August is supposed to be a wicked month. It certainly is for claims in the U.S. media about the inadequacies of the British National Health Service (NHS).
The NHS is still struggling, clearly, with many of the problems that we are, but not obviously doing less well than here. Overall the UK currently ranks 18th in the World Health Organization league table, the US ranks 37th The UK currently ranks 36th in the CIA World FactBook league table of average life expectancy, the US ranks 50th. In 2007 the UK spent $2,560 per head on healthcare services while the US spent $6,096.
The Brits have been watching our health debate unfold, and quietly trying to set the record straight. The Guardian newspaper in London set claim against reality in a full page spread on Aug. 12:
Claim 1: Senator Ted Kennedy would not be treated for his brain tumor in the UK because he is too old (claimed by Senator Charles Grassley).
NHS response: “This is entirely untrue. There is no ban on anyone of any age receiving any treatment.”
Claim 2: Government health officials in the UK have decided that $22,750 (£14,000) is what six months life is worth. Under their socialized system, if a medical treatment costs more, you’re “out of luck” (claimed by the Club for Growth).
NHS response: The number is based on a ratio of £30,000 a year used by the National Institute for Health and Clinical Excellence in its assessment of whether drugs provide value for money. A NICE spokesperson replied, “This is a gross misrepresentation of how NICE applies health economics to try and address the central issue: how to allocate healthcare rationally within the context limited of healthcare resources. NICE assesses the cost of a treatment in terms of a cost-quality analysis which takes account of the …amount and quality of extended life it is hoped the patient will gain. The current ceiling is £30,000, but exceptions are made.”
Claim 3: In the UK anyone over 59 cannot receive heart repairs, stents or bypass because it is too expensive and not needed (an anonymous claim, widely circulated among seniors).
NHS response: Again, entirely untrue. More and more seniors are having such treatments. The average age of heart by-pass operations in the UK has risen from 59 in 1991 to 66 in 2008.
Claim 4: The NHS does not allow women under 25 to receive screening for cervical cancer (claimed by Senator Jim DeMint).
NHS response: The NHS in Wales, Scotland and Northern Ireland invites women for screening from age 20. In England the figure is still age 25.
Claim 5: In Britain, 40% of cancer patients are never able to see a specialist, and there is explicit rationing for services such as kidney dialysis, open-heart surgery and care for the terminally ill (claimed by Conservatives for Patients’ Rights).
NHS response: The figure is based on a 15-year-old study. There has been a significant increase in the number of cancer consultants since then. The claim about explicit rationing of open-heart surgery is false, but there is a shortage of dialysis machines (at least 20% of the UK’s renal units are currently working at 100% capacity) and access to end-of-life care is uneven across UK regions. Correcting both these shortcomings is a current government priority.
Claim 6: UK breast cancer survival rates are 11% lower than the US rate (claimed by N.C. representative Sue Myrick).
NHS response: This is true. In fact the gap may be slightly greater, anything from 12.3% to 14.2%.
Claim 7: A Merseyside man had to use superglue on a loose crown because he couldn’t find an NHS dentist (claimed by Sean Hannity).
Response: Not typical, but entirely likely. UK dentists have increasingly moved into private practice. This summer there was much public outcry about excessive dentists’ earnings. But this seems to be an argument against privately-provided dentistry, not against the NHS.
I can personally attest to some of this: particularly the quality of care provided without charge for my father’s angina during the 12 years of his retirement, and the even more remarkable support that my mother received at the end of her long widowhood. Increasingly incapacitated but determined to maintain her own apartment, the local social services helped by sending in a team of women — three visits a day — to feed, clean and sustain her, until in the last 18 months she agreed to move first to an assisted living establishment and finally a hospice. My mother’s pensions helped to pay for part of the costs of the latter, but only part. Otherwise no money changed hands — certainly not during her frequent hospital stays or for her medicines.
The NHS does run a co-pay system for drugs. People pay a prescription charge (currently £7.20 per item, roughly $10); but you are exempt from those charges if you are under 16, in full-time study, over 60, are pregnant or a nursing mother, have cancer, diabetes, epilepsy (or other long-term conditions), or are unemployed or poor. Currently 88% of all prescriptions issued in the UK are issued without co-pay.
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