Another lovely little report out insisting that the NHS is the very finest health care system on the planet. A report that does have more than its fair share of problems it should be said. Vox on it here, the report itself here.
Access: Not surprisingly—given the absence of universal coverage—people in the U.S. go without needed health care because of cost more often than people do in the other countries. Americans were the most likely to say they had access problems related to cost. Patients in the U.S. have rapid access to specialized health care services; however, they are less likely to report rapid access to primary care than people in leading countries in the study. In other countries, like Canada, patients have little to no financial burden, but experience wait times for such specialized services. There is a frequent misperception that trade-offs between universal coverage and timely access to specialized services are inevitable; however, the Netherlands, U.K., and Germany provide universal coverage with low out-of-pocket costs while maintaining quick access to specialty services.
Well now, that is interesting, isn’t it? The NHS provides quick access to specialty services, does it?
The National Audit Office has highlighted the increasing challenge to the NHS of sustaining the 18-week waiting time standard for elective care and the importance for trusts of having reliable performance information and shared good practice.
The target for elective care is 18 weeks. The NHS might do quite well by that target. But note that this is a survey of patients and doctors that is being used to measure this “quick access”. So whether the access sis quick or not will be by the standards of the society in which the access is being offered. So, the NHS might offer quick access by UK standards but not, say, by US ones. And the report doesn’t take that into account.
Hands up everyone who thinks Americans would describe a four month wait to get a knee fixed as being “quick access”?
Cancer patients’ chances of survival are being put at risk by growing delays in carrying out vital tests on them on the NHS, experts in the disease warn today.
New official figures show that the number of people waiting more than six weeks for an MRI or CT scan has doubled in a year and reached its highest level since 2008.
6 fucking weeks for an MRI for a cancer patient? Is there anywhere at all other than the NHS where this is described as “quick“?
What are maximum waiting times?
You have the legal right to start your NHS consultant-led treatment within a maximum of 18 weeks from referral, unless you choose to wait longer or it is clinically appropriate that you wait longer.
“Quick” obviously has a variable meaning across countries.
And there’s another problem with that access thing. They measure when the patient doesn’t get treatment because the patient doesn’t have enough money. OK, obviously, this problem will be rather less in free at the point of use health care systems. However, they don’t measure people who cannot get a treatment because a free at the point of use health care system won’t pay for it. You know, the Nice and £30k per Qualy thing. So they do measure the meth dealer who doesn’t get the experimental lung cancer treatment because he can’t pay for it but they don’t mention the Brit equivalent who is sent home to die with some morphine because the NHS won’t pay for the same treatment.
They’re not really being all that impartial are they? And we shouldn’t expect them to be either. This is the Commonwealth Fund. They generally campaign against the current US health care system and in favour of something more like the NHS.
Oh, and one lovely part. They praise the NHS on its use of healthcare information technology. They do know the result of that program to computerise the NHS do they?
One final point. It would be absolutely fascinating to have the same people go over the Singapore system. A health care system at least as good as the US, UK, French or whatever but costing only 4% of GDP. One where routine care is out of pocket, catastrophic govt paid and providers compete in the market to attract custom. Couldn’t be that people don’t examine it just because it doesn’t fit their preconceptions of what ought to work, could it?