If the NHS is the envy of the world, why
are so many doctors moving abroad?

One of the privileges of my job as a reporter is I get to meet a lot of people who I wouldn’t otherwise encounter from many different walks of life. One of these walks of life, I’m pleased to say, is doctors; I have been blessed with fine health thus far. I did, however, meet quite a few doctors yesterday on the picket lines of Southend Hospital in Essex.

Despite the horrendously biting cold (try writing shorthand when you can’t feel your fingers), they were jolly and in high spirits, thankful for the all the car horns and goodies they were getting from passing motorists, and hopeful the government would take heed of their grievances over the new contract proposals.

There were even a few retired consultants there who popped by demonstrate their support, one of which was Dr Eric Watts, a former haematologist and chairman of Doctors for the NHS – an organisation which his banner helpfully informed me was for “service not profit,” adding “the NHS is being broken apart” and that “enough is enough,” apparently.

What I wasn’t aware of at the time was that Dr Watts is also a regular contributor to the Socialist Health Association website so, while I found him to be a very pleasant and charming fellow, it’s fair to say we’re probably not going to see eye to eye politically.

One of the concerns Dr Watts raised with me during our interview was the concern that, due to increased work pressures within the NHS, many junior doctors were upping sticks and finding healthcare jobs abroad. “There are people fleeing the country to take jobs elsewhere because of the uncertainty of the NHS,” he told me. “Australia is very popular, but people are also going to Canada and the USA, as well as Europe.”

It turns out there are thousands of doctors doing this every year. Which is interesting because, earlier, Dr Watts was telling me the NHS was “the envy of the world.” But, if that doesn’t demonstrate people voting with their feet in the marketplace of ideas, I don’t know what does. Pushing the limits of my neutrality as an impartial journalist (I take this very seriously but still accepted a fairy cake from the strikers), I did point out to Dr Watts that neither of the locations he listed had healthcare systems on the same model as the NHS.

His response was that other countries tend to spend more on their healthcare systems, which is true, and that while the US system had centres of excellence, this was not consistent or evenly spread. Also true, but I found this response unsatisfactory. However it was extra-curricular, so to speak, so I left it there.

But it did make me wonder, what are other countries like for doctors’ strikes? Well, I looked into it, and the results are illuminating to say the least. Firstly, though, it may be helpful to briefly go through the healthcare systems found in these countries (I’ve chosen France and Germany to represent Europe) and how they differ from the NHS.

The main difference between them collectively and the NHS is that, while in this country the government pays for the health service, it also runs the health service and employs all the people working within it. In the American, Australian, Canadian, French, and German systems, however, some or all healthcare is paid for by the government, but largely run by independent organisations.

The American system is, as everyone knows, largely private with everyone now being required by law to purchase health insurance, though the Medicaid and Medicare systems respectively provide government social insurance for low income families and pensioners. Australia has a system which combines a government-funded universal healthcare system (Medicare, introduced in 1984) with private insurance, while the Canadian system is publicly funded but provided by private organisations.

France, providing “close to best overall health care” according to the World Health Organisation, has a largely private system of health insurance in which the government refunds about 75 per cent of patients’ costs. Germany has a compulsory insurance system which combines non-profit “sickness funds” with private insurers.

And you know what I found? With the exception of Germany, where doctors struck over pay and conditions ten years ago, the only evidence I could find of strikes in any of the other countries was when the government attempted to extend its control over healthcare. And, in France, doctors have repeatedly gone on strike over the threat of an NHS-style system being imposed on them. I shit you not.

It happened in Australia in 1984 ahead of the introduction of Medicaid, in the Canadian province of Saskatchewan in 1962 when the government introduced universal medical insurance and, as mentioned previously, French doctors went on strike in December 2014, November 2015, and March 2015, in protest against the Socialist government’s “NHS-style” reforms which would make the service free at the point of use. So much for the envy of the world, eh?

Meanwhile, in Britain, the religious fervour surrounding the NHS blinds us to such a degree that one of said castaway doctors who actually managed to escape to Australia could, presumably with a straight face, still write in the Guardian that although she is now literally paid double the money for half the work she did in the UK, she still supports the NHS and feels guilty for leaving it.

I don’t even. I mean, I just..I don’t even.


Paul is Creative Director for Conservatives for Liberty. Follow him on Twitter: @Whiggery

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The views expressed in this article are that of the author and do not necessarily reflect the views of Conservatives for Liberty