How daft to believe America would ruin our NHS

Perhaps the only belief that unites the entire British nation at this time of division is that allowing Donald Trump to plunder the NHS would be a very bad thing.

The NHS is our national religion. It doesn’t matter how many statistics are produced that show health outcomes in economically comparable countries such as France and Germany are appreciably better for most serious illnesses.

We may grumble about the NHS — in fact most of us regularly do — but if anyone threatens to reform it we rise up in horror. A druid could not have worshipped the misshapen stones of Stonehenge with more fervour than we extend towards our creaking health service.

So when Donald Trump declared that the NHS must be ‘on the table’ in future British-U.S. trade talks — echoing the comments of the American ambassador to Britain a few days earlier — my first thought, doubtless in common with tens of millions of others, was that this was an unbelievable presumption.

Perhaps the only belief that unites the entire British nation at this time of division is that allowing Donald Trump to plunder the NHS would be a very bad thing.

Mercurial

Evidently someone quickly told the mercurial President something similar since he changed his mind, as he so often does, and told an interviewer just a few hours later that the NHS had been taken off the table on which he had just put it.

‘Better not mess with the Brits over the NHS, Mr President,’ some flunky must have advised. ‘It’s like a kinda God for them. You’ve got more chance of persuading Kim Jong-un to give up his nukes in North Korea than getting the Brits to give you a slice of their precious NHS.’

There, for the time being, the matter rests. But we may be sure that the threat which the rapacious Americans allegedly pose to our most cherished institution will be cited by Remainers over coming months as yet one more reason for clinging to the EU.

Warnings about American plans to replace our beloved health service with a kind of costly privatised rip-off will vie for some with the abominations of U.S.-imported chlorinated chicken. (Please note that no one would be forced to eat the stuff.)

As for the Donald, he could easily change his mind again, and ignore the entreaties of aides better attuned to the peculiarities of our national psyche. He clearly considers himself an expert on our hospitals, having described them on Tuesday as a ‘sea of blood’ with ‘everyone being stabbed’ in reference to an epidemic of knife crime.

Do we have anything to fear? Is it really possible that a future Tory Government — perhaps one led by Boris Johnson, who is portrayed in Left-wing circles as a British Trump — would cheerfully hand over swathes of the NHS to American companies for privatisation?

Of course not. It is practically lunatic to foresee such an eventuality, though this doesn’t prevent Labour from doing so. No British prime minister is going to agree to privatise even parts of the NHS because to do so would amount to electoral suicide.

Virtually all, if not all, of the Tory leadership hopefuls have sworn to protect our health service in its current model, and in this instance one should almost certainly take their protestations at face value.

Do we have anything to fear? Is it really possible that a future Tory Government — perhaps one led by Boris Johnson, who is portrayed in Left-wing circles as a British Trump — would cheerfully hand over swathes of the NHS to American companies for privatisation?

Do we have anything to fear? Is it really possible that a future Tory Government — perhaps one led by Boris Johnson, who is portrayed in Left-wing circles as a British Trump — would cheerfully hand over swathes of the NHS to American companies for privatisation?

American negotiators in possible future trade talks with their British counterparts won’t ask for the NHS to be ‘put on the table’ because there is no point in requesting something that cannot conceivably be delivered.

What they will ask for, however, is greater market access. About 7 per cent of the English (as opposed to UK because the Scots and Welsh have devolved powers) health budget at present goes to so-called private providers, who are deemed to offer more efficient services.

Since annual expenditure on health is England is running at about £127 billion and rising, which is slightly more than the entire gross domestic product of Ukraine, a sizable share of that 7 per cent is worth having.

If anyone can tell me a good reason why well-run American private companies should not be able to compete for a larger portion of the budget for private providers, I should like to know what it is.

U.S. pharmaceutical companies will also want to sell the NHS more medicines. Here it is reasonably pointed out that these companies already sometimes charge the NHS less for some drugs than they do their American customers.

This is the opposite of what one might expect, given that parts of the NHS display little commercial nous, and are happy to pay, to take an extreme example at random, as much as £1,500 for single pots of moisturiser on sale elsewhere for less than £2.

But when it comes to buying drugs, although there are instances of the NHS being fleeced by ruthless pharmaceutical companies, the buying power of the organisation is so great that it has succeeded in bringing down the overall cost of drugs to lower levels than in many parts of the developed world.

Idiotic

Obviously it would be idiotic if this advantage were threatened by a new trade deal with the United States. Why would any British government want to end up paying more for drugs? Our negotiators would have to be certifiable to agree to such an outcome.

In theory, of course, increased competition should lower the price of drugs imported from America, while opening up new opportunities for the powerful British pharmaceutical industry. What could be wrong with that?

In theory, of course, increased competition should lower the price of drugs imported from America, while opening up new opportunities for the powerful British pharmaceutical industry. What could be wrong with that?

In theory, of course, increased competition should lower the price of drugs imported from America, while opening up new opportunities for the powerful British pharmaceutical industry. What could be wrong with that?

Naturally it won’t all be plain sailing, but the idea of President Trump being allowed to carve up the NHS to American advantage is utterly fanciful. I think it arises from a kind of over-protection. Like some primitive tribe, we have become uncritically attached to our sometimes ineffectual ancient deities.

A trade deal with America is unlikely to make our health service much more efficient, though it might have a small effect at the margins. But those on the Labour benches who maintain that the only thing wrong with the NHS is lack of resources should examine the facts.

Shaming

Britain devotes to the NHS a proportion of its gross domestic product similar to most of the rest of Europe, but its outcomes are worse than those of many countries, including some which spend appreciably less on healthcare.

According to a monumental study in the Lancet medical journal last year, the UK is 27th out of 61 countries in the developed world when it comes to outcomes for prostate cancer, 47th out of 56 for pancreatic cancer, 45th out of 59 for ovarian cancer, and 33rd out of 63 for colon cancer.

The truth is that Donald Trump doesn't threaten our sacred NHS. Instead of hyperventilating about him, it would be a good idea to remove our rose-coloured spectacles, and think about how we could make it better.

The truth is that Donald Trump doesn’t threaten our sacred NHS. Instead of hyperventilating about him, it would be a good idea to remove our rose-coloured spectacles, and think about how we could make it better.

Is it possible this shaming performance owes something to the defects of an organisation which, created in an admirable spirit of idealism more than 70 years ago, has turned into an unwieldy and sometimes dysfunctional behemoth with the number of employees approaching the headcount of the People’s Liberation Army of China? Heinous thought!

Needless to say, no politician will dare to ask such a question in public for fear of the pillory. It’s why Nigel Farage has ducked joining in the argument over the remarks by his friend Trump. He doesn’t want to risk alienating Brexit Party supporters, often ex-Labour, who revere the health service.

The truth is that Donald Trump doesn’t threaten our sacred NHS. Instead of hyperventilating about him, it would be a good idea to remove our rose-coloured spectacles, and think about how we could make it better.

 

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