The Commonwealth Fund’s latest Mirror, Mirror report – which analyses how healthcare in the US compares with services in other rich countries – has downgraded the NHS from top spot to fourth position in its global rankings, citing increased patient delays post-covid and lack of investment as the main reasons for the change.

The NHS achieved top place in the Washington-based thinktank’s two previous reports, but now ranks behind Norway, the Netherlands and Australia.

The Commonwealth Fund report looked at the performance of healthcare systems in 11 countries. It found that the UK scored lower on three main criteria – access to care, care processes and the ability to obtain healthcare regardless of income – than in previous years, and most crucially ranked just ninth this year for health outcomes such as infant mortality and cancer survivability. For access to specialist mental health services, the NHS was the second-worst performer.

These findings will come as no surprise to some. Similarly negative findings emerged three years ago in How good is the NHS? – a joint report from the Health Foundation, the Institute for Fiscal Studies, the King’s Fund and the Nuffield Trust – which compared the NHS to healthcare services in 18 other countries.

This found that the UK had high rates of child mortality around childbirth, and that mortality rates for patients treated for cancer, heart attacks and strokes were also higher than average.

It also noted – despite the NHS doing better than health systems in comparable countries at protecting people from heavy financial costs when they’re ill – that healthcare spending was actually lower than the average, and that the UK had fewer doctors, nurses, CT scanners (8 per million population compared to an EU average of 21.4) and MRI machines (6.1 per million compared to an EU average of 15.4) than the other countries in the report.

Those pressures on staffing and resources continue to this day, made worse by the pandemic and helping to explain the downgrading of the NHS in the Commonwealth Fund’s latest report.

Just this week NHS Confederation policy director Dr Layla McCay told LBC there were 76,000 unfilled vacancies in England alone, while Cancer Centre London clinical oncologist Professor Angus Dalgleish told the same radio programme that the NHS was short of 40,000 doctors, with no funding in place to pay for them.

Soaring waiting lists are predicted to overwhelm the health service unless it receives a massive spending boost to clear the backlog and cover unfunded legacy costs, which could amount to £7bn a year according to the Office for Budget Responsibility. Health secretary Sajid Javid’s warning earlier this year that waiting lists could reach 13m now looks to be an underestimate, with a new analysis by the Institute for Fiscal Studies predicting a figure closer to 15m by the end of 2025.

According to reports, the Treasury is desperately trying to rein in spending aspirations during the current NHS budget negotiations, signalled by the department’s reluctance to finance the nurses’ 3 per cent pay deal with new cash rather than from existing funds.

Without that extra funding, the NHS’ performance is set to slide further down the global rankings. If further evidence is needed, just consider the following statistics from science website Our World in Data – published last week, only days after the release of the Commonwealth Fund report.

These figures show that six EU states – Belgium, Denmark, Ireland, Malta, Portugal and Spain – have now fully vaccinated a higher percentage of their populations than the UK, with the Netherlands already ahead on first doses and France set to exceed the UK’s tally of second doses shortly, thereby calling into question prime minister Boris Johnson’s claim earlier this year that the NHS’ pandemic response was “world beating”.

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