The UK's National Health Service at 75: What Are the Root Causes of the Current Discontent?

The UK National Health Service (NHS), now in its 75th year, has devoted supporters inside and outside the country who admire its egalitarian ethic and public-service orientation. However, the rapid deterioration of its performance in recent years, and especially after the COVID-19 pandemic, is too glaring and dangerous to overlook. A major challenge is the health service's near-exclusive reliance on political and bureaucratic processes for resources and organizational direction. Free care at the point of service and publicly owned hospitals sustain the NHS's popularity, but long waits for needed care, even when the services are 'free,' harm patients. Neither major political party appears ready to explore systemic reform, but if political conditions create an opening, UK leaders might consider moving the NHS closer to the public-private models found in other European economies, as has been suggested at various points in its history and also recently. The lesson for other countries from the NHS's ongoing crisis is that full governmental control of medical care brings risks, not just potential and often-overstated rewards.
On February 15, 1944, with D-Day approaching, British Prime Minister Winston Churchill chaired a cabinet meeting with an agenda that went beyond the ever-present military and diplomatic concerns. In particular, [...]