We read Dr Kruger's comment on the difference between health care in South Africa and the UK and the stinging rebuke that, should he become ill, he would fly back to South Africa for his health care, with some concern.1
His reflections are based on the power of the market and the perils of ‘socialis’ medicine. We suspect, however, that he writes from the perspective of the economically advantaged healthcare consumer in South Africa. Such a consumer can benefit from the power of the market, which has made high technology and interventionist medicine more readily available in South Africa than to similar people in the UK. But let us compare the case for the economically less advantaged healthcare user in both countries.
In the UK, whether in urban deprived areas of the inner cities or in the economically disadvantaged parts of the rural hinterland, everyone has access to interventionist high-tech medicine. Perhaps access is not quite so timely or the care provided in quite so pleasant an environment as Dr Kruger can access in South Africa? But can he say that everyone in Soweto or Transkei has access to health care, which the economically advantaged in South Africa enjoy, when 85% of people in South Africa have no health insurance?
We acknowledge that health care in the UK chafes under a huge burden of bureaucracy and that frontline healthcare staff often feel they are outnumbered by the ‘Elevator People’; there are delays in access and the care environment can often be improved. However, we must not lose sight of the simple truth. The UK's much derided socialist and imperfect NHS has succeeded in delivering first-world care to all its people, whether they have the economic clout to access the healthcare market or not.
- © British Journal of General Practice, 2004.
