The Realities of Rationing

Is health care rationed in the National Health Service? If so, who decides which patients to treat and which should go without? John Spiers argues that rationing and scarcity are built into the structure of the NHS. It embodies the collectivist assumptions of the 1940s which have become increasingly irrelevant in the modern world. By removing the price mechanism and stifling competition it has disempowered the consumer - the patient - in favour of an all-powerful producer. Political goals such as re-distribution and equality have taken precedence over health objectives, but the NHS has failed to deliver even on its own terms. It falls short of what people living in a rich country expect, and its failings affect the scarcest resource of all - the days of our lives.The NHS is the last failed nationalised industry. Radical reform is required to allow individual consumers to escape to their preferred provider.Contributions from three medical practitioners reflect the stresses and compromises of a rationed service.
Suggested measures include raising health spending to make rationing unnecessary and accepting that rationing is inevitable at any level of expenditure, but that it should be explicit. "As Professor John Spiers shows ...services are rationed in an irrational way. A patient's access to expensive treatments often depends on where he or she lives." The Times. "...a devastating critique which ought to be required reading for William Hague and the Shadow Cabinet,...argues that the Health Service is the last of the monolithic, inefficient, nationalised industries." Daily Mail. "John Spiers ...writes that European and other healthcare systems based on locally pooled insurance systems are fairer and better than the National Health Service." Melanie Phillips, The Sunday Times. "The case for making choice and competition central to health policy is admirably set out ...by Professor John Spiers." The Sunday Telegraph.