NCPA - National Center for Policy Analysis

The British Health Care System: Universal Mediocrity

August 23, 2012

In April, the British Medical Journal published a report comparing the quality of health care systems in 14 advanced countries. Britain's centralized system, the National Health Service (NHS), performed well in 13, indifferently in two and poorly in five areas of comparison. However, as far as actual achievement goes, the NHS came out worst of all the systems compared. Despite this, Britons rejoiced at the report, claiming it as victory for the centralized health care system, says Theodore Dalrymple, a contributing editor of City Journal and the Dietrich Weismann Fellow at the Manhattan Institute.

A look at the fact reveals the dissonance between British satisfaction and the actual performance of the NHS.

  • Forty-eight years before the establishment of the NHS, life expectancy rose from 47 years to 66 years, a 40.4 percent increase.
  • However, 48 years after the establishment of the NHS, life expectancy has risen from 66 years to 77.5 years, only a 17.4 percent increase.
  • Furthermore, the five year survival rate for colorectal cancer is 51.6 percent in Britain compared to 59.8 percent in Sweden.
  • Similarly, the 30 day fatality rates for myocardial infarction are 6.3 percent in Britain and 2.9 percent in Sweden.

The primary impetus for having a centralized health care system for the British is to reduce social inequality and ensure that everyone is able to access affordable health care. Nevertheless, since the inception of the NHS, the health care gap between the highest and lowest social classes has widened.

  • From 1930-1948, a man in the lowest social class was 1.2 times more likely to die than a man in the highest social class.
  • Yet by 1993, a man in the lowest social class was 2.9 times more likely to die than a man in the highest social class.
  • Furthermore, the gap widened between 1997 and 2007, despite the Labour Party nearly doubling health spending.

And while Britain is known for its relatively low health care costs, that might be changing soon.

  • The NHS was initially inexpensive because it rationed care by creating long waiting lists.
  • In the face of this, health spending doubled to purchase new equipment and provide for more hospitals.
  • However, it has not yielded the desired effects and long waiting lists still exist for a population that wants more money pumped into health services.

Source: Theodore Dalrymple, "Universal Mediocrity: Why Do Britons like Their Sub-Par Health care System So Much?" City Journal, Summer 2012.


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