The NHS debateBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a628 (Published 01 July 2008) Cite this as: BMJ 2008;337:a628
- Rebecca Coombes, journalist
As Ara Darzi was preparing to deliver his final report into the future of the NHS, four experts from the worlds of business, journalism, clinical services, and Whitehall gathered to discuss whether it should have a future at all. The motion of the debate was that “The founding principles of the NHS—services funded by taxation and available to all regardless of ability to pay—are no longer relevant in 21st century Britain.”
The motion was supported by entrepreneur and businessman Luke Johnson and Karol Sikora, cancer specialist and champion of privately funded medical schools in the UK. Opposing were Polly Toynbee, from the UK’s leading liberal broadsheet newspaper the Guardian, and Paul Corrigan, special adviser to two successive health secretaries at the Department of Health.
A poll of the invited audience at the Royal Institution, London, taken before the debate showed that just under a quarter (24%) supported the motion, 71% opposed, and 5% were undecided.
Luke Johnson, chairman of Channel 4, who studied medicine at Oxford University and has been instrumental in the success of many businesses, including Pizza Express, stepped up to support the motion. Perhaps unsurprisingly for an entrepreneur, he believed the NHS suffered because it was divorced from the commercial world’s twin drivers of efficiency and value for money.
An outdated model
The NHS was nothing but a “politically controlled state monopoly that is inefficient, outdated, and unsustainable,” he said, claiming the UK taxpayer does not see an adequate return on its almost £105bn (€133bn; $209bn) annual investment—an average of £3500 for every working Briton. “Yet we have some of the worst survival rates in Europe for …