EDITORIAL OPEN ACCESS Journal of the College of Physicians and Surgeons Pakistan 2023, Vol. 33(01): 2-4 2 Prevention is better than Cure - Healthcare Systems in United Kingdom and Pakistan Irshad Nabi Soomro Department of Histopathology, Nottingham University Hospitals, Nottingham, United Kingdom Benchmarking identifies a system with superior performance, breaking down what makes such performance, and then comparing those processes to other system. Healthcare oper- ates on a business model where performance metrics need to be compared to the industry best performers. This helps imple- mentchangeswithsuperioroutcomes.Thiseditorialisabench- marking exercise between two healthcare systems. The idea is to measure the outcome of investment in healthcare in United Kingdom (UK) and Pakistan. TheCoronavirusdiseaseoccurredinWuhaninDecember2019, which spread all over the world within two months. 1 Other dangerousvirusesareEbola,Rabies,HIV,Dengue,HantaVirus, Rotavirus,Influenza,smallpox,andhepatitisviruses.Infections haveaglobalimpactduetoeasewithtransportationofhumans and animals, adding a growing list of global health issues. IntheUK,bytheendofWordWarII,theconceptofstate-funded hospital service was established. In 1948, national health service(NHS)wascreatedwhichprovidedpreventiveandcura- tive services. 2 The founding principle is free service at the point of use independent of color, creed, race, gender, religion, and based on need rather than the ability to pay. The NHS budget was £14 Billion at today’s price. This has increased to £277.6 Billion/year which is more than 10% of UK’s GDP. The US-based Commonwealth fund ranked NHS as the best of 11 advanced nations. 3 Data on healthcare standards is published by OECD, the organisation which brings together 35 rich nations. Life expectancy for males in UK has increased from 66 to 79.2 years and for females from 70 to 82.9 years in last 70 years. Doctors/- dentists regulated by GMC and GDC are 110,000 and 285,097 nurses are working for the NHS. Health board took control of 2751ofUK’s3000hospitals.Bythedayofitslaunch,94%ofthe public was enrolled in NHS. In 1951, the founder leader Bevan resigned in protest for voting to bring charges for dental care, prescriptions, and spectacles. Correspondence to: Dr. Irshad Nabi Soomro, Department of Histopathology, Nottingham University Hospitals, Nottingham, United Kingdom E-mail: irshad.soomro@nuh.nhs.uk ..................................................... Received: November 11, 2022; Revised: December 17, 2022; Accepted: December 20, 2022 DOI: https://doi.org/10.29271/jcpsp.2023.01.2 NHS increased life expectancy and liberated people from debt trap. Innovations made in UK with the second highest number of Nobel prize winners in the world. 4 Discovery of DNA (Watson and Crick), linking smoking and cancer (Richard Doll), invention of MRI in Nottingham, 4 first test tube baby (Cambridge University), vaccination programmes (Polio, TB, Diptheria, meningitis, HPV, hepatitis B, flu vaccine), screening for cancers, organ transplan- tation, emergency care pathway, transfusion service, robotic surgery, ultrasound, joint replacements, keyhole surgery, gene therapy, bionic organs, primary health care, genetic testing for cancers/rare disease, compensation for occupational diseases are to name a few. NHS has centres like the National Heart and Lung Institute, Great Ormond Street, Royal Marsden Hospital, National Orthopaedic Centre, Watson and Crick Institute and manycentresofexcellence.Newtrialsasprovenbyarecenttrial of dexamethasone on COVID-19 patients is possible in an inte- gratedNHS.Officeofnationalstatistics(ONS)hasdataoncauses of death. NHS database is key to health policy formulation and allocationofbudget.UniversitiesattachedtoNHShospitalshave benefitedpatientsinthediscoveryofnewdrugs,equipment,and tests. Next 10 year NHS plan will focus on digital and artificial intel- ligence, prevention of smoking, obesity, alcohol, air pollution, antimicrobial resistance and health inequalities. An ageing population is driving the demand within NHS predicting a financial hole of more than £30 Billion. There is a private sector creeping into the delivery of healthcare in UK. There are several screening programmes in UK. Five national adult programmes in the UK save 10,000 lives/year. Fifteen millionpeopleareinvitedandtenmillionpeopletakeuptheinvi- tation. This costs £660 million/each year. 5 Screening programmes include breast screening where 3 million women areinvitedforscreeningbyregionalcentres.Only2%willrequire a biopsy to confirm or rule out cancer. This is saving 1300 lives/year. Lung health checks involve computed tomography scansforheavysmokerstodetectlungcancerinitsearlystages. NHS cervical screening programme invites women between the agesof24.5and49yearsevery3yearsandages50to64every5 years. HPV-positive cases have colposcopy and biopsy. In 2018, a total of 4.46 million women were invited to reduce cervical cancers in UK. The bowel cancer screening is offered every 2 years to men and women aged 60-74 years. Faecal immunochemical test (FIT) kit is sent with a letter. The programme offers individuals with an abnormal result a colonoscopy and biopsy.