Philip Booth is Editorial and Programme Director at the Institute of Economic Affairs and Professor of Insurance and Risk Management at Cass Business School.
Nigel Lawson once said that the NHS is the closest thing the English have to a religion. Of course, we also have the established church. And, indeed, the established church seems to see the NHS as part of its theology. Last week, Archbishop Welby, at his enthronement, said: “Slaves were freed, Factory Acts passed, and the NHS and social care established through Christ-liberated courage.” In their response to the Mid Staffordshire NHS scandal the local bishops of Lichfield and Stafford said: "We have now seen what many of us suspected - that the marketisation of the health service has gone too far…This Christian basis has been weakened in recent years and covering the bottom line has become all important."
This is a totally inappropriate response to the deaths of 1,200 people in a state-run health system. It is quite extraordinary to blame the scandal on the marketisation of healthcare in the UK. Indeed, by almost every measure, the UK has amongst the least marketised health systems in the world (along with Iceland and Canada). For example, 4 per cent of UK hospitals are not publicly owned compared with 26 per cent in Spain, 51 per cent in Germany and 34 per cent in France. Many of these non-state hospitals in other countries are operating within state-financed health systems which Anglican bishops would describe as “marketised” state systems (though there is generally a much higher level of private insured funding too). If the Bishops were right, surely France and Germany should be experiencing a Mid Staffs scandal each week.
If you look at mortality amenable to healthcare, the UK has amongst the worst records in the EU, some way behind countries with more marketised health systems. It is worth noting, however, that the figures of mortality amenable to healthcare fell more rapidly in the UK than in any other OECD country apart from Ireland during the period 1997-2007 – this is the period when the UK government began to introduce some limited marketisation (though not, I believe, in Mid Staffs hospital). But, of course, if the NHS is your religion, then evidence is not relevant to the debate – for some, the NHS is an article of faith.