How to fix the NHS

Britons are prouder of their health-care system than they are of the monarchy. But when the English National Health Service (NHS) turns 75 in July, the mood will not be celebratory. Hospital waiting lists in England spiral beyond 7m, forcing many to wait months or even years for treatment. Almost 300,000 adults are waiting for a social-care assessment. A record 2.5m Britons are out of work because they are sick. NHS staff are leaving the workforce in droves. On basic measures of health, Britain suffers by comparison with its rich-world peers. Its people barely live any longer than they did a decade ago, and have some of the worst survival rates for diseases such as cancer. During the pandemic the public clapped for the NHS. Now they are more likely to throw up their hands in frustration.

When something is broken, the boldest reforms can often seem the most tempting. Some want to overhaul the NHS’s funding model, switching from a system funded by taxation to one based on social insurance, as in France or Germany. Others mull the case for much wider use of means-tested charges. But Britons will not easily ditch what Nigel Lawson, a former chancellor, once called their “national religion” of health care funded by taxes and free at the point of use. And the country’s recent record of revolutionary change does not inspire confidence.