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National healthcare can’t fail if there are no goals

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As the Brexit debacle monopolizes UK news, the government quietly released a consequential announcement: The National Health Service (NHS) is considering repealing requirements that emergency rooms in England treat or release patients within four hours. The new guidelines vindicate critics of single-payer health care, who say the government inevitably rations care, downgrades its own standards, and then declares victory.

The UK’s goal of a four-hour wait in accident and emergency rooms (A&Es) is roughly twice as long as patients wait in American ERs. However, the government has moved the goalposts in its own favor for nearly two decades, as the Guardian reports:

When Labour introduced the measure in 2004, hospitals had to treat 98% of patients in England within that time [four hours]. The coalition government then reduced the target to 95% in 2010.

However, hospitals in England have not met the 95% target since July 2015 and the relentless rise in demand for care means the performance of some has sunk as low as 50% as the NHS has faltered.

Furthermore, hospitals inflating those numbers by rushing 20 percent of all admissions within the last 10 minutes before the deadline.

The problem restricted to A&Es. Some 24 percent of British cancer patients – or 127,000 people – suffered when the NHS missed its 62-day target over the last five years.

Canceled surgeries and delayed treatment became the norm during the annual “winter crisis,” which often lasted longer than winter. Care standards so eroded that the British Red Cross likened NHS service to a “humanitarian crisis” in 2017.

So, politicians handed out the one thing never in short supply: promises. Last June, Health Secretary Jeremy Hunt said Theresa May’s increased funding would mean “the NHS can regain core performance [on key waiting time targets] and lay the foundations for service improvement.”

The new guidelines unveiled by NHS England’s medical director, Stephen Powis, hope that A&Es will see patients with the worst conditions within one hour and expedite the treatment of mental health patients. The new rules will be tested in the 2019-2020 year and, if deemed successful, will take effect in 2020.

The cynical notion behind the decades-long slide is that the government cannot miss its targets if there are no targets.

Instead of improving service, the government reduced its standard to one it could meet. And with the wave of its wand, and the lowering of expectations, its programs go from a failure to a success.

Next year’s report will undoubtedly show “improvement.” But results will not improve in tandem.

A socialist health care system increases demand by providing care “free at the point of service” (although not, nota bene, free). But it does so without increasing the supply. In fact, its payment structure reduces supply by failing to reward innovations, like the invention of new drugs. By removing price signals and separating service from payment, single-payer health care overburdens the medical system. Coupled with an aging population, hospitals find themselves strained to the breaking point.

Preserving people’s lives is the greatest gift next to eternal salvation. As St. Luke of Simferopol, an archbishop in the Orthodox Church and a surgeon, said, “I help people as a physician, and I help them as a servant of the Church.” Christians should speak out against socialism, a system that inhibits all forms of personal charity, secular and ecclesiastical.

(Photo credit: Department of Foreign Affairs and Trade. This photo has been cropped. CC BY 2.0.)

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Rev. Ben Johnson Rev. Ben Johnson is Senior Editor at the Acton Institute.

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