05/07/2013 11:44 BST | Updated 04/09/2013 06:12 BST

An NHS for the World

The UK's National Health Service is sixty-five years old and the government seems intent on retiring it, on forcing it out of the work place, bit by bit. But the NHS was born out of values and principles that the passage of time can never defeat.


The UK's National Health Service is sixty-five years old and the government seems intent on retiring it, on forcing it out of the work place, bit by bit.

But the NHS was born out of values and principles that the passage of time can never defeat. Despite the treatment it's been given, and despite its frequent failings as a consequence, the idea the NHS was built on is so fundamentally brilliant that it could still transform the world today - and it just might.

It is easy to take the NHS for granted. The idea of someone being turned away from treatment because they lack the money is an alien concept here in the UK - or at least it used to be. But for people in the Majority World (i.e. those living in extreme poverty) the idea of receiving medical care regardless of personal wealth can seem almost incomprehensible.

Every day untold numbers of of people die because they can't afford to pay for health care. Others survive for the moment, but at the cost of them and their families being plunged into inescapable future poverty because of the fees. And then, most tragjc of all, there are many, many families whose loved ones die, and all they are left with is crippling debt.

Most of us accept, in theory at least, that every person on the planet has an equal right to healthcare. It's a simple idea: Healthcare, available for all, free at the point of delivery. Fantastic. Utterly brilliant. It's an idea that would change the world beyond all recognition. So... here's another idea: why not implement it?

It might seem unrealistic in terms of cost, but the NHS was introduced when the country was almost on the verge of bankruptcy. When you consider the incredibly close connection between health levels and poverty - and between a healthy work force and successful economic development - it soon becomes clear that denying people their health rights is a ludicrous economic policy.

Breaking the cycle of poverty and poor health is pivotally important. Poverty leads to poor health through things like malnutrition, overcrowding, lack of clean water - and many, many other reasons. In turn, poor health prevents people working their way out of poverty, and imposes huge economic costs on entire populations and nation states -combining the enormous expenses of dealing with illness and the opportunity costs of lost productivity.

Making real and sustainable improvements in the lives of the world's most disadvantaged people means moving beyond intermittent aid focused on specific diseases, and instead striving for long-term change to strengthen comprehensive national health systems.

Reliance upon 'aid' is no long term solution - even if there was enough of it to meet the need. The important thing is to stop resources being taken out of poor countries in the first place - through things like tax dodging, and unfair trading relationships. It's not about the rich giving more to the poor. It's about the rich stopping taking from the poor.

All countries need sustainable taxation systems - systems that enable the long term financing of health care and other essential services.

Twenty five years ago, the World Bank and others were forcing the introduction of fees for health care throughout the Majority World. Today it's widely accepted that this was a devastatingly terrible thing to do - to the point that some are calling for compensation to be paid for the damage this policy did. Now the rheotiric (if not yet the practice) is about a new paradigm - Universal Health Coverage (UHC).

This is about every human being having access to quality health services without the risk of financial hardship from out-of-pocket expenses. UHC at the moment is far from perfect. For example, 'Universal Health Care' (rather than 'Coverage') would be a better term to use - as this recognises that health rights are about more than just medical provision, and that medical provision is about more than everyone having access to a package of just the most basic services.

Nevertheless, the increasing focus on UHC is a big step back in the right direction. It shows that bad policies can be reversed. It's a step back towards the principles that the NHS was founded on.

It's not time to pension the NHS off. We shouldn't be fighting to preserve what's left of it. We should be revisiting and recommitting to its founding principles. We must build the NHS anew, to be better than it's ever been - and this time as part of a global community, with our eyes not just in the UK but working with others to fulfil that same vision worldwide. That way, the NHS's greatest contribution to the world - and to the vision of Health for All - is yet to come.