“Older and poorer” – the UK’s future?

The Health Secretary, Wes Streeting, said last week that the UK risks becoming “a country with an NHS attached.” Coming from a Labour MP this constitutes admirable candour.

The problem is, we’re long past that point already.

The NHS is by far the biggest employer in the country (over two million people) with a budget amounting to roughly ten per cent of GDP. Neither of these figures is likely to decline, not least because demand for NHS services will continue to grow.

The Office for National Statistics projects that the UK population will rise from 68m to 82m by the mid-2070s. By that point, the share of people of working age will fall to 58 per cent, and 27 per cent of people will be over 65, up from 19 per cent today.

Responding to the ONS forecasts, the Office for Budget Responsibility said that “the ageing of the population is projected to drive a growing gap between government spending and government revenue over the next 50 years.”

This is a polite way of saying Britain is going to get older and poorer. Or, more bluntly, “we’re screwed.”

It seems a sensible time, then, to really consider the kind of healthcare that we need – and that we can afford. While the Health Secretary sounds more sensible than the Prime Minister (whose commitment to the NHS goes so deep he famously said he would never use private healthcare, even if it was the only way to alleviate the suffering of a loved one) the chances of this government pursuing truly radical reform are slim.

Last week, the eminent professor (and Labour peer) Robert Winston told Sky’s Sophy Ridge that our demographic and economic challenges are so great that “we have to ask whether or not we need to consider an insurance scheme” as part of our healthcare provision. He added, knowingly, “Labour won’t want me to say this.”

While we’re on the topic of unsayable truths, it’s worth noting a report published today by the Institute of Economic Affairs, which makes the case for replacing the NHS with a “European-style social health insurance system.”

The IEA’s report deserves to be taken seriously by anyone interested in the future of healthcare, or anyone interested in why European systems consistently deliver better health outcomes than the NHS.

Unfortunately, we’ve long since given up on having rational conversations on this topic.

So, here’s to getting older and poorer.