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What the NHS Could and Should Be in a Post-Brexit World

by John Brian Shannon

One of the great things about a post-Brexit Britain is that almost everything in the UK can begin anew with a clean sheet as it were, and number one on that list should be the country’s National Health Service (NHS).

At present, the UK contributes £12 billion more to the annual EU budget than it receives, and that’s a nice round number to spend on the NHS once Brexit occurs. Although there are certainly other worthy sectors of the UK economy that could use that level of funding.

But, for now, let’s concentrate on what the post-Brexit world could (and should) mean for Britain’s NHS.

And as we’re starting with a clean sheet, let’s not be limited by our present thinking and instead focus on how the NHS could provide better healthcare to Britons, and how the NHS could better serve the UK.


How to Maximize the NHS

The NHS should be required by UK legislation to begin operating at a 10% profit within 10-years of Brexit

How can the NHS operate at a profit when it can’t even hit break-even now, you ask?

Simple.

Secret Ingredient #1 – Cost savings through energy efficiency

At present, the NHS operates a large number of old hospitals, which at the time they were built were probably considered world-class hospital and administration buildings. But I guarantee that none were built to the LEED Gold nor the LEED Silver energy efficiency standard — let alone the net-zero energy usage standard called LEED Platinum.

Many NHS hospitals face energy bills of more than £1 million per month because they’re very old buildings and it isn’t worth the astronomical cost of renovating them to LEED energy efficiency standards.

As there are over 1600 NHS hospitals, clinics, and administration buildings (but nobody knows for certain because there’s so much overlap and duplication) and if each of those buildings is spending £1 million per month on heat, light, and air conditioning, that totals £‭19,200,000,000‬ annually.

So, £‭19 billion is going straight out the window every year in wasted energy. And let’s pretend there’s another £‭1 billion in other inefficiencies in these older, no longer fit for purpose hospitals, for a grand total of £‭20 billion worth of wasted NHS funding annually.

That’s a lot of wasted money.

However, the NHS has never been asked to turn a profit, and therefore, didn’t have the money to build newer, more fit for purpose buildings over the decades — or even worse — to throw good money after bad trying to turn old, unfit for purpose buildings into LEED Certified energy efficient buildings that require zero (net) energy from the grid.

Indeed, some buildings in the United States contribute more energy to the grid than they consume due to their LEED Platinum certification, which results in a net zero energy cost annually, and such buildings provide a tidy return on investment each February 1 when the utility companies are obligated by law (California) to settle-up with minor power producers connected to the grid.

Granted, there’s a lot more sunshine in California and is therefore easier for a building to produce more power than it uses over the course of a year. But wind turbines produce power all year (particularly in the autumn, winter and spring) when the solar insolation value (the amount of sun that falls on one square metre) is highest during the summer months in the UK.

So, one the one hand, we have a cash-strapped NHS that can’t afford the new buildings that would allow them to save £‭20 billion in wasted energy per year, nor can they afford to refit their existing buildings to make them more energy efficient because that’s even more expensive than building new, energy compliant hospitals and administration buildings.

Should the UK continue to throw good money after bad in the NHS, or should the government use taxpayer money to turn the NHS into a profit-making venture?

The answer… couldn’t be clearer.


So Far, We’ve Talked About Saving £20 Billion Annually; But How Can the NHS Earn 10% Profit Annually?

Almost every developed country in the world has a universal healthcare system that charges their citizens a monthly healthcare insurance premium. In Canada, that premium tends to be $65.00 – $100.00 per month/per adult — although some provinces in Canada pay the monthly premiums for their residents from general (tax) revenue.

Here’s the monthly healthcare insurance premiums in the province of British Columbia, Canada:

BC monthly healthcare insurance premium chart 2018

BC monthly healthcare insurance premium chart 2018. Image courtesy of the British Columbia Medical Services Plan. Click the image to visit their website.

Yet, as reasonable as those premiums are, the full cost of care is covered by the Medical Services Plan (MSP) whether those injuries/sudden onset disease/chronic disease or other malady and required medical procedures befall the patient while in British Columbia or anywhere else in Canada, or in other countries should medical emergency occur there.

Further, whenever wait times for patient care become extended within the BC (MSP) system, British Columbia’s Medical Services Plan authorizes Doctors and Surgeons to outsource patient treatment to Canada’s other provincial healthcare systems, or patients may be sent for treatment to the United States where MSP pays the full cost of treatment — even if said treatment costs more in the U.S. than it would in British Columbia.

Which is a typical model that developed nation healthcare systems follow.

Secret Ingredient #2 – Accepting Foreign Patients to Add Revenue to the NHS

Some developing countries also follow this model with their national healthcare systems (outsourcing and paying for medically necessary procedures they can’t perform in their own country, or when they can’t arrange to perform necessary procedures in a reasonable timeframe due to scheduling issues) and private healthcare systems often shop for a better rate or timeframe for insured persons so that the patient receives expert and more timely care — which creates better healthcare outcomes for their patients.

So, why wouldn’t the UK government fund the building of dozens of brand-new, state of the art, energy efficient NHS hospitals specially designed with extra capacity to accept planeloads full of patients from foreign healthcare systems?

In that way, over time — and let’s be realistic, this is a 10-year programme to capture every possible foreign healthcare opportunity and payment from the respective healthcare systems abroad — the NHS could begin to show a profit, thereby helping to subsidize the astonishingly high cost of providing healthcare services to Britons.

Even if advertising for and accepting foreign patients subsidizes the NHS budget by only 50% at the 5-year mark, that’s still 50% more funding that the NHS presently receives from healthcare insurance premiums paid by Britons and from contributions (subsidy) from the NHS paid by the UK government.

Therefore, a massive NHS spending programme is a sensible way to improve on the already high standards of the NHS and for Britons receiving treatment from the NHS. Not to mention for Commonwealth nation citizens who travel to the UK to receive healthcare that is paid-for by their respective healthcare insurer, whether private or public.

Let’s hope that British politicians are wise enough to see the value of such a proposition and that they’re larger than life — because that’s what it’s going to take to get the job done.

In previous generations British politicians were up to the challenges of their time; Wouldn’t it be great if this generation of UK politicians were up to the challenges of our time?

UK and 10 other countries, Health Care System Performance Rankings

UK and 10 other countries, Health Care System Performance Rankings 2018. International Health Policy Center. Image courtesy of the Commonwealth Fund.

The above chart demonstrates why foreign countries could and should send their overflow patients to the NHS… as every year since ranking began the NHS has scored either #1 or #2 in the annual Commonwealth Healthcare Index (ranking) study.


Next week, we’ll talk about doing a similar thing with the UK education system.

Have a great week, everyone!

Parliament Approves UK General Election for December 12th

by John Brian Shannon

The UK Parliament voted today to hold a UK General Election on December 12, 2019 which should help end the present Brexit impasse in the House of Commons.

Some 3.5-years after the June 23, 2016 referendum a majority of Britons voted to leave the EU (that’s 1,223-days ago!) and the UK is no closer to leaving the EU. So with the House of Commons deadlocked, Prime Minister Boris Johnson pressed for a General Election to allow their bosses (the UK People) to decide the future of the country. Smart!

A Quick Look at the Brexit File:

  • On June 23, 2016 a majority of Britons voted to leave the EU,
  • Followed by the February 1, 2017 House of Commons vote where MP’s approved  the Article 50 Withdrawal Act to Leave the European Union (498-114),
  • And then PM Theresa May’s June 8, 2017 General Election win (an election where every party ran on a platform of delivering Brexit),
  • Followed by last week’s House of Commons vote approving Prime Minister Boris Johnson’s Brexit deal (but in a separate vote, MP’s didn’t approve the timing of the deal)
  • Now Britons have another opportunity to weigh-in via the ultimate ‘People’s Vote’ — a UK General Election — where citizens of legal voting age can support Brexit or not, support the domestic platform of any party or not, etc.

With polls favouring the Conservatives and their lead increasing, it might be a tight race.

YouGov UK General Election 2019 voting intention tracker October 2019

YouGov Westminster voting intention tracker October 2019. Image courtesy of YouGov/Express.co.uk

Certainly the ruling Conservatives are a known quantity, in power since May 11, 2010; First with PM David Cameron until June 24, 2016, followed by PM Theresa May until July 23, 2019, and now, PM Boris Johnson since July 24, 2019 — while Labour hasn’t formed a government since PM Gordon Brown stepped down almost a decade ago.

The only way Labour can manage to stay-on as the official opposition is to run on anything but their Brexit platform, and instead, run on what they could do for the NHS, for low-cost housing, for worker’s rights and other social issues, IMHO.

While this election shouldn’t be all about Brexit, it will be for a majority of voters who want 3.5-years of economic uncertainty to end and they know the Conservatives will deliver.

The issue of our times, at present, is Brexit. And that’s what The People will be voting for, or against.


Predictions?

Based on nothing except that I always get these things right… hehehe, here are my UK General Election 2019 predictions.

The Conservatives will form a small majority government, Labour will gain many seats — while the Lib Dems, the SNP, and independent MP’s will take a beating at the polls. The Brexit Party will become the 3rd party in the House of Commons behind Labour, while the Greens and Plaid Cymru will barely hold onto their existing seats. UKIP won’t win a seat.

Whatever happens, I hope that every MP who is dedicated to serving their constituents does well in this election no matter what side of the Brexit divide they’re on.

Good MP’s like that are worth their weight in diamonds. Good luck, MP’s!


Read: UK set for 12 December general election after MP’s vote (BBC)

Read: UK General Election: A Really Simple Guide (BBC)