The large majority of the public don’t know anything about health and therefore healthcare provision.
The majority of journalists and politicians who write and speak about the NHS don’t know anything about working in healthcare and therefore the realities of delivering healthcare to actual patients.
If these two statements are true, then it’s safe to say that most people don’t have a real grasp of the actual problems faced by modern healthcare and where we’re heading.
What You’re Told
The public discourse always revolves around the same lines.
The left always ask for more funding as this would provide the public with more doctors, more hospital beds, more access to cancer treatments and so on.
The right, while not necessarily for privatisation, generally don’t like the idea of paying ever more taxes when the are so many inefficiencies in the healthcare system, when the country has a lot of debt and when people (immigrants etc) who they deem should not have access to the NHS are using up its resources.
Here’s the thing. Both of these stances are not addressing the problems the NHS is facing. The demand in healthcare has been growing at an insane rate (some estimates state that healthcare demands have increased by 50% over the last decade) and will continue to increase. Therefore if we were to hypothetically provide all the funding needed to provide optimal healthcare for everyone and we were able to satiate this need right now, we would still end up in the same situation as now just a few years later.
It is important to realise that no country or system in the world has managed to solve the problem of healthcare provision. All healthcare systems around the world are facing imminent disaster as the demand is growing at such a fast pace, so to say that either providing more funding or reducing inefficiencies would make much of a difference is wrong.
Re-defining The Question
It is often said that if you are given an hour to solve a problem, that you should spend the first fifty-five minutes defining the problem.
I think instead of asking the question: “What can the NHS do?” a better question would be “What should the NHS do?”.
The NHS is treating people mainly for conditions which are a result of poor lifestyle choices. Diabetes, hypertension, COPD, cancers, osteoarthritis (due to being obese), anxiety, depression and so on are all largely due to poor lifestyle choices. If hypothetically the NHS had all the money in the world, we would still end up with a society of over medicated diseased, unproductive people. Is this what we should be aiming for?
The fact is that the only solution for the future of health is not new technology, AI, new medications etc to treat the ill, it’s actually getting patients to take responsibility for their own health by leading a healthy lifestyle. The only way to meet demand is to reduce demand, by reducing the number of ill people.
The problem with this solution is that it puts the onus of health back on patients. I cannot see any politician or person in power really trying to push for this. The backlash would be career suicide. There would be a public outcry if this was talked about seriously. I would imagine that a lot of patients would start to blame their circumstances for their poor lifestyle choices and demand that the government take responsibility and provide support for patients to make sure that they don’t develop chronic diseases.
This leads you to think that perhaps we shouldn’t be asking “What can the government do for public health”, but we should be asking “What should the government do for public health”. This is where the debate needs to be. How much personal responsibility should we all take for our own health? And what would this type of society look like?
Keeb's Blog 