The NHS is not a religion

People proclaim that they “believe” in the NHS, as if it were a religious institution rather than a medical one.” Matthew Syed in the Sunday Times today.

The problem with religions is that their teachings are largely non negotiable. Transubstantiation is obviously and scientifically provably nonsense. But if you’re a Catholic you are supposed to have faith to believe it. The current construct of healthcare in Britain has been created as arbitrarily as the Catholic Church was. It is equally full of sentiment and lack of logic at times.

We lived in a mixed economy in which virtually everything we do requires a mix of public and private enterprise. The treatment of the COVID emergency is a good example. Looking after patients has been primarily a public sector task, but the development of vaccines was handled by private companies. In the NHS the dispensing of prescriptions is, and always has been, carried out by independent pharmacies large and small.

The mixed economy nature of British healthcare requires careful “Who does what?” decision-making. But for many if you suggest an activity would be better contracted out by the NHS to the private sector you move into “Who moved the stone” territory. You won’t be burned at the stake for apostasy these days but you may well be vilified.

The NHS is a huge employer and a huge enterprise. As such it needs the most professional management in both its patient care activities and in its structure. It does not benefit from ideology. It needs systematic efficiency improvements, less sentimentality and a far better definition of what it’s really for and how best to run it.

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