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Case/Article Review 5


​You have two minutes to read the enclosed article, and you will subsequently be asked a range of questions by the interviewer. You may wish to make notes, however please note you will not be allowed to refer to your notes or the article during the discussion.

​​
‘’The NHS has been judged the best, safest and most affordable healthcare system out of 11 countries analysed and ranked by experts from the influential Commonwealth Fund health thinktank.
 
It is the second time in a row that the study, which is undertaken every three years, has found the UK to have the highest-rated health system. The NHS has held on to the top spot despite the longest budget squeeze in its 69-year history, serious understaffing and the disruption caused by a radical restructuring of the service in England in 2013.
 
Its ranking is even more notable because the thinktank found the UK to put the fourth smallest amount of GDP into healthcare among the 11 countries. While the US spends 16.6% of its national income on health, the UK comes near the bottom, investing just 9.9%. Only New Zealand (9.4%), Norway (9.3%) and Australia (9%) put in less.
 
The UK emerged with the best healthcare system overall, just ahead of Australia, with the Netherlands a little further behind. A group of experts assessed them against 11 criteria designed to measure the effectiveness of different health systems.
 
 Supporters of the NHS are likely to use the Commonwealth Fund’s findings to rebut claims that the NHS is wasteful and inefficient. Theresa May has told the chief executive of NHS England, Simon Stevens, to ensure that the service uses its £120bn annual budget more efficiently.
 
The US was again judged to be the worst system, despite investing far more money than the other countries. It spends 5.2 percentage points more of its GDP on health than France, which invests the second largest amount (11.4%).
 
The UK came first in four of the 11 categories. It was judged to deliver the safest care, be the best at “care processes”, provide the most affordable care and offer the most equity.
 
However, the gap between the UK and the next best-placed countries is narrowing. Those four categories are only half of the eight in which the UK came top in 2014, when the fund last undertook its in-depth multi-country research. The UK also came second for providing preventative and well-coordinated care.
 
But the NHS came 10th on healthcare outcomes, a category that measures how successful treatment has been – a significant weakness that was also identified in 2014. The experts concluded that the UK does very poorly in relative terms on five-year survival rates for breast and bowel cancer, and deaths among people admitted to hospital after a stroke, for example.
 
An NHS England spokesperson said: “This international research is a welcome reminder of the fundamental strengths of the NHS, and a call to arms in support of the NHS Forward View practical plan to improve cancer, mental health and other outcomes of care.”
 
(Adapted from: https://www.theguardian.com/society/2017/jul/14/nhs-holds-on-to-top-spot-in-healthcare-survey)

 Outline the main issues raised.
​


Average Candidate Response
This article suggests that the NHS is the best healthcare system amongst a number of economically developed countries in the world. It is efficient, with comparatively small expenditure and performs well across a broad range of measures. One area where the NHS performs poorly is health outcomes, with the NHS coming 10th out of 11 countries.
​

​Excellent Candidate Response
This is a promising article which highlights how efficient the NHS is as a health service. Despite a comparatively small budget, it is able to provide an efficient and comprehensive service. Additionally, with the NHS coming top for a second study cycle in a row, it suggests long term consistency and promise rather than a ‘one-off’ result or analysis.
 
On the other hand, this study only compares 11 countries in a world of nearly 200 countries, and hence wholesome conclusions cannot be drawn. There are many countries such as Cuba which are regarded to have excellent healthcare provision which are not included in this study.
Additionally, there are a number of areas where the NHS does not perform particularly well, notably health outcomes which include five year survival rates for common cancers such as bowel and breast.
 
Overall, whilst the article is a compliment to the efficiency of the NHS, there are undoubtedly areas for improvement and with the increasing number of unfilled vacancies within the NHS, these areas could prove a more significant problem in the coming years, if not promptly addressed.

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