Samizdata

I saw this on Fraser Nelson’s Substack (it seems everyone has a Substack these days). The British journalist has been to Thailand with his wife, and noted this positive healthcare outcome in Thailand:

Thai private hospitals are a phenomenon. I had a foot complaint that had me hobbling around London for months, wearing trainers into the office. My local GP was of no use; I wasted money on private MRI scans and consultants trying to diagnose the problem. Nothing worked. But when I went into Wattanapat hospital in Aonang the problem was diagnosed, surgery carried out and completed all within 90 minutes. I felt like Lazarus for the rest of the holiday. In Bangkok, one of my friends had a trapped nerve in her leg – which was diagnosed and treated in two hours. She walked in without an appointment and was never unattended for more than a few minutes. Blood tests, x-rays, intravenous painkillers, specialist diagnosis, treatment pathway for when she returned home: all for 7,500 bhat (~£175). I was operated on by the same doctor who diagnosed me: they don’t seem to fragment it into specialities. I paid about £400. The UK has a good private health sector, but money cannot buy the integration or speed that Thai hospitals offer.

I found out later that people now travel to Thailand to bypass European hospital logjams. Most Thai private hospitals hold Joint Commission International (JCI) accreditation, a gold standard for global healthcare quality with ~350 standards for things like surgical hygiene, anaesthesia protocols, medical personnel qualifications and patient safety. I suspect most NHS trusts would fail to meet this standard, even though they cost far more money. UK private healthcare is more a premium-priced overlay on NHS infrastructure rather than a reimagined delivery model. Thailand shows what proper integration achieves: clinical outcomes Western healthcare once promised but increasingly fails to deliver.

I had the same frustrating experience in dealing with my own ankle/knee pain issues about six years ago, but unlike Nelson, I did not fly thousands of miles to get treated (which clearly has to be factored in for the health tourist equation to work. But then Fraser Nelson was in the country anyway on holiday.) I have private medical cover, but did not use it on this occasion, and got sorted with specially made insoles, and did physio and various exercises – including barbell lifts such as the deadlift – to strengthen my knees, and so forth. I am a lot better and feel fitter than when I was a decade younger.

Whatever the specifics, the example given from Thailand shows that the UK’s free-at-the-point-of-use system has major faults, because there’s less of a price incentive to focus on what people are looking for, and therefore fresh sources of supply aren’t drawn in. Prices are information carriers, and like a clogged artery, a healthcare system run on socialist lines can produce the national equivalent of a stroke. (This in some ways describes the economy of the UK.)

Healthcare needs a sharp dose of capitalism along with green veggies and a daily walk. Think of how under free market healthcare, technologies such as 3-D printing/processing scale up production, in a customised way, of items such as hip replacement parts, knee replacement parts, insoles, and other things. This tech already is being used, but under a more market-based UK system, this will accelerate. The toolkit that is promised by AI could really drive change in a positive way (and I am not as starry eyed about AI as some might be). Healthcare needs its Jobs, Dyson and Rockefeller.

Anyway , thoughts about health and wellbeing often crop up in the cold, post-Christmas days of January, so it is time for me to hit the weights. Wishing everyone here a happy 2026.