I’m very fortunate to have been well through my eighth decade before spending a single night in hospital.

That all changed earlier this year on becoming ill in Gran Canaria. It came as a shock to learn I needed immediate surgery. The procedure was caried out around midnight at the island’s public hospital. An interpreter was even on hand to explain what was to happen. The surgical and nursing teams’ skills and care probably saved my life. Ten days later, l walked out under my own steam, with nothing to pay. Thank you, Spanish health service.

Having never previously been hospitalised, I had nothing against which to judge my Spanish experience. The hospital was modern, large, and there seemed no shortage of high-tech equipment. The most noticeable feature though was staffing. There appeared to be medical, nursing and ancillary staff everywhere. A Polish nurse explained he formerly worked at a London hospital, but had left after Brexit. Yet another Brexit bonus for Global Britain. It reminded me of Churchill’s observation, “I see little glory in an Empire which can rule the waves and is unable to flush its sewers.” To which can be added: or pay for its health service.  

On returning home, I was referred to the local hospital. There followed a six-week wait for an appointment. The initial delay compounded by a further two-month wait for treatment.  Don’t get me wrong, I’ve no complaint about the care I finally received. I can’t help wondering, however, if the four-month wait led to a worsening of my condition and a reduced chance of recovery.  

Since returning home I’ve been able to compare my experiences in Gran Canaria and Scotland.  We’re rightly proud and fiercely defensive of the NHS and its staff. That shouldn’t blind us to the fact that other countries, like Spain, have similar systems that deliver as good or even better patient outcomes.  Yet they don’t seem to be in permanent financial crisis. Recent personal experience makes me hugely appreciative of NHS staff. Despite their best efforts, however, the system is creaking ominously.

In its most recent survey, the US-based Commonwealth Fund noted the NHS’s slippage down the league table of comparable countries. One of the main reasons is “delays in accessing treatment”. That certainly chimes with my recent experience.  Only this month, independent charity, The Health Foundation, reported the UK’s spending on health as a proportion of GDP is lower than most comparable countries. The Foundation concluded “Either we are going to have lower quality health care relative to other countries, or we spend more.”

That stark message has been echoed by Scotland’s NHS leaders who have warned the present funding model is unsustainable. From its inception, there have been concerns about NHS funding.  Its founding father, Aneurin Bevan, believed costs would fall as the nation’s health improved. As it turned out, the NHS has been a victim of its own success. Improved health care has contributed to an aging population, often requiring expensive care, placing the system under even more pressure. Ironically, improved standards of living have enabled more of us to undermine our own health through smoking and excessive alcohol consumption.

Scotland’s NHS is in critical condition. Given the current financial meltdown, it’s questionable if the billions required can be found through the present funding model.  A doctrinaire and increasingly desperate Tory government is likely to look to private providers, possibly in the US, for salvation. Inevitably, much-needed funding would be diverted into the pockets of fat cat shareholders. There is another way. As the health chiefs have suggested, in one way or another, we all must pay more.

Politically, free at the point of delivery appears sacrosanct, so it boils down to increased taxation and contributions. The Institute for Fiscal Studies has calculated that in 2019, the “take” from UK National Insurance represented 6.6% of GDP, as opposed to the average 12% over 14 other European countries. Yes, yes, I know you’ve paid national insurance all your working life and can’t be expected to pay more. Fair enough, but you’ll have plenty of time to reflect on that when waiting hours for that ambulance or a few extra years for your hip replacement.  

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