there would moral implications if it was done. The in fact, the public sector is actually more efficient than the private sector. Thirdly, the citizens of the UK will be able to get a choice to where they go for medical care. All these reasons are important as these are things that would be affected if healthcare was privatized. The NHS is a big part of the UK and the change will might cause a backlash that the government cannot deal with.
In conclusion, after analyzing both sides of the argument and looking at what the people in power – the government – believe and the promised that they wish to make, the advice I would give is that, healthcare, shouldn’t be privatized. This is due to the fact that, despite there being many valid reasons for there being a privatized sector, the fact is, it would be dangerous for something so big that will cause a huge impact on a whole country. This change could cause mass chaos and that and the points outlined in the arguments against, are the reasons why I advise that health care is not privatized.
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