This all came from your exchange with jamie which was about the cost to the NHS of a box of paracetamol. So we're talking about the NHS, not tarmac, lampposts or anything else.

He actually said "higher standards" not the "highest standards".

I've never heard of the European Health Consumer Index, but the report Johnny linked to conflicts with the Commonwealth Fund, whose findings I posted a link to a report about, who said the NHS was the most efficient in the world.

We're talking at cross purposes then. I was referring to the NHS, not the totality of public services.

Higher, highest, high, whatever. I think we know when we're getting good quality care or not.

The report I linked to said this: "The United Kingdom ranks first overall, scoring highest on quality, access and efficiency"

The Telegraph says: "In the Commonwealth Fund study, the UK came first out of the 11 countries in eight of the 11 measures of care the authors looked at. It came top on measures including providing effective care, safe care, co-ordinated care and patient-centred care. The fund also rated the NHS as the best for giving access to care and for efficient use of resources.

"Despite investing the most money in health, the US refuses care to many patients without health insurance and is also the worst at saving the lives of people who fall ill, it found."

See for yourself: [Link]

Personal experience. I've worked in contracts to government and private sector, private sector work has a lot less in the way of requirements, compared to government sector work.

For example, there when providing IT into government sectors you have all manner of health and safety requirements that you just don't see in the private sector (such as RSI systems, Special Needs Software, higher data protection requirements, security protocols are higher, environmental systems requirements, more resilient DR and fallback plans, restricted infrastructure requirements are higher etc). You'll need to security clear staff to just be on site, which you almost never will for private sector contracts. Chances are you'll have restricted hardware limitations as well.

Even requirements in regards to development, testing and QA is much higher when you're working with governments, as is auditing requirements.

Defense is even more extreme in its standards and requirements.

It all has to be recouped somehow, and invariably it costs more.

It costs about 750-1000 per end user to provide a workstation to a government worker. Its about 500-750 in private sector.

We were.

11 measures and 11 countries isn't exactly a large pool of data. It obviously isn't comparing NHS to private within this country either.

No one's bashing it, but I still think there are probably better health services out there. Probably costing astronomical sums I'll grant you.

The NHS, im my very very recent experience, is in a shocking state & getting worse.

I phoned to see my GP yesterday & was told they no longer take same day appointments. There is a same day walk in clinic from 2pm but they'll only see the first 18 people. I arrived at 1pm and the queue was out the door. I called again this morning to book a future appointment - the earliest they can book me in is the 24th December.

My group practice has 9 GP's and I'm willing to see any of them.

I'm going to have to join my work private health care. An action I despise as I don't see why I should when we have the NHS - but a 15 day wait for a doctors appointment is unacceptable.

It's not as transparent in terms of how it generated the scores. Or what data it used. Which makes it hard to judge.

It seems that the UK's high score for "efficiency" stems from the fact that Britain spends less per capita than other countries. Which it does, certainly compared to the US. Not sure if that automatically means it's the "best" system though.

Some of the categories seem a bit woolly. Eg, 'Equity'. What does that mean?

And Britain comes first on "patient-centred care". Which sounds good, but what does it mean and how do they measure it?

I find it remarkable that the UK comes first on virtually everything while countries which perform a lot better in other studies (Germany, Netherlands, Norway) all do comparatively so poorly. Is the NHS really that wonderful!?

The cynic in me makes me wonder if the people behind this study were keen on using it to bash the American healthcare system, which is a bit of a political hot potato over there.

Glad to hear I'm not being tarred with any brushes.

It's understandable that people are wary of privatisation. But the NHS is completely intertwined with the private sector anyway. And the US system is hardly a pure free market. Medicare and Medicaid are huge state-funded programmes. It's not as simple as reducing "privatisation bad, nationalisation good."