UK should look East for radical healthcare solutions
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.
During the First World War 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” healthcare, 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 has grown ever larger, even as the working, tax-paying proportion of the population has grown 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 healthcare has risen from £121 billion in 2008-2009 to the record £182 billion budgeted for 2023-2024.
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 healthcare and insurance companies keen to start charging Britons for services which, for the past three-quarters of a century, have been free.
For the UK to adopt the UAE’s heathcare model would require huge political courage.
The immensely complex US healthcare 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 healthcare provision.
The systems of countries such as Singapore and Denmark usually feature near the top of global healthcare 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 funded one of the world’s most modern and efficient healthcare systems, which attracts some of the world’s best clinicians.
For the Emiratis themselves, who account for only a fraction of the UAE’s population, healthcare 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 healthcare 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 healthcare 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 healthcare 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 heathcare model 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.
Disclaimer: Views expressed by writers in this section are their own and do not necessarily reflect Arab News’ point of view