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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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:

 

In 2015, 29.3% more 25-34-year-olds died in the north than the south.

For those aged 35-44 it was almost 50% higher than the south in 2015!

 

Overall, there were 1.2MILLION more early deaths for those under 75 in the North compared to the South over the last 50 years. That is 24000 people dying younger than needed every single year extra in the North.

 

Leading complex change in the NHS and social care system involves systems thinking and economic modelling, which is more like gardening than a traditional mechanistic approach. However, you can prune all you like and plant all kinds of new seeds, but if your soil is depleted of the resources that plants need to grow and flourish and if you’re living in an area of drought, then no matter how hard you try, your garden remains barren. This is our experience in the North and it has to change now! We can’t simply take the same approach as the south. The soil is different here, the land is barren and the environment is harsher.

 

What the North needs now is a clear admission, by central government, of the inequalities that exist and a fair redistribution of resources to tackle the health deficit we experience here. As gardeners, we are working our fingers to the bone. We are engaging in population health, redesigning our systems, ensuring that we are dealing with our waste appropriately and joining up our depleted partnerships to provide the best care we possibly can. But we need investment in our soil! We need water! We need to know that northern gardens matter as much as southern ones do. The wider determinants of health – poverty, housing, education, aspiration, adverse childhood experiences and isolation are themselves in need of investment. But we also need investment, not further austerity, in the health and social care systems that are trying to deal with the consequences of these issues. Yes, we need a people movement in the North (see previous blogs), but we need a fair allocation of resource also!

 

The evidence is clear. The challenge to the centre is this: what will be done differently to redress this imbalance? What will be done to allow the North to flourish in health and wellbeing?

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