The Workings of a Typical British Hospital

by JRO on November 26, 2013

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The British National Health Service (NHS) established in 1948 is one of the world’s truest forms of socialized medicine. Under the system, the British government provides medical service to individuals who then pay for services through their tax dollars. The system has both positive and negative aspects to it. While all appointments and medicines are free for individuals at the time of service, a person walking into a typical hospital in the U.K. might find themselves sent home to wait for a procedure one could get in the U.S. within a matter of hours.

Formation of the NHS

The NHS was established in 1948, a few years after World War II. During the war, many had inadequate access to medical facilities and doctors. Scheduling an appointment for a simple mammogram, for example, was challenging. Many volunteer hospitals sprung up around the U.K. to alleviate the problem, and these hospitals were funded by the British government. The framework established during the war paved the way for what is known today as the NHS.

Advantages of the British System

The number one advantage for patients entering a U.K. hospital under the NHS is that is it free.  Consequently, the average health care cost per person in the UK is about $3,500 less than patients in the United States. In fact, the World Health Organization ranked the NHS 18th when it comes to healthcare, while the U.S. was ranked 37th.

Some may assume that with the lower cost spent on healthcare per person, British patients would find themselves with a higher death rate; the opposite is true. Compared to the U.S., the U.K system actually has a lower death rate and a longer life expectancy. Part of this can be attributed to the National Institute for Health and Clinical Excellence (NICE), which is the branch of the NHS in charge of deciding which medical procedures and prescription drugs the government will pay for. In order to keep costs down but still offer patients the best medical service, NICE must measure between cost-effectiveness and medical effectiveness. The NHS is generally unwilling to experiment with drugs that have not proven to be beneficial in extending a person’s life.

Disadvantages of the British System

Some of the work of NICE, however, receives criticism around the world. While the institute helps keep the prices of the U.K. system down, it also limits patient choice. Compared to the U.S., the U.K. mortality rate for various cancers is much higher. This can be directly tied to the policies established by NICE.

Take, for example, a twelve year old boy who finds himself diagnosed with an advanced stage of leukemia. Under the NHS, a new experimental medical procedure or medicine more than likely wouldn’t be covered. According to NICE officials, the cost-per-life threshold they are willing to spend is $45,000. If an experimental new drug or procedure is going to cost the government more than $45,000 to extend that 12 year old’s life beyond a year, NICE will not cover it.

Another disadvantage to NHS is the wait time patients are faced with when it comes to medical procedures. It is estimated that, on average, NHS patients wait eight weeks for treatment, while that same treatment could be taken care of in the U.S. in just two to three weeks. Returning to the example of the twelve year old boy, in order to receive a surgery that may save his life, he has to wait for his general doctor to refer him to a hospital that will perform the surgery, something that could take months. Along with the wait time on surgery and treatment that requires an admission to a hospital, a simple out-patient procedure under NHS has an average waiting period of four weeks and the wait time for receiving a CAT scan or MRI is roughly two weeks.

Weighing the Costs

Those walking into a British hospital today will not get the same fast action care one might see in the U.S. A simple CAT scan could take weeks to receive and those in need of a hip replacement might find themselves waiting well over two months. While there are advantages to the U.K’s NHS, the drawbacks can be severe. In the end, one must decide if the slower wait times and fewer options outweigh its friendly price tag.


Jerome Shockley writes on health, medical science, hospital environments, the medical profession and other related topics; those interested in potentially joining the medical field are encouraged to check out

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