An international ranking of health services in 11 countries rates the UK NHS at the top. The Commonwealth Fund, an American think-tank, ranks health systems on five main criteria: Access, Equity, the Care Process, Administrative Efficiency and Health Outcomes. Each of those criteria is based in turn on a range of subordinate indicators: the “Care Process”, for example, takes into account prevention, safe care, coordination, and patient engagement. It’s backed up further by more detailed assessment; for example, the US does badly on infant mortality and premature death, but relatively well in relation to doctor-patient relationships and the management of stroke. But speaking as a carer, I find it hard to believe that the state of our mental health services really represents the best that anyone can do.
The main purpose of the report is to give a critical perspective on health care in the US, which is outstandingly expensive as well as being the least effective of the systems; but there are questions to raise about other countries, too. For the UK, we might wonder how it is that the health care system is ranked top of the league while the UK’s health outcomes are the second worst in the table. The neo-liberal Institute of Economic Affairs commented, acerbically: “the NHS’s provision of care is equally poor for everybody, irrespective of income.”