In the current climate with so much wrong or going wrong in the UK, it seems almost churlish to further criticise that ailing monolithic entity the NHS.
Since my brush with the four horsemen, see earlier entries, I have had plenty of time to analyse my recent appointments with the organisation. Clearl, in its current form it is largely not fit for purpose. So much is glaringly wrong that it is a question of where to start.
The obvious place is the GP surgery There is no doubt that a postcode lottery is part of the GP set up. Some people I know have a decent GP practice allowing same day appointments, phone calls and decent services all round.
My one falls into the ‘not fit for purpose’ category. Whilst they bombard you with requests to visit them for jabs and annual health checks for all and sundry the primary purpose of GP surgeries getting to see a doctor remains frustrating, time-consuming and if you are working nigh on impossible. The Blair contract was the start of a slide in service: he or his government gave the BMA all it asked for with no questions asked over the removal of weekend and after hours work. It became a five day 9-5 service with (in our case and many others) an hour for lunch.
Why was it allowed to fester and end up like this? The fact it is a ‘private’ though publicly funded entity is a part of the reason. GP surgeries use the private and NHS parts according to their needs not those of the patients; again not all but far too many do. The fact they are paid for the amount of patients on their books rather than those that they treat makes them the sole arbiters as to treatment and when it is administered, often it seems at their leisure.
You have the ridiculous case of the NHS bombarding people with adverts to go and see their GP with various serious ailments and then the same people not being able to get an appointment to have the problem analysed. This is plainly wrong and costly for the obvious reasons of delay in treatment and costs in treating the delayed treatment when in many cases the need has reached serious levels or cannot be treated at all.
Plus how come our GP surgeries have the information screens telling migrants they do not have to have any paperwork to get treated as our recently did? We pay for all this and we are not asked how our money should be spent. There is a mindset within the NHS that they know best on all matters, not universally but by enough to make the hairs on the back of your head stand up as happened to me at a routine health check a while ago when the nurse after being asked a simple question about a long wait for treatment smiled and said ‘it is free, you know.’ I did not dare say what I wanted to.
This early diagnosis and treatment which would save lives and money has been promised for years and little has happened. If it did happen there would be nowhere to put the patients anyway, there often isn’t now, as we have the lowest ratio of beds available to patients in Europe - Germany for instance has four times as many and France twice the number.
https://www.pgweb.uk/health/3546-comparing-uk-hospital-beds-with-other-countriesSome years ago the Conservative government decided to introduce a system that it hoped would see patients treated quickly and free up beds to save money. It has backfired spectacularly, with old hospitals like our local one being turned into flats and replaced by new ones with fewer beds. The crisis has been exacerbated by the rapid increase in the migrant population - our indigenous population has remained at the same level for some years, so the migrant problem has affected the NHS twofold: not enough capacity and not enough staff to cope with the increase.
Staffing is another issue and is as stupid as the lack of beds. The NHS employs more people than any other organisation in Europe yet those who manage it (if you can call it that) constantly clamour for more staff. Despite their constant denials it is clear something is wrong. Those that work on the front line will now tell you so - which they would not have done a few years ago, denying the NHS was anything other than the best in the world and saying they would defend it to the hilt! But now during my prolonged stay in hospitals and subsequent visits for myself and more recently my wife, they are much more forthcoming about the organisation’s shortcomings. The district nurse who treated my wife recently was one of many who having spent many years in all areas of nursing spoke of the multiple managers they now have compared with just one a few years ago. Again compared with the European counterparts there is a massive imbalance in the staff employed, something is badly wrong and again the patient/ taxpayer suffers.
The figures show we do indeed have a shortage of doctors, yet the system is not employing front line staff that are available. This is simply a case of lack of funds to employ them or so we are told, despite bringing in staff from third world countries that can ill afford to lose them. Something is very wrong here.
The infrastructure has been neglected for decades, Boris, he of the promises, said we were to build forty new hospitals; not one was built and now we have no money to build one. A local hospital, the Queen Elizabeth in King’s Lynn, has been falling down for decades and was recently voted the worst performing hospital in England. We now have almost permanent scaffolding and supports to keep some hospitals upright as well as having people sitting on the floor in A&E waiting. Truly third world status.
With cottage hospitals and convalescent homes a thing of the past there is no spare capacity so the shortage of beds crisis is now a problem all year round not just in winter.
There is no outside the box thinking with the NHS. On the Continent clinics built to provide short stay facilities and minor ops are very successful and take pressure off GPs and main hospitals. Many of our old cottage hospitals did provide those services but were subsumed into the big hospitals; we had a very well-used and successful one in Sudbury Suffolk when we lived nearby, but that was closed.
They are not the answer but would help, especially as main hospitals are suffering from bed blocking with elderly patients not being able to move as no suitable facilities are now available. With an elderly population this is a problem not going away anytime soon.
There is much made of the fact that the NHS are recruiting staff from the third world. Why this should be is a mystery, many qualified British nurses cannot get jobs yet are available and the folly of these decisions is the almost routine employment of expensive agency staff, all of whom left the NHS for better pay and conditions in the private sector in the first place.
One of the observations I made when in for my long stay was the difference in quality among nursing staff. Many of the supposedly qualified nurses from abroad are very much “one item at a time” people. They seem incapable of multi-tasking: a simple request made when passing is met with ‘I will see to that when I have finished this’ and the nurse is never to be seen again - quite a normal occurrence.
And the ward where I was sent before being discharged was full of them and also the same third worlders who took a literal age to do standard tasks. As an example we had the drugs nurse come round and he/she spent three and a half hours, yes really, to dispense to ten patients, starting at eight and finishing at half eleven. So importing staff creates problems as well as solving a few.
A common problem that many can relate to is the time taken to sort out what the problem is in the first place. Again here is a personal example: my wife started to suffer pain in her knee, it got worse and a doctor’s appointment was successfully obtained and the doctor sent her to a specialist at the hospital for diagnosis and X-rays. The result was not conclusive so another appointment with another specialist was made for two months later. All the time the pain was getting worse. The second diagnosis was also inconclusive and a few weeks later it was suggested another expert would have a look at it. This one actually knew what she was doing and thought the X-rays showed little and the problem was her knee. Fine but of course this required another X-ray appointment. That happened a couple of weeks later and lo and behold it was her hip, so back to the hospital for an assessment and the news that it needed a hip replacement. How long to wait? About a year, came the reply.
By now she could not walk but dragged herself around in increasing pain. No way could she go a year like that so with reluctance we went private.
As so many people are having to make the same decision the private hospitals also have a waiting list. On the day of the op it was discovered she had developed an infection in the leg and the op was cancelled. Six weeks later it finally happened, but the endless delays caused problems with further infections and it took an age to get her back on her feet such was the state of her legs after all the inactivity.
If the initial diagnosis and op had taken place quickly it would have been very beneficial to my wife and our bank balance as we are the most expensive in Europe if you go private. Even taking that route the delay was eight months which considering her condition was inexcusable, but we are are part of an army of patients in the same position. I could not imagine how she would have ended up if we could not have afforded to go private.
But the bottom line is what is to become of the NHS? For years any criticism was met with disdain, even up to Covid where the few were still banging pots and pans in appreciation of the few still working. In my area live many doctors of all types as we are near the main hospital. Most spent the whole period at home and the GPs in many cases never went back to a full week ever again.
In the mind of someone who has seen just a smidgen of the whole problem it is obvious that the long term strategy of the NHS needs to be laid out and big changes made. Advances in medical science means many more conditions can be treated and even eliminated, but at a cost. Can we afford it? In an ideal world we would say yes but we are not in an ideal world and we frankly cannot go on this route for ever.
So priorities have to assessed and approved. Many will like the outcome but it has to be done. The service has to be streamlined. Some services e.g. IVF cannot be seen as a God given right; those who want it must start to pay towards that and many similar elective procedures such as many forms of cosmetic surgery. I am sure readers can think of many other items to add.
The NHS is just that, a ‘national’ health service funded by British tax payers for use by British nationals. Where those CEOs of trusts get the authority to decide to treat the world’s illnesses I have no idea, but it is wrong. Nowhere else that I know treats outsiders for free, all have to pay - and if you are abroad you also have to pay for your own translators if you need one, they are not supplied for free.
The waste in the NHS from prescriptions to procurement is legion. As an example on a previous stay in the local hospital they had just been issued with new bleepers which worked rarely or not at all. It transpired that whoever purchased these never did in-house trials to see if they worked and the cost was £800,000. Again I am sure there are many who can give similar stories, a scandalous waste of other people’s money and it always is.
There is also the annual increase in compensation claims that have reached record levels. There will always be mistakes but is there an effort to reduce these often fatal errors? I recently had an acquaintance whose wife had a heart attack in hospital because no ultra sound was used before the procedure and the qualified doctor was absent when a camera was inserted which caught on a tear in the heart lining and caused an instant cardiac arrest. They have admitted liability for negligence but what of the young woman’s future?
Many of the NHS trust chiefs treat their charges as a personal fiefdom. In the wake of the Supreme Court’s recent trans decision ours recently announced she would not be complying with the ruling and the hospital would continue with trans women using women’s spaces. Just leave such stuff alone and get on with running a hospital! The rainbow flags on the roof and the PRIDE notices everywhere do not help anyone get better. Just stop it! There is no place for wokeism in hospitals or, as we have discovered, anywhere else.
There have been suggestions the current agreement with GP surgeries should be scrapped. They should be paid for the patients they see not those on their books, and maybe the whole ‘private’ make up of the GP set up should be scrapped and all of it should come under the umbrella of the NHS as an integral part. Anyone old enough to remember when doctors did home visits often at night knows what we are talking about. If the paperwork is weighing them down as claimed then change the set up along with the current failure in many sections of the NHS to inform other parts - they were still using fax machines until recently in some areas.
The NHS cannot fix everything. There is no health service anywhere that can fulfil the needs of all, and no amount of money can solve all the problems unless one wants a health service and no other public services. There simply isn’t enough money.
There was a glimmer of hope in some quarters when the current health secretary Wes Streeting made his first public announcements on the state of the NHS. He said no more money until reforms have been made. That lasted about two weeks when a delighted Wes was seen applauding in Parliament the giving of an extra £29 billion to the health service. As the leader of NHS England said most has already been taken up with wage demands. NHS England is to be disbanded over two years, long enough to find those sacked?
Another announcement, again from the health secretary is the listing of league tables as mentioned earlier. Why? We all know which local hospitals or medical services are good or bad, league tables will do nothing to change that and the poor patients have no choice in what they are given. The Brexit failure PM David Cameron promised, as they all do, that we would have choice in doctors hospitals and surgeries; as with everything else he promised nothing ever materialised.
There has been little to change the minds of those that believe the Conservatives were indeed heading towards a private health service. Only in the Tory Government’s dying moments was money put in to help slow down the decline, the classic “too little, too late,” and again there were no plans for any changes or reform. Perhaps they really did not want the NHS to survive.
And if this is an example of the ten year plan to fix the NHS we are in serious doo-doo:
https://www.telegraph.co.uk/politics/2025/06/29/supermarkets-told-to-cut-100-calories-from-shoppers-baskets/So either Wes Streeting steps up to the plate and actually makes some meaningful changes or we are screwed for even more tax payer funds to throw at a service that currently is not fit for purpose in many areas.
I’m not holding my breath.
