David Mytton

Book Review (5/5) – Universal Healthcare without the NHS: Towards a Patient-Centred Health System (Kristian Niemietz)

Published (updated: ) in Book Reviews.

Originally published on Goodreads.

It’s clear that the current approach to funding the NHS is not going to work in the long term. The UK tax burden is already the highest it has ever been, significantly higher than global averages. With changing age demographics, funding for health is only going to become even more of a problem. That doesn’t even consider social care. How we go about addressing this at the same time as maintaining the crucial principle of universal healthcare is the subject of this book.

The instant reaction to any discussion of changes to NHS funding is to cry about the extreme inequity of the US system. Yet most healthcare systems, especially those in similar-income countries globally, and within Europe, use some form of social health insurance. These are much better comparators as likely alternatives than the US. The outcome measures tell you everything you need to know about those systems – the NHS ranks near the bottom and whilst it has improved significantly over time, the current snapshot of performance today is still poor, relative to alternative systems.

This is a discussion that needs to be had. Unfortunately, given the inability to have any form rational debate about the NHS within the UK, it will take a brave politician to set about implementing the reforms the system badly needs. This book does a good job at describing how we got to where we are now, how we compare to alternative systems in Europe and what changes might be workable given the religious nature of anything to do with the NHS. It serves as a good basis for starting that discussion.