But, but, the National Health Service should be cheaper

There’s a certain logical problem with the never ending calls to spend more upon the National Health Service:

Yet there is no escaping the truth that, as with supermarket chicken or a new pair of trainers, we get the health service we are willing to pay for. A world-class health service cannot be sustained by claps alone.

It is no exaggeration to say I do not know a single doctor or nurse who believes that the NHS as we know it will survive much longer. We watch, resigned, despairing, as the electorate drifts — eyes wide shut — into a de facto two-tier system in which the NHS provides a limited rump of core and emergency services while the rest is rationed to oblivion unless you can pay.

Perhaps more should be spent. Perhaps not. What we require is some method of working this out. The thing being that we do in fact spend just about bang on the European Union average on health care. So if our system is worse than those others then it’s not the money which is the issue - it’s the system, how it is run perhaps.

Yet we are also continually told that the NHS is a more efficient manner of running health care than other methods. By banishing that waste of competition and profits, leaving only that cooperation not mediated by money, we have a system which maximises output compared to input.

If that is true then the NHS should be cheaper than those other European systems. Either we should be gaining the same level of health care for less cash, or better for the same. If the organisational method is indeed more efficient. This not being what we are generally told of course, nor what is said when the NHS budget is discussed. That we should be spending less upon the NHS precisely because the NHS is so special and wondrous.

Or, perhaps, we might have a different answer. That the NHS is special and wondrous but not in a good way. That we already spend that European average and yet have health care that is not up to that average. In which case we should concentrate on the construct of the system, perhaps remove the manners in which the NHS is so special and wondrous.

No? Perhaps introduce a bit more of that competition that so many other systems use in order to attain that same performance and link between money in and health care output?