NHS or IHS?

The commonwealth fund (an influential US think tank) recently declared the NHS to be the best healthcare system in the world, for the second year running!

https://www.theguardian.com/society/2017/jul/14/nhs-holds-on-to-top-spot-in-healthcare-survey

 

Many think of the NHS as the Jewel in the UK Crown, more popular, as it is, then our own Royal Family. Andrew Street (professor of Health Economics at York) tells us why, and compares it to the US Insurance-based System:

http://theconversation.com/why-the-british-love-the-national-health-service-66314

 

We spend less of our GDP, per head of population, than almost any other developed nation and yet continue to have the best service there is.  It clearly is not unaffordable. It is something to be extremely grateful for! Why on earth would you spend over 18% of your GDP on health, as our friends in the US do, and still not be able to provide great health care for every person in your nation, no matter of their ability to pay? I do not understand why the NHS (or any “social model” of healthcare) is vilified from the other side of the Atlantic Ocean, when it is the most cost effective and clinically safe health system that there is anywhere in the world.

 

So, I’ve been wondering – why keep it to ourselves? Why just stop at a National Health Service? Why not go International (but not in an awful old-school Imperial Way, but rather a life-giving, loving kind of a way?). We have some of the best public health knowledge there is. We are learning to work creatively and differently with our population for prevention of illness and self-care. We know how to manage complex systems and budgets and we are able to adapt to new challenges relatively quickly. We know what it is to limit our spending and not allow it to get out of control and we know how to regulate corporate giants who would love to turn it into a profit-making machine.

 

The issues of global justice, when it comes to healthcare are insane. We keep talking about wanting to ‘lead the world’. Well – that old style of imperial dominance is thankfully dead and buried and will never be recovered. But we can humbly offer what we do know onto the table and see if we could all learn together about how to have a more globally just health care system. Why stop at the NHS? Why be satisfied with only a National Health Service? Let’s stop wasting time, money and resource on space exploration, projects which destroy the environment and building ridiculous weapons. Instead, let’s imagine a world with an International Health System in which we really get to grips with the kind of issues that are needlessly destroying millions of human lives every year. The possibilities of an IHS are endless and there are multiple ways it could be stewarded. If every nation contributed 8.9% of its own GDP towards it (as we do in the UK), I wonder just what might be possible and how much more connected we might become as a family of nations. Do we still dare to dream these days?

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Perspective

Earlier this week I wrote another blog about the health inequalities we face in the North, compared to the South. Then I spent some time with a good friend of mine, who has spent much of his life in other countries. In what I’m about to write, I’m not negating the injustice that exists between North and South in the UK, or belittling the struggles that many of us face. But it did make me reflect again about wider issues of justice, not just locally but globally. Perspective is everything.

 

There has been much in the press over recent months about the rise of food banks – I do agree that this is shocking. But how amazing it is to live in a country where food banks are possible! Currently, 1 child dies every 10 seconds in the world today from HUNGER! Can you pause to imagine that?

 

It is true that some of our most economically deprived communities still have outside toilets. But those toilets are connected to a mains sewerage system that keeps disease far from us. 500,000 people (most of them children) – die every year from DIARRHOEA! That is like the entire population of the City of Leeds being wiped out every year from something entirely preventable. Clean water and sanitation – think about it.

 

The so-called childhood diseases of measles, rubella, pertussis (whooping cough), tetanus, and diphtheria are responsible for several hundred thousand deaths per year. Fortunately, all of these diseases are preventable through inexpensive vaccines.

 

Can you imagine for one minute if children across the UK were dying of hunger, diarrhoea and preventable illnesses? There would be uproar and rioting. But the poor suffer what they must.

 

Why am I writing this? Because we must constantly challenge our perspectives. It doesn’t mean that we should not tackle injustice at a local level. But, I think it does mean that if we challenge injustice at a local level, let’s not just be satisfied to stop there. We must tackle injustice at every level, wherever we see it and keep pushing ourselves to look further and deeper, beyond our own borders.

 

 

 

 

 

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Previous 10 Posts

Don’t Mind The Gap – Address It!

So, here it is in black and white: the health gap between the north and south is getting wider, and in fact it is now the worst it has been in over 50 years!   https://www.theguardian.com/society/2017/aug/08/alarming-rise-in-early-deaths-of-young-adults-in-the-north-of-england-study?CMP=Share_iOSApp_Other http://www.dailymail.co.uk/wires/pa/article-4770286/Death-records-growing-north-south-divide-study-finds.html?ito=email_share_article-top   I’ve blogged about this on here before, but the figures from this latest study are utterly stark:   [Continue Reading …]

What Next for General Practice?

Last week, I had a sixth form student spend the week with me. She is hoping to go to medical school and is gaining the necessary work experience ahead of her applications. It was so great to be able to share with her the variance of my work and the great privilege it is to [Continue Reading …]

The Rules of Engagement

I am increasingly concerned by the use of the word “customer” to describe people who use the NHS and social services. I hear it often in meetings and it is, in my opinion really dangerous. It is dangerous for 2 reasons: firstly, it assumes that people “buy” services, which they do not (because our services [Continue Reading …]

Learning from The Well

The Well is an extraordinary community of people. I respect them deeply and learn so much from every time I have the privilege of being with them, listening to their stories. They are all people on the journey of recovery from drug and/or alcohol addiction. They are welcoming, non-judgmental, caring, embracing and kind. Most importantly [Continue Reading …]

Hosting Conversations That Matter

In my last blog, I was exploring how some of the biggest determinants of our health and wellbeing have very little to do with healthcare at all. They are societal issues, with huge implications on how we live together. Issues like poverty, homelessness, loneliness and adverse childhood experiences are far greater drivers of health inequalities [Continue Reading …]

A 3 Fold Approach to Population Health

Here in Morecambe Bay, we are trying to develop a strategy around Population Health – by that we mean we want to take a much broader view of the health needs of those who live in this area, ensuring that we try to tackle the disparities we see in the health of our population. In [Continue Reading …]

Continuously Learning Health Systems

Learning requires humility. It requires us to accept that we don’t know everything, that we get it wrong sometimes, make mistakes and need to own up to them so that we don’t do the same thing again. Learning is a vital part of all we do in health and social care, if we are to [Continue Reading …]

We Have a Power Problem!

NHS – we have a problem! This blog forms a hiatus in the middle of a 4 blog mini-series about what I call the four rings of leadership (in the context of healthcare). I have been musing on some statements made at the IHI conference in London, Quality 2017, and before I go any further, [Continue Reading …]