Rob Delaney’s deeply moving account of his son’s illness and the family’s experience with ill-health, seen from the perspective of a US citizen, reminds us that it often takes somebody from the outside to see things clearly (The NHS is a British marvel. Vote to save it, Journal, 5 December).
The NHS, now over 70 years old, is indeed a marvel, consistently offering world-class care despite its many well-publicised shortcomings. Don’t believe me? Look at the independent reports from the Commonwealth Fund, which assess both overall features and key outcomes for the major health systems across the western world, and you’ll see that the NHS consistently excels.
Its greatest achievements include relative equality of access to decent healthcare for all, a high level of patient satisfaction, and extraordinarily low cost. Largely due to the devotion of staff and their belief in the ethos of the NHS, it still works pretty well despite decades of appalling underfunding.
Fear of inability to pay, as described so powerfully by Delaney, is essentially absent in the UK. The US is – disgracefully, for such a wealthy nation – almost at the bottom of the rankings. Vote on Thursday, as Delaney implores us all, but one other thing you can do is watch The Dirty War on the NHS. In his review (G2, 29 November) Peter Bradshaw called the film “necessary”. I’ll say – it shows us what an increasingly privatised NHS is likely to resemble, and the graphic scenes of life and health for the poorest in the US are chilling indeed.
One of the satisfactions of my 35-year stint as an NHS hospital consultant has been to treat patients visiting from the US from time to time, and listen to their astonishment at the massive difference between what they had been led to expect of the NHS, and what it’s actually capable of delivering.
Prof Jeffrey Tobias
University College London Hospitals
• If every voter read Rob Delaney’s article immediately before putting their cross on the ballot paper, Labour would win by a landslide.
• Of course Donald Trump has no interest in “buying” the NHS – the idea of a health service that is free to all at the point of need sounds far too much like socialism and is anathema to him. But that does not mean he would not impose huge increases in the price of drugs, for instance, as a condition of any trade agreement. Labour should certainly continue to keep up the pressure on this issue (Corbyn ups pressure over NHS as Trump rows back, 4 December).
• It is unfortunate that Labour’s election campaign has not given greater prominence to the points raised by Denis Campbell (Private firms win £15bn of NHS contracts in five years, 30 November) and other letter writers (Private contracts at heart of NHS crisis, 7 December). The NHS has already been privatised to a dangerous degree, and privatisation by the coalition and Conservative governments has contributed directly and intentionally to the present NHS crisis.
Boris Johnson asserts repeatedly that the NHS will not be privatised or sold to the US, and will remain free to all at the point of need – a characteristic obfuscation. Numerous significant NHS services have already been outsourced, ie, contracted out to private, profit-making companies. Initially these were primarily diagnostic and facilities services, but since 2015 an increasing number of treatment services have been privatised. In conjunction with the Conservatives’ dramatic reduction of NHS funding, and resultant loss of services and escalation of waiting times, this has led to progressive fragmentation of the NHS.
Privatisation of the NHS takes numerous forms, most hidden from public view. Long NHS waiting times lead an increasing number of patients, including many who can ill-afford it, to seek private treatment. Loyal but demoralised NHS staff have been poached by private companies. A plethora of profit-making companies operate alongside NHS services (though patients will not always recognise this), but pass patients back to the NHS when emergencies and complications arise. The quality and continuity of care is all too often compromised at the interface between NHS and private services.
NHS funding, already squeezed, is draining into the profits of private companies. Despite the secretary of state’s promises and the NHS chief executive’s commitment to end tendering of NHS services to private companies, this disastrous policy of privatisation continues. Renationalisation of the NHS will be extremely complex, but is imperative if it is to survive.
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