This is from a UNISON Factsheet specially prepared for sister unions in the USA and was produced by UNISON to counter the lies and half truths that the right in the USA produce about the NHS in the UK. I hope UNISON do not mind me posting it here, even though it is a bit out of date, dating back to Augst 2009.
The UK’s National Health Service provides a comprehensive range of services that is free at the point of need and accessible to all. It provides peace of mind to millions, regardless of their income or employment circumstances.
The NHS has come under attack from right-wing critics of President Obama’s health plans. Some of these claims, such as those that patients over a certain age cannot receive treatment for brain tumours or heart bypasses, are simply untrue – there are no such bans and nor have there ever been.
Various rogue British commentators, such as Daniel Hannani and Karol Sikoraii, are trying to portray the NHS as dysfunctional or describing it as a “60 year mistake”. However, as the facts and figures below demonstrate, nothing could be further from the truth.
Is the NHS an efficient system?
- OECD figures show that UK total health expenditure as a percentage of GDP (8.4%) is actually below the OECD average and a long way below that of the USA, which has easily the most expensive system at 16%, nearly double UK spending.iii
- The UK spend per head of population is $2,992 as opposed to $7,290 in the USA.iv
- The UK NHS is largely free of the huge transaction costs associated with revenue collection and marketing that blight other systems, such as the USA.v As a result, the cost of administration in the UK is estimated at around 12% compared to more than 30% in the USA.vi
- The UK spends 3% of its budget on management costs, as opposed to 17% in the USA.vii
- The NHS has not been complacent or uncritically carried on as normal; a major review at the start of this decade evaluated different healthcare funding options and concluded that the current method of NHS funding through general taxation was both the fairest and most efficient one.viii
- The UK spend per head of population is $2,992 as opposed to $7,290 in the USA.iv
- The UK NHS is largely free of the huge transaction costs associated with revenue collection and marketing that blight other systems, such as the USA.v As a result, the cost of administration in the UK is estimated at around 12% compared to more than 30% in the USA.vi
- The UK spends 3% of its budget on management costs, as opposed to 17% in the USA.vii
- The NHS has not been complacent or uncritically carried on as normal; a major review at the start of this decade evaluated different healthcare funding options and concluded that the current method of NHS funding through general taxation was both the fairest and most efficient one.viii
- Productivity in the NHS has been rising alongside recent extra funding, for example by 0.7 per cent in 2006 and by 1.2 per cent in 2007.ix
What are the waiting times for treatment on the NHS?
- From January 2009, no one in England waits more than 18 weeks from the time they are referred to the start of their treatment.x Most importantly, the average wait for treatment is much shorter, at just 8 weeks. And median waiting times are just over 2 weeks for outpatients and 4 weeks for inpatients.xi
- For cancer patients, 99.7% of patients are seen within 2 weeks from urgent GP referral to outpatient appointment. For breast cancer, 99.8 % of patients are treated within 1 month from diagnosis to treatment. xii
- Virtually all patients are treated within four hours at Accident & Emergency units in hospitals.xiii
How is the NHS performing?
- Claims that clinical outcomes in the NHS are lagging behind other countries, particularly the USA, are wide of the mark.
- For example, the UK outperforms the USA where mortality rates from lung cancers are concerned.xiv
- Likewise, UK mortality rates from heart disease and stroke are considerably better than the USA.xv
- And in terms of in-hospital recovery from stroke, the UK is ranked second only to Japan amongst the OECD countries.xvi
How does the UK system compare to others?
- In comparison with the healthcare systems of five other comparable countries (Australia, Canada, Germany, New Zealand and the USA) the NHS was found to be the most impressive overall by the New York-based Commonwealth Fund in 2007 (the USA came last). Specifically the NHS was rated as the best system in terms of quality of care, co-ordination of care, and equity, but also, crucially, in terms of the efficiency of care.xvii
- The last time the World Health Organization produced a ranking of the world’s health systems, the UK was ranked considerably higher than the USA.xviii
- Life expectancy at birth is greater in the UK than in the USA and the infant mortality rate is lower in the UK than in the USA.xix
What is NICE?
- Far from being a “death panel”, the National Institute for healthcare and Clinical Excellence (NICE) is a world-renowned body that evaluates the effectiveness of drugs for use in the UK health system.
- NICE does not put a limit on the amount the NHS can spend on an individual patient.
What are the waiting times for treatment on the NHS?
- From January 2009, no one in England waits more than 18 weeks from the time they are referred to the start of their treatment.x Most importantly, the average wait for treatment is much shorter, at just 8 weeks. And median waiting times are just over 2 weeks for outpatients and 4 weeks for inpatients.xi
- For cancer patients, 99.7% of patients are seen within 2 weeks from urgent GP referral to outpatient appointment. For breast cancer, 99.8 % of patients are treated within 1 month from diagnosis to treatment. xii
- Virtually all patients are treated within four hours at Accident & Emergency units in hospitals.xiii
How is the NHS performing?
- Claims that clinical outcomes in the NHS are lagging behind other countries, particularly the USA, are wide of the mark.
- For example, the UK outperforms the USA where mortality rates from lung cancers are concerned.xiv
- Likewise, UK mortality rates from heart disease and stroke are considerably better than the USA.xv
- And in terms of in-hospital recovery from stroke, the UK is ranked second only to Japan amongst the OECD countries.xvi
How does the UK system compare to others?
- In comparison with the healthcare systems of five other comparable countries (Australia, Canada, Germany, New Zealand and the USA) the NHS was found to be the most impressive overall by the New York-based Commonwealth Fund in 2007 (the USA came last). Specifically the NHS was rated as the best system in terms of quality of care, co-ordination of care, and equity, but also, crucially, in terms of the efficiency of care.xvii
- The last time the World Health Organization produced a ranking of the world’s health systems, the UK was ranked considerably higher than the USA.xviii
- Life expectancy at birth is greater in the UK than in the USA and the infant mortality rate is lower in the UK than in the USA.xix
What is NICE?
- Far from being a “death panel”, the National Institute for healthcare and Clinical Excellence (NICE) is a world-renowned body that evaluates the effectiveness of drugs for use in the UK health system.
- NICE does not put a limit on the amount the NHS can spend on an individual patient.
- Its evaluation process involves top medical experts working alongside members of the public and many other health systems in the world are now looking to duplicate its approach to drug evaluation.
- NICE rejects only a tiny percentage of all the drugs it assesses for use on the NHS (around 5 per cent) and since 1999 has recommended over 90 per cent of the cancer drugs it has been asked to look at.xx
What do patients think of their NHS?
- The NHS remains a defining feature of life in the UK, consistently rated as more popular than the Royal Family or Parliament.
- The NHS regulator’s latest patient survey recorded 92% of patients saying their care was “good”, “very good” or “excellent”.xxi
- According to the 2009 British Social Attitudes report, satisfaction with the NHS is at its highest level for 25 years. And those with personal experience of the NHS rate it highest of all.xxii
What do people say about the NHS?
- Professor Stephen Hawking: “I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived”.
- Explorer Sir Ranulph Fiennes: "I love the NHS because they saved me from certain death following a massive heart attack. Also, when my wife of 36 years was terminally ill with cancer the NHS looked after her diligently and with expertise and patience".
- Prime Minister Gordon Brown: “The NHS makes the difference between pain and comfort, life and death”.
- UNISON General Secretary Dave Prentis: “Regardless of your income, the NHS provides peace of mind even at the most uncertain economic times, like those we're experiencing now. In the US, losing your job means losing your health insurance”.
About UNISON
UNISON is a powerful voice for working people in the United Kingdom. We have over 1.3 million members working in public services, the community and voluntary sector and for private companies.
UNISON is the UK's largest healthcare trade union – representing 400,000 nurses, student nurses, midwives, health visitors, healthcare assistants, paramedics, cleaners, porters, catering staff, medical secretaries, clerical and admin staff and scientific and technical staff.
UNISON campaigns for quality public services as the foundation of a strong economy and a fair society. Add your voice to ours at http://www.unison.org.uk/million
- NICE rejects only a tiny percentage of all the drugs it assesses for use on the NHS (around 5 per cent) and since 1999 has recommended over 90 per cent of the cancer drugs it has been asked to look at.xx
What do patients think of their NHS?
- The NHS remains a defining feature of life in the UK, consistently rated as more popular than the Royal Family or Parliament.
- The NHS regulator’s latest patient survey recorded 92% of patients saying their care was “good”, “very good” or “excellent”.xxi
- According to the 2009 British Social Attitudes report, satisfaction with the NHS is at its highest level for 25 years. And those with personal experience of the NHS rate it highest of all.xxii
What do people say about the NHS?
- Professor Stephen Hawking: “I wouldn’t be here today if it were not for the NHS. I have received a large amount of high-quality treatment without which I would not have survived”.
- Explorer Sir Ranulph Fiennes: "I love the NHS because they saved me from certain death following a massive heart attack. Also, when my wife of 36 years was terminally ill with cancer the NHS looked after her diligently and with expertise and patience".
- Prime Minister Gordon Brown: “The NHS makes the difference between pain and comfort, life and death”.
- UNISON General Secretary Dave Prentis: “Regardless of your income, the NHS provides peace of mind even at the most uncertain economic times, like those we're experiencing now. In the US, losing your job means losing your health insurance”.
About UNISON
UNISON is a powerful voice for working people in the United Kingdom. We have over 1.3 million members working in public services, the community and voluntary sector and for private companies.
UNISON is the UK's largest healthcare trade union – representing 400,000 nurses, student nurses, midwives, health visitors, healthcare assistants, paramedics, cleaners, porters, catering staff, medical secretaries, clerical and admin staff and scientific and technical staff.
UNISON campaigns for quality public services as the foundation of a strong economy and a fair society. Add your voice to ours at http://www.unison.org.uk/million
i Daniel Hannan is a Conservative Party Member of the European Parliament for SE England.
ii Dr Karol Sikora is a founder member of the UK think tank Doctors for Reform.
iii OECD Health Data 2009, http://www.oecd.org/dataoecd/46/4/38980557.pdf
iv OECD Health Date 2009, http://www.oecd.org/dataoecd/46/4/38980557.pdf
v See for example, “Competition in a publicly funded healthcare system”, S Woolhandler, D Himmelstein, British Medical Journal, 2007, http://www.bmj.com/cgi/content/full/335/7630/1126
vi David Rowland, Allyson Pollock & Neil Vickers, “The British Labour Government's Reform of the National Health Service”, Journal of Public Health Policy, 2001. And S Woolhandler, T Campbell, D Himmelstein, “Costs of health care administration in the United States and Canada”, New England Journal of Medicine,2003, http://content.nejm.org/cgi/content/full/349/8/768
vii NHS Confederation, Key Statistics on the NHS, http://www.nhsconfed.org
viii Derek Wanless, Securing our future health: taking a long-term view, 2002,
http://www.hm-treasury.gov.uk/consult_wanless_index.htm
ix Office for National Statistics, June 2009, Total public service output and productivity, http://www.statistics.gov.uk/articles/nojournal/TotalPublicServiceFinalv5.pdf
x Department of Health, Referral to treatment statistics, http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/18WeeksReferraltoTreatmentstatistics/index.htm
xi NHS Confederation, Key Statistics on the NHS, http://www.nhsconfed.org
xii Department of Health, NHS cancer waiting times, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_091122
xiii Department of Health, Total time spent in A&E, http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/AccidentandEmergency/DH_079085
xiv OECD, Health at a Glance 2007, http://www.oecd.org/health/healthataglance
xv OECD, Health at a Glance 2007, http://www.oecd.org/health/healthataglance
xvi OECD, Health at a Glance 2007, http://www.oecd.org/health/healthataglance
xvii The Commonwealth Fund, 2007, Mirror Mirror on the Wall: An International Update on the Comparative Performance of American Health Care http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2007/May/Mirror--Mirror-on-the-Wall--An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx
xviii WHO, http://www.photius.com/rankings/healthranks.html
xix OECD Health Data 2009, http://www.oecd.org/dataoecd/46/4/38980557.pdf and http://www.oecd.org/dataoecd/46/2/38980580.pdf
xx Health Service Journal online, “NICE chairman hits back at critics”, Sir Michael Rawlins, 18 August 2008, http://www.hsj.co.uk/nice-chairman-hits-back-at-critics/1799765.article
xxi Adult Inpatient Survey Results 2007, published 2008, http://www.nhssurveys.org/Filestore/documents/Key_Findings_report_for_the_2007_Inpatients_Survey.pdf
xxii John Appleby and Miranda Phillips, “The NHS: satisfied now?”, British Social Attitudes: the 25th Report, 2009, http://www.natcen.ac.uk/bsa/docs/BSA-25-Report.pdf
ii Dr Karol Sikora is a founder member of the UK think tank Doctors for Reform.
iii OECD Health Data 2009, http://www.oecd.org/dataoecd/46/4/38980557.pdf
iv OECD Health Date 2009, http://www.oecd.org/dataoecd/46/4/38980557.pdf
v See for example, “Competition in a publicly funded healthcare system”, S Woolhandler, D Himmelstein, British Medical Journal, 2007, http://www.bmj.com/cgi/content/full/335/7630/1126
vi David Rowland, Allyson Pollock & Neil Vickers, “The British Labour Government's Reform of the National Health Service”, Journal of Public Health Policy, 2001. And S Woolhandler, T Campbell, D Himmelstein, “Costs of health care administration in the United States and Canada”, New England Journal of Medicine,2003, http://content.nejm.org/cgi/content/full/349/8/768
vii NHS Confederation, Key Statistics on the NHS, http://www.nhsconfed.org
viii Derek Wanless, Securing our future health: taking a long-term view, 2002,
http://www.hm-treasury.gov.uk/consult_wanless_index.htm
ix Office for National Statistics, June 2009, Total public service output and productivity, http://www.statistics.gov.uk/articles/nojournal/TotalPublicServiceFinalv5.pdf
x Department of Health, Referral to treatment statistics, http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/18WeeksReferraltoTreatmentstatistics/index.htm
xi NHS Confederation, Key Statistics on the NHS, http://www.nhsconfed.org
xii Department of Health, NHS cancer waiting times, http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_091122
xiii Department of Health, Total time spent in A&E, http://www.dh.gov.uk/en/Publicationsandstatistics/Statistics/Performancedataandstatistics/AccidentandEmergency/DH_079085
xiv OECD, Health at a Glance 2007, http://www.oecd.org/health/healthataglance
xv OECD, Health at a Glance 2007, http://www.oecd.org/health/healthataglance
xvi OECD, Health at a Glance 2007, http://www.oecd.org/health/healthataglance
xvii The Commonwealth Fund, 2007, Mirror Mirror on the Wall: An International Update on the Comparative Performance of American Health Care http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2007/May/Mirror--Mirror-on-the-Wall--An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx
xviii WHO, http://www.photius.com/rankings/healthranks.html
xix OECD Health Data 2009, http://www.oecd.org/dataoecd/46/4/38980557.pdf and http://www.oecd.org/dataoecd/46/2/38980580.pdf
xx Health Service Journal online, “NICE chairman hits back at critics”, Sir Michael Rawlins, 18 August 2008, http://www.hsj.co.uk/nice-chairman-hits-back-at-critics/1799765.article
xxi Adult Inpatient Survey Results 2007, published 2008, http://www.nhssurveys.org/Filestore/documents/Key_Findings_report_for_the_2007_Inpatients_Survey.pdf
xxii John Appleby and Miranda Phillips, “The NHS: satisfied now?”, British Social Attitudes: the 25th Report, 2009, http://www.natcen.ac.uk/bsa/docs/BSA-25-Report.pdf
