A think tank with close ties to the Conservatives has called for the NHS to be scrapped and replaced with a European-style insurance scheme.
The Institute for Economic Affairs (IEA), which is said to have inspired Liz Truss during her short period in Number 10, claims there has been a “huge shift” in public support for replacing the NHS.
A report written by Dr Kristian Niemietz, the IEA Editorial Director, said: “Until not even three years ago, the NHS used to be Britain’s most revered sacred cow, and criticising it was the ultimate social taboo.
“Now, three out of ten people say openly that some of the continental European health systems deliver better-quality healthcare than the NHS does.
“I have rarely seen a social taboo lose its bite so quickly: there has been a dramatic shift in what people feel they are allowed to say in public. We have now reached a stage where pointing out that the grass is greener on the other side is no longer good enough.”
The IEA is advocating replacing the NHS funded by taxpayers with a social health insurance (SHI) system which, it claims, would cut waiting lists and boost the nation’s access to life-changing and life-saving medical care.
SHI systems are market based and require people, generally in partnership with their employers, to pay premiums to private social insurers who compete for customers. The markets are regulated to ensure access to healthcare for those with pre-existing medical conditions and governments support those who cannot pay for insurance on a means-tested basis.
These social insurance organisations would buy services and operations from the NHS and other operators on behalf of their customers.
The IEA claims: “A transition to an SHI system could improve healthcare outcomes. Introducing competitive pressures and expanding patient choice, as is the case in many European countries, could improve standards and save lives.”
The new Government has pledged an NHS overhaul, with Prime Minister Sir Keir Starmer stating that “this isn’t just going to be solved by more money, it’s solved by reform”.
And last week a government-commissioned report by Lord Darzi found the NHS is in “critical condition”, triggering the Prime Minister’s claim that the health service must “reform or die”.
A recent YouGov poll found 29 percent of Britons were likely to say the NHS is worse than European healthcare systems, with only 20% saying it as better.
The IEA said that in the last year before Covid, the United Kingdom had the second-highest avoidable mortality rate in Western Europe after Greece (71 per 100,000). Whilst this is high among developed countries, it was still Britain’s lowest-ever recorded rate.
For all of the common types of cancer, the UK’s survival rates are among the lowest in Western Europe, typically not far ahead of Slovenia and the Czech Republic.
The IEA said that even prior to the pandemic, the UK had significantly longer waiting times compared to countries like the Netherlands, with waiting times for many procedures about twice as long in the UK.
Professor Karol Sikora, ex-Director of the World Health Organisation Cancer programme and founding Dean of the University of Buckingham Medical School, said: “We all know the NHS is in the graveyard. Even the Labour party are saying it’s broken and needs reform.”
Professor Gwyn Bevan, Emeritus Professor of Policy Analysis at the London School of Economics and Political Science, said: “This paper by Kristian Niemietz offers the radical solution to that crisis of changing to a social health insurance system with choice between competing insurers.
“Such a system was implemented over 20 years in the Netherlands with agreement across key stakeholders. Even if that change were desirable, would England’s political system ever maintain a consistent direction for NHS reform for 20 years?”
The Nuffield Trust, which produces reports on health policy, said there is no guarantee that changing the way health services are funded will improve services.
It said: “Countries with social health insurance like France, the Netherlands and Germany all perform better than the UK on key indicators, including rates of death from avoidable causes, life expectancy at birth, and infant and maternal mortality rates. But so do countries with tax-based systems like the NHS, such as Denmark, Sweden, New Zealand and Norway.”
