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Transatlantic Blog

The NHS and the spell of the White Witch

In The Lion, the Witch, and the Wardrobe, C.S. Lewis described the dreary state of Narnia under the curse of the White Witch as “always winter but never Christmas.” His assessment may soon apply to the National Health Service (NHS), whose annually intensifying “winter crisis” threatens to become permanent, according to the UK’s leading doctors’ association.

“The winter crisis has truly been replaced by a year-round crisis,” said Dr. Chaand Nagpaul, chairman of the British Medical Association (BMA).

Each winter, the need for medical care strains the nationalized healthcare infrastructure to the breaking point. This year, the NHS preemptively cancelled all surgeries it deemed “non-urgent,” with some waiting times exceeding 18 weeks; then, it canceled an additional 25,000 surgeries with one day’s notice or less.

Emergency waits lasted longer than ever. The NHS has never met its goal of having 95 percent of patients seen within four hours. (To put that in perspective, the average U.S. wait time is 138 minutes.) But some waits well exceeded UK standards. On 2,010 occasions, patients waited in emergency rooms 12 hours or more in the Royal Cornwall Hospital alone – six-times higher than last year.

The inevitable rationing that accompanies single-payer health care discriminates against the elderly. “Older people were more likely to face long waits,” Cornwall Live reported. “One in 23 people aged 90 and over (4.4%) waited longer than 12 hours from arrival to admission, discharge or transfer in 2017/18.” Yet no one under the age of 10 did.

The long waits in A&E rooms came about because NHS hospitals lack sufficient beds. Some 54 of 137 NHS trusts reached 100 percent occupancy. A record 16,900 people were stuck waiting in ambulances during the week between Christmas and New Year’s.

The UK’s health care troubles became so acute that last year the British Red Cross likened NHS service to a “humanitarian crisis.” And winter’s chill still hangs in the air. In April, 20 percent of Welsh emergency patients spent 12 hours or more waiting for treatment – worse than last year.

Only a massive funding increase, the BMA warns, can stave off perpetual winter. A new report from the Institute for Fiscal Studies (IFS) and the Health Foundation puts a dollar figure on that: £2,000 a year from every single home in the UK. Funding would have to increase by three to four percent a year to make even “modest” improvements, the report states.

“Taxes will have to rise” to “historically high levels” (“but not especially high by continental European standards,” the report helpfully notes) to meet current wait time goals. “We will have to pay a lot more,” said IFS Director Paul Johnson – and, he admitted, the burden will fall on the middle class, since the wealthy are “very mobile.”

NHS spending would grow faster than the most optimistic GDP estimates. British families would see one-quarter of all their projected income gains consumed by the NHS tax.

At the same time, the NHS engages in “a ridiculous waste of resources,” according to one health care expert. He specified the practice of “bed-blocking”: Surgeons are idled “daily,” unable to operate because social care does not have beds available for patients who should have already been discharged.

Lifting the veil of winter and making death itself “start working backward” will require a deeper magic than tax increases and government centralization.

Social care – government health care provided for sick adults, especially the elderly – is also in crisis, according to the IFS, and needs a corresponding funding increase of its own. “If the NHS is to celebrate its 100th birthday, then it’s imperative that adult social care is … given parity with the health service,” said the chair of the Local Government Association’s (LGA) Community Wellbeing Board. The current “sinkhole in funding” is “putting at risk provision of care for a growing number of people of all ages.”

But more funding may only incentivize bad practices. The Centre for Policy Studies (CPS) found that as NHS spending rose, waste increased and productivity fell. “Unless [the funding increase] goes hand in hand with structural improvements to how the NHS is run, we risk betraying patients and taxpayers,” said CPS Director Robert Colvile. 

The enormity of the crisis seems lost on no one, except the NHS and certain U.S. religious leaders. Instead of fixing any of these potentially life-threatening shortcomings, the executive director of one NHS Trust spent the Bank Holiday weekend decrying “white privilege.”

Worse yet, some Christians in the U.S. appear to be under the spell of the White Witch. Two weeks ago, liberal denominational leaders launched a new, reimagined version of the Poor People’s Campaign with a call to import something akin to the NHS. Its members wore buttons endorsing Bernie Sanders’ “Medicare for All,” and the campaign’s “Moral Agenda” endorses “universal healthcare” (as well as abortion-on-demand). The man who delivered the homily at the royal wedding, Bishop Michael Curry of the Episcopal Church, has attempted to portray the campaign as a clear outworking of the Gospels – proclaiming it a “Jesus Movement” and a “Pentecost Movement.”

But Jesus never told His followers to petition the State for their medical needs (or anything else): He gave a far more demanding responsibility to provide for the needs of others personally. We must care for others even if, like the widow, it requires giving our last two mites. It is fair to say that Jesus would look askance at giving Caesar, Herod, or Pontius Pilate more power over life-and-death decisions. And Christian prudence would reject any system with the manifest, systemic failures of the NHS.

Lifting the veil of winter and making death itself “start working backward” will require a deeper magic than tax increases and government centralization.

(Photo credit: Andy Mabbett. This photo has been cropped. CC BY-SA 3.0.)


Rev. Ben Johnson is a senior editor at the Acton Institute. His work focuses on the principles necessary to create a free and virtuous society in the transatlantic sphere (the U.S., Canada, and Europe). He earned his Bachelor of Arts in History summa cum laude from Ohio University and was inducted into Phi Beta Kappa.