Ask Full Fact: Does the World Health Organisation think the UK no longer has an NHS?

Published: 21st Mar 2016

In brief

Claim

The UK no longer has an NHS according to the WHO’s definition.

Conclusion

Incorrect. There has been privatisation of services according to the WHO’s definition, because more NHS care is run by private sector companies. But the WHO didn’t say this means there’s no longer an NHS.

“Terrifyingly, according to the World Health Organisation definition the UK no longer has a NHS”

Youssef El Gingihy, GP and author writing in the Independent online, 10 March 2016

The World Health Organisation (WHO) doesn’t have a definition for what makes a ‘national’ health service.

It has, in the past, defined ‘privatisation’. According to this definition we can say that the NHS has seen some privatisation in that its money is being spent on services provided by private companies.

That private sector involvement isn’t disputed—the government says 6.3% of the day-to-day NHS budget went to private sector companies in 2013/14, up from 2.8% in 2006/07.

Whether that means there’s no longer a “national health service” depends on how you interpret the phrase. But we’ve seen no evidence that the WHO thinks this, as you might have interpreted this headline claim as meaning.

The NHS in England has seen some privatisation

In a 1995 report the WHO defined privatisation as:

“…a process in which non-government actors become increasingly involved in the financing and/or provision of health care services.”

Mr El Gingihy told us this was his source.

What’s happened to the English NHS in recent years comes under the ‘provision’ part of this definition—successive government reforms have focused on allowing private companies to compete to provide healthcare services.

This was one of the aims of the Health and Social Care Act of 2012, passed under the Coalition government, and of earlier policies from the previous Labour government.

That policy doesn’t apply to Scotland, Wales, or Northern Ireland.

The government says it spent £7 billion on private sector healthcare providers last year, 6.3% of its day to day budget in England.

No WHO definition of what should count as a National Health Service

Broadly speaking, the NHS is a system that provides healthcare to the public, based on a person’s health needs rather than their ability to pay, and is funded mostly via taxation.

It’s never been entirely publicly funded though.

Since being founded in 1948 the NHS in the four countries has undergone big changes to the way it operates. In a 2011 report the WHO said that in England major changes since 1997 included the expansion of private provision, along with a fairly lengthy list of other changes such as the introduction of patient choice and more freedom for some hospitals, among other things.

Just how fundamental a change the privatisation has been is controversial. You might agree with the article’s author, who argues that public ownership of services is central to what the NHS is, or should be, about. Full Fact isn’t going to get into a debate over what principles the service embodies, or should embody.

But neither has the WHO—so the claim is inaccurate.

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