Should the NHS be privatized? Annual varsity medical debate - London, 22 January 2010

The 2010 Varsity Medical Debate between historical rivals Cambridge and Oxford Universities took place at the Royal College of General Practitioners in London on the 22nd January. The debate was overseen by a prestigious panel of judges including the President of the College, Dr Iona Heath, and the former President of the Royal Society of Medicine, Baroness Finlay of Llandaff. Representatives from Oxford University proposed the motion that "This House would Privatize the Provision of Healthcare" and put forward the case for a privatized model, built upon an amalgamation of successful international frameworks (as seen in Appendix 1 [1]), to replace the secondary and tertiary care sectors in the ageing NHS. The motion was opposed by representatives from Cambridge University who argued that improving the publicly funded status quo was still plausible and preferable.Since 1997, NHS expenditure has more than doubled from ￡35 billion to ￡89 billion [2]. However, a soaring deficit estimated at ￡3 billion per year has prompted many to question how much longer the current socialized system can be sustained. The 2006 Herceptin scandal is an example of the sensitive nature of any discussion of healthcare financing issues. Initially chemotherapy for breast cancer using this agent was not approved by the National Institute of Clinical Excellence (NICE) for public access due to its high cost. However, patient appeals to the High Court compelled NICE to reverse its initial decision [3]. Future controversy is undoubtedly inevitable as the NICE threshold of ￡20-30,000 per Quality-Adjusted Life Year (QALY) gained is tested by an ever more expensive array of drugs [4]. Other recent examples include the arthritis drug RoActemra and the cancer drug Nexavar; both of which are currently unavailable in England on grounds of unqualified cost-effectiveness: although an appeal against the Nexavar ruling is set to take place later this month [5].Many argue that we are already proceeding toward