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4 February 2002

EU health: our guide to where it’s best to be ill

You've got to have a hip replacement. Would you rather be in a) Germany, b) Spain, or c) Britain?

By Hywel Probert

“The NHS is not in crisis. It is not on the verge of collapse. But it does suffer from excessive political control, too much centralisation of power, and a lack of responsiveness to patients.”

That was the assessment made by the Labour peer Lord Haskins, chairman of the Better Regulation Task Force, in the King’s Fund’s blueprint for the future of healthcare in Britain. The report recommended that the health service remain in public ownership, but strongly advocated a decentralised NHS, operating with greater independence from the government.

The report envisaged a national corporation running the NHS free of political interference. It suggested that the corporation have responsibility for allocating funds within the system, regulating healthcare and setting standards for services. At a local level, plans involved NHS healthcare providers being re-established as non-profit organisations with complete control over their assets. The report stressed that all patients should have more choice as to how their own healthcare is managed, including where, how and by whom they are treated.

If these proposals were carried out, Britain’s NHS would be brought into line with the premier health services in the European Union. Although the NHS is placed higher than its German counterpart in the latest rankings from the World Health Organisation, it languishes far behind the Mediterranean pace-setters of Italy, France and Spain. Even Germany benefits already from the decentralised system advocated by the King’s Fund report: its non-profit sickness funds deal with the majority of needs on a local level.

The Mediterranean diet is not the only substantial health benefit that the citizens of France and Spain enjoy over the British – their advantage can be seen in more tangible criteria, such as the numbers of hospital beds, doctors and nurses, as well as the accessibility of primary care.

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The King’s Fund report urged that Britain’s passage into Europe embrace wider issues than merely notes and coins.


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