All is not well:
- The waiting list for hospital-based procedures stands at 7.2 million—about 12 percent of the population
- In mid-2022, 42.7 percent of all patients were forced to wait more than four hours before they received any care.
- Compared to 2019, outpatient appointments are down 13.8 percent.
- Official measures of mortality indicate that the NHS’s shortcomings are contributing to higher-than-normal death rates, with perhaps as many as 500 “excess” deaths occurring every week.
This is not a tale of a good thing going shaky.
It’s the unfolding story of a shaky thing going worse.
Milton Friedman wrote, “British physician Max Gammon, after an extensive study of the British system of socialized medicine, formulated what he called “the theory of bureaucratic displacement.” He observed that in “a bureaucratic system . . . increase in expenditure will be matched by fall in production. . . . Such systems will act rather like ‘black holes,’ in the economic universe, simultaneously sucking in resources, and shrinking in terms of ‘emitted production.’”
The more you spend the longer the wait time. The Ukrainians go back to their hell hole for medical care after getting in the waiting lines in England. Socialism is dying.
Economic theory (and reality) posits that when prices are not used to ration goods another method must be used. If the price of a service is near zero, the demand will be infinite. Thus, shortages will occur. Shortages (i.e. waiting lists) are useful to reduce utilization and fully use fixed resources like hospitals. Add to this the politics of medicine, when most people are healthy and prefer lower taxes. Sick people cannot vote as easily and that explains the NHS in a nutshell.
Paul Krugmsn claimed in 2009 “In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false.”
Not false in 2009. Not false today. Seems to me fear is the rational response to the unending stories like these.
I would add one detail on rationing by queue. UK (and Canada, and others) put relatively more resources into primary care vs specialty/hospital care. Difficulty in seeing a specialist or encountering a hospital wait list affects a minority of people. The latter don’t experience a system that is “fine” but their minority opinion is on average. outweighed by the majority.
That’s arguably a rational strategy. But it still irritates me to read these governments’ claims that their programs are “popular”. Sure – because the surveys are effectively rigged.
Good comments above.
Here are two additional items:
1. Frail seniors sometimes stay for weeks in the hospital after they are cured — because there are no skilled nursing facilities to give them intermediate care. The NHS geniuses forgot to provide these in the master plan.
2. A growing percent of nurses and doctors are calling in sick each day. This is a problem with unionized workforces in many settings, as people take advantage of generous benefits.
It may be worse right now because hospital work during Covid is riskier, and more unpleasant due to the protective equipment et al. I am lucky not to have been hospitalized lately, but I watched a video about a Covid ward and it looked like an awful place to work.