Through the looking glass: myths and magical thinking about the NHS

A series of short articles looking at common critiques of the NHS and why they're mistaken.

Comment series

Published: 25/10/2022

The crisis engulfing the health service is plain to see. Warning lights are flashing in almost every area, from ambulances to A&E, GP services, cancer screening, staff morale and vacancy rates. And just as night follows day, an NHS crisis is usually swiftly followed by a rash of analyses of the problem in media, social media and wider public debate, followed by the advocacy of overly simplistic solutions.

Policy stasis during the Conservative leadership election has been followed by political instability under the new administration. This, combined with an NHS entering perhaps its most challenging winter yet and struggling to maintain public satisfaction, has created fertile ground for commentators to reach for ‘easy’ solutions: The NHS sacred cow must be put out of its misery” wrote Melanie Phillips in The Times. Veteran MP Sir Edward Leigh argued in parliament that we should “have an open mind to looking at the social insurance systems of France, Germany and Italy” (let’s ignore for the moment that Italy does not have a social insurance system).

The steady drumbeat of arguments against the NHS model from its detractors has become almost constant in recent discourse. But there is no political monopoly on error in this area – and the inaccuracies and misconceptions of the NHS’s most ardent supporters are also legion. My colleagues Helen Buckingham and Mark Dayan have detailed the flaws in the clarion cry of the left that the NHS is being sold off to private companies. In this series of short articles, I look at common recent critiques of the NHS model, which are generally found under the following four interrelated arguments:

  1. We already spend too much on our health and despite this our outcomes are poor
  2. The NHS is a ‘sacred cow’ and has not been reformed
  3. We should copy other countries and adopt a social insurance model
  4. There is not enough use of competition and choice

A final article explores some specific policy ideas that are even less well thought-through, but are still popular.