In this Institute of Economic Affairs briefing, Communications Manager Reem Ibraham interviews Kristian Niemietz, Editorial Director, who has written a piece in The Telegraph entitled "The NHS Truths the Left Don't Want You to Hear." The conversation examines whether the NHS was ever truly the best healthcare system in the world, with Niemietz arguing that it never was, despite popular belief in a "lost golden age." They discuss how the NHS has consistently lagged behind other developed countries' healthcare systems across measurable clinical outcomes, avoidable mortality rates, and cancer survival rates, challenging the narrative that recent funding cuts are responsible for current failings.

Niemietz debunks the myth of systematic NHS defunding, explaining that while budget growth slowed in the 2010s, the system was never actually starved of funds as commonly claimed. He argues that the assertion of deliberate underfunding to enable privatisation makes no theoretical sense, as poor NHS performance typically leads to calls for more spending rather than privatisation. The discussion covers how Health Secretary Wes Streeting initially presented himself as a radical reformer but has since moved away from fundamental institutional changes, focusing instead on minor adjustments around the edges.

The interview concludes with Niemietz outlining his vision for genuine NHS reform, drawing on examples from countries like the Czech Republic, Slovakia, and East Germany that successfully transitioned from NHS-type systems to social insurance models. He proposes a gradual transformation that would maintain current arrangements as a default option while opening up new choices for those who want them, allowing the system to evolve over time without disrupting care for those who prefer the status quo. Niemietz argues that such transitions have been accomplished elsewhere in less than a decade without significant disruption to patients.

Get full access to Institute of Economic Affairs | Insider at insider.iea.org.uk/subscribe