Aid v NHS: dilemma or red herring?

You may have seen the news that, while doing an interview for LBC radio yesterday, David Cameron was confronted by a cancer patient who asked why the UK government is giving billions to tackle poverty overseas when she can’t get the specialist drugs that she needs from the NHS.

This lady was in particularly desperate situation as she has an allergy to the drugs normally offered by the NHS and her predicament was very moving.  However, David Cameron was quick to point out that aid is less than 1% of our national income and is helping to make a huge difference around the world.

I was interviewed by  Premier Radio this afternoon and was asked for my opinion on this story.  The points I made were very similar to

Love for the NHS featured in the Olympics opening ceremony

the Prime Minister’s: that we have a moral commitment to stick to the promises that we’ve made to the world’s poorest communities, that aid money can and is having a huge impact and that the generosity of the British public in response to appeals shows that, as a nation, we are as committed to tackling poverty as we are to our NHS (see my post last November on the Independent poll which showed overall public support for aid.)

On my way out, though, I was hit by an enormous frustration about the way that much of the mainstream media are framing this debate as investment in aid v. investment in healthcare here in the UK. Of course the moral imperative for both is strong and resources are limited.  But why was this wonderful lady not calling for a  a crack down on tax fraud or rogue bankers, high executive pay in the public sector, or perhaps the scrapping of our nuclear weapons as ways of increasing the money available to the NHS, rather than cuts in aid which really will hit the poorest hardest?

How as a development sector have we allowed ourselves to be backed into this corner?  And what can we do to re-frame the debate? Should we be doing more to get the voices of aid beneficiaries heard, so that their plight becomes as personal to us as the lady on LBC’s was yesterday?  Is there more we can do to communicate the huge impact that a relatively small investment has made to people that matter to us – no matter which country they live in?  Or perhaps we should be doing more to collaborate with those in the NHS and others to re-frame the debate and to say that, rather than fighting each other over ever reduced resources, we should be fighting together to ensure that those with plenty contribute more so that we can give more support where the need is greatest?



  1. Peter, Midlands says:

    The question of priorities is a key one, as you say. What is less well known to the public is that the NHS has a standard by which it assesses whether a drug is cost effective given its clinical results. Any drug that passes the test of up to £30,000 per year of life extended is made freely available.

    The drug manufacturers know this at the time they are price setting which means the more pertinent question for someone not able to get a drug is – why is the drug company pricing the drug higher than the rate it can get approval for it (given the research costs are already spent, and the manufacturing costs are tiny)

    The other way for aid advocates to think about investing is, with the interventions you do, what does it cost per year of life extended? I’d imagine the cut off would be a fraction of the 30,000 per person per year of life that we spend on our own health.

    I am a director in the NHS and I am committed to both aid and health and social care to meet our essential needs. The truth is, we have the ability to add years to life and life to years both home and abroad. We also have the responsibility.

    • laurataylor says:

      Thanks Peter. That’s really helpful for understanding this debate a bit more, and it sounds like the media should be shining a spotlight on the pharmaceuticals as much as the aid industry. And you’re right, perhaps we could do a bit more to highlight the small costs involved in making basic improvements in health for so many. It’s great to have your thoughts as someone committed both to the NHS and to aid – thanks!

  2. I agree with the previous post but would also ask for a more compelling narrative around how helping developing nations is actually better for a sustainable global economy. Unfortunately moral arguments don’t seem to get much sympathy from a rather lazy and cynical media. Maybe a bigger picture which shows how less inequality and better global stability can help reduce domestic challenges?
    And of course we are assuming the cuts to public services are the only way of reducing public sector debt… The debate seems to have excluded a number of viable alternatives. Where do these debates happen now that the media reduce most compexity to a 2min segway or one on one slanging matches?

  3. laurataylor says:

    Thanks Tim, really interesting. We often chat here about whether we should stress the moral arguments for something we believe in, or if we should make the “self-interest” arguments. I noticed that David Cameron also argued that giving aid helped to prevent conflict and mass migration, which would have an impact on the UK. I tend to feel less comfortable with these as the perceived self-interest can often seem quite remote, even though completely intellectually compelling. I’d be interested in the thoughts of others? And I completely agree, it would be great if we could have some media time for a well-reasoned debate.

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