The National Health Service Crisis

by Kelvin Hopkins

Decades of Underfunding

The National Health Service is working under relentless and severe pressure which has been increasing year by year leading inexorably to the current crisis. This has been brought about simply by desperate underfunding inflicted by successive governments.

It is astonishing that despite the Health Service being  starved of resources it has continued to function, working miracles on its pitiful funding. It has worked through the Covid pandemic as well as ongoing pressures across the whole range of wider health needs, but we are all now facing inevitable shortages in provision despite the heroic efforts of the thousands of National Health Service staff who need all our support as never before.

The cause of these immense pressures can be very easily demonstrated by comparisons with other nations. Statistics published by the Health Foundation and the Financial Times show that average(median) annual spending on health in 14 EU countries between 2010 and 2019 was 21% higher than in the UK.

This was a funding gap of £40 billion each year, a cumulative total of £400 billion over the decade. This equates to £62 million for each of the country’s 650 parliamentary constituencies every year, over £600 million for the decade. It is not surprising that the National Health Service is struggling to cope with all our health needs despite the magnificent efforts of all NHS staff.

The enormous gap between UK health funding and that of other countries is a national scandal, nothing less than a social crime for which the present and previous governments must be condemned. The government knows that the only solution is a substantial increase in public spending on The National Health Service to meet the nation’s health needs and to begin to close the yawning and shameful gap between Britain and other countries.

March for NHS in London - Cropped

Health Provision Comparisons Between the UK and Selected Neighbour Countries

 The following statistics are taken from a 2018 report by The King’s Fund. They are selected to give the clearest picture of just how far we in the UK have lagged behind other European countries. In all  measures we are at or close to the bottom of the European league tables and far below the averages of the 14 comparator nations in the King’s Fund report.

Numbers Per Thousand of National PopulationsNumbers Per Million People
DoctorsNursesHospital BedsCT ScannersMRI Scanners
Germany4.113.38.13633
France3.19.96.11718
Belgium310.86.22312
Netherlands3.510.24.21412
UK2.87.92.697
Averages of 14 Comparator Nations3.610.24.32415

These statistics show in stark terms how far the UK has fallen behind other comparable and neighbouring countries in health provision. At their most extreme they show that Germany had 46% more doctors per head, 68% more nurses, 3 times more hospital beds, 4 times more CT scanners and a staggering almost 5 times more MRI scanners than the UK.

But the UK is far behind even the national averages of the 14 comparator nations on all measures.

While the data is correct only up to 2018, no-one is claiming that the situation has improved since then. Indeed, the numbers will have changed a little since 2018 but the comparisons will be similar. It is possible that the UK’s relative position may have further deteriorated and updated figures will be of interest.

Privatisation Inflicting Further Damage

The National Health Service has already suffered costly damage from creeping privatisation and it is now necessary  not just to stop this process but to reverse it. Private health  is much more expensive and less efficient than public provision. Those nations with largely private health demonstrate this beyond argument with the USA the clearest example.

Among the European nations Switzerland has predominantly private health and is far and away the most exceptionally expensive provision in Europe. A programme of insourcing of privatised components of National Health Service provision is essential.

We must stress that publicly provided health means not just health which is free at the point of need but also provided by publicly employed staff at all levels motivated by their commitment to the public service ethos and not employed by companies driven by the profit motive.

 

Indeed, the key reason why the National Health Service has coped as it has under enormous pressure despite decades of serious underfunding is precisely because it has been a true public service and thus much more efficient than private systems.

The precious and vital commitment of National Health Service staff must not be abused or put at risk by low or inadequate pay. The government must accept that public spending on health must rise substantially both to support staff incomes as well as to expand the workforce, bed numbers and health technologies to necessary levels. The massive gap in health funding between the UK and comparable neighbour nations must be closed.  

The isssues above and much more will be analysed in Rebuild Britain's Health Pamplet.