Most Britons will not accept the truth about the NHS. It is not that it produces uniformly terrible results, as its harshest critics say. The truth is that its performance, in terms of comparison with sophisticated mature economies, is middling. Yet, just as the minority of critics tend to overdo it, so its defenders sound completely barmy when they hail it as the best and the envy of the world. It isn’t.
The British make a compromise on health care. For many the NHS is a unifying idea, part of an idealised notion of what it is to be British. In return for that warm, fuzzy feeling they tolerate OK-ish health care (with pockets of disastrous failure and some examples of excellence).
In the opening ceremony Boyle fed the myth, with three giant letters spelling NHS in the middle of the Olympic stadium. For many of those watching, it seems to have been the high point. To me it looked like irrational, smug self-congratulation. Anyone attempting to make the system more responsive to consumer demand – to drive improvement, innovation and productivity and thus deliver better health care for patients – can forget it for another 20 years. more...
