European healthcare lessons for Wes Streeting

Under the headline “Only we can cure this”, Wes Streeting, Opposition health spokesman, declared in The Sun newspaper that a Labour government would reform the NHS. “The problem is it’s a 20th-century service that hasn’t changed with the times and isn’t fit for the modern era,” he wrote.

Perhaps that is because any serious attempt in the past to overhaul the NHS has been greeted with screams of “privatisation” from the Labour Party and resistance from medical unions. The Conservatives have been terrified of accusations that they intend to dismantle the universality of health care, free at the point of delivery. Reforms have been sporadic and accompanied by vast amounts of money, which have made little or no impact on the quality of the service.

Not for the first time, Mr Streeting has talked a good deal of sense about an institution that his party has treated like a deity. It was designed to ease health care disparities between the well-off and the poor but has succeeded in embedding those inequalities. People with money or with workplace benefit schemes can afford to go privately, at least for consultations; everyone else has to put up with a gimcrack system seemingly unable to improve however much is spent on it.

“The NHS is a service not a shrine,” Mr Streeting said. “It is judged by how well it serves the public.” We could not agree more and it has been found wanting. In a recent survey just one in four was satisfied with the NHS as it is. Yet they also want universally available health care free at the point of use. Is this a circle that cannot be squared? The answer is no.

European social insurance-based health systems are universal, mostly free when used, though many charge to see a doctor, and have better outcomes often with the same or even less money to spend.

Is the Labour spokesman proposing we adopt one of their approaches; or maybe Medicare as in Australia, which he visited last year and found impressive; or Ireland, which has a thriving health insurance market?

If Mr Streeting, who is likely to be the health secretary before the end of the year, really means what he says then he will have no compunction about ditching the nationalised model, which does not work, for one that does. He must also be prepared to take on the forces in his own party and in the medical world which will try to thwart him. Writing articles in the newspapers is the easy bit.