The United Kingdom and Canada are both modern, first-world nations renowned for the efficiency, quality and cost-effectiveness of their healthcare systems. Much of the healthcare is free at the point of service which means that patients are not responsible for any costs for any emergency medical assistance and most non-emergency medical assistance. Though the United Kingdom has consistently come top of the tables for its world-famous National Health Service, Canada also has a very strong reputation in this area.
So how do they stack up against each other, and what are the major differences?
It is first vital to state and acknowledge that there is no such thing as a national standard for Canada’s healthcare system. The structure, rules and organisations differ between provinces so that it almost as if each province has its own healthcare system. Then within those provinces, there are smaller differences depending on location. For the purposes of this article, we will be using Ontario as our example. It is also worth noting that different areas and groups in Ontario may have slightly different rules, so we’re using the GTA (Greater Toronto Area – the area and towns surrounding Toronto) as standard.
One of the biggest initial differences which affect patients who use these two services is the difference in cost. Though both are free for most services, there are significant differences in the amount of money a patient may need to shell out.
Canadian citizens who are residents in Ontario and also have their permanent and primary home within the province are entitled to the Ontario Health Insurance Plan – commonly known and referred to as OHIP. OHIP is the government-run health insurance plan for the ovince, and is funded by taxes from wages, taxes on businesses and from government grants. When a Canadian person sees a doctor for emergency or preventative care, their bill is sent to the government who pays it and the patient does not really need to be involved in this process at all.
In the United Kingdom, however, the NHS is 98.8% funded from general taxation and National Insurance. This means that the NHS is given a budget that it must stick to for the year, and dedicate resources accordingly. There is no ‘bill’ for each patient. Only 1.2% of funding is generated through patient charges. Patients who are not in full-time education, are employed, are not receiving any state benefits and who do not require emergency treatment generally have to pay for dental work, glasses, and less urgent medication such as cough syrup or nasal sprays. However, those on low income can fill in forms to have these costs returned to them by the government if their income is below a certain threshold. In Canada, this is similar and patients generally do pay for their dental and optometry requirements.
The real difference here, though, is in scale. Even when paying in full for dentistry in the United Kingdom, the costs are unlikely to break the bank. Emergency dental treatment from an NHS dentist such as pain relief or fillings is around £20.60 ($34.14). The most expensive treatments such as crowns, dentures and laboratory work are still only around £244.30 ($404.83). In Canada, patients are looking at around $133 just for a dental exam, with a basic clean costing around $144. Procedures such as crowns are significantly more expensive, with a single crown costing around $1625. Braces may set back a Canadian dental patient around $5000 as standard. In the United Kingdom, the NHS provide braces for free for under-18s, but adults may be entitled to free braces on a case-by-case basis depending on whether they are needed for medical or for cosmetic purposes. If paid for in full, braces in the United Kingdom cost around £2000 ($3314).
Another major difference in point-of-care treatment is the use of health cards. The Canadian health system absolutely requires patients to have an up-to-date health card. This shows that they are entitled to the treatment they are receiving, and there can be charges if this is not presented. Sharing a health card with someone else is illegal, and can result in imprisonment or deportation. In the United Kingdom there is no such scheme. This has resulted in some foreign nationals such as tourists or early-stage immigrants receiving free healthcare in error, but efforts by the government to force medical staff to carry out checks met harsh resistance from the medical community who stated that their role was to treat sick and injured people, not to act as border guards. The notion was quickly quashed.
Universally, Infant Mortality is used as the litmus test for the quality of a healthcare system. The Infant Mortality Rate is how many infants under a certain age per 1000 live births die. For under-fives, this is 4.9 in Canada opposed to 4.2 in the United Kingdom. The United States, bordering Canada to the south, has an infant mortality rate of 6.5 and is one of the only modern first world nations to have a rate this high.
The United Kingdom and Canada have similar psychiatric care statistics in terms of the patients it cares for. Both nations have 0.4 psychiatric care beds per 1,000 people in 2015.
The government of the United Kingdom currently spends 9.75% of its GDP on healthcare each year (figure from 2016), compared to 10.34% in Canada. This means that the NHS spends less money and achieves slightly better results; Canada suffers from poor access to healthcare for many people simply because many smaller towns and settlements do not have access to a local healthcare provider such as a doctor or dentist.
When all factual evidence is taken into account, both Canada and the United Kingdom have very highly performing healthcare systems which are free at the point of care in most cases, except very low priority medications or dental/optical treatments. Both have a good Infant Mortality Rate record, are relatively inexpensive in an emergency and have a low GDP spend compared to the high quality of the system. Both healthcare systems take great care to ensure that no patient suffers financial adversity from medical care, or is put off from seeking medical care for the fear of financial adversity. Where Canada has a poor record of access to care, the United Kingdom suffers from long waiting times for non-urgent treatments or appointments. Ultimately, both systems have a wealth of strengths, but have some areas which need improvement.