On
May 24, 1948, my maternal grandfather, Herbert Johnson, died suddenly in bed,
the victim of a cardiac arrest. He was just 50 years old.
Bert,
as the family knew him, had seemed indestructible.
اضافة اعلان
During
World War I he was wounded several times, but somehow survived four years of
fighting in France. During the Second World War, the bombs that rained down on
the East London docks where he worked claimed the lives of dozens of his workmates
but spared him and his family.
But
Bert, who came into the world in 1898, could not escape the fate inscribed in
the genes of every child born in the UK at the beginning of the 20th century —
the limited average life expectancy for a boy of about 48 years.
Not
without irony, Bert died just over a month before the birth of the UK’s National
Health Service, which was founded on July 5, 1948.
Seventy-five
years later, thanks in large part to the UK’s visionary provision by the NHS of
universal “cradle to grave” health care, free for all at the point of delivery,
a boy born in the UK today can expect to live to see their 78th
birthday.
And
that, as the omni-crisis currently threatening to overwhelm the NHS
demonstrates on an almost daily basis, is a massive problem.
As
Britons are living longer, but not necessarily healthier lives, the burden on
the NHS grows ever larger, even as the working, tax-paying proportion of the
population grows ever smaller.
As Britons are living longer, but not necessarily healthier lives, the burden on the NHS grows ever larger, even as the working, tax-paying proportion of the population grows ever smaller.
As
a result, ambulances are taking
hours to respond to even the most urgent calls, injured and seriously ill
people are lying unattended, and occasionally dying, in hospital corridors or
inside ambulances stacked up outside overwhelmed emergency departments.
Waiting
times for every kind of operation grow ever longer, and patients are dying
because cancers and heart problems are going undiagnosed.
Nurses,
who only recently were being applauded on doorsteps by the public and
politicians for their part in the battle against the COVID-19 pandemic, are
now striking for a living wage and safe levels of
staffing.
Doctors,
too, and ambulance staff, are understaffed and overworked, even as government spending on
health care has
risen from £121 billion in 2008-2009 to the record £182 billion budgeted for
2023-2024 — a sum bigger than the annual GDP of Qatar.
It
is obvious to everyone that something must change, but the NHS has always been
a political football. Those on the left, who regard the NHS as a sacred cow,
resist all change and demand that the government must simply find more money.
Free-marketeers,
meanwhile, salivating at the thought of a blizzard of private-sector windfalls,
are baying for the NHS to be privatized. Waiting in the wings, ready to pounce,
are numerous mainly US-based health care and insurance companies keen to start
charging Britons for services which, for the past three-quarters of a century,
have been free.
The
immensely complex US health care system, which mixes publicly financed Medicare
and Medicaid with diverse private insurance schemes, is a stab in the right
direction, but fails so many people on such a regular basis that it is clearly
not a model that could or should be adopted off the peg.
However,
there are other systems around the world that rarely crop up in all the furious
NHS debates, that blend public and private health care provision.
The
systems of countries like Singapore and Denmark usually
feature near the top of global health care rankings, and in the Middle East, it
is the UAE that leads the way.
Of
course, the UAE is not the UK. The vast majority of its much smaller population
are expat workers.
But
the insistence of the government since the earliest days of the UAE boom that
all employers must provide every employee with health insurance has created and
funds one of the world’s most modern and efficient health care systems, which
attracts some of the world’s best clinicians.
For decades now, Western consultants have sold Western best practice in everything from education to engineering to the Gulf states, but times are changing. Now, perhaps, is the time for consultancy to start flowing in the other direction.
For
the Emiratis themselves, who account for only a fraction of the UAE’s
population, health care is provided free of charge at publicly funded hospitals
and clinics. This is something the government is able to fund easily, because
the burden of health care for the vast majority of the population — the expats
— is borne by the companies that employ them.
With
imagination, this system could be adapted and adopted in the UK, perhaps with
free health care provided only for children and those no longer of working age
— and in the latter case perhaps only after means testing.
By
law, each job could come with private health care insurance — not as a perk for
a handful of high earners, as it is now, but for all.
Of
course, employers would moan — especially those who are currently offering
pitifully low wages to staff on so-called zero-hours contracts — but the
existing and frankly byzantine tax system could be tinkered with to reduce the
impact.
But
for the UK to adopt the UAE’s heath care model, it would require huge political
courage, and something more than a bit of tinkering.
For
decades now, Western consultants have sold Western best practice in everything
from education to engineering to the Gulf states, but times are changing. Now,
perhaps, is the time for consultancy to start flowing in the other direction.
If
Western governments can discard the ingrained and outdated notion that good ideas
flow only west to east, they might discover it could also be good for their
people’s health, and for their treasuries.
Jonathan Gornall is a British journalist, formerly with The Times,
who has lived and worked in the Middle East and is now based in the UK.
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