The NHS

I usually agree with the electorate whose opinions reflected  in issue polls are often more sensible than the views of government and opposition parties.

I agree with current polls that reveal a deep dissatisfaction with the NHS. I do not agree that the answer is more money. If only it were that simple. If more money on its own would fix it we would have fixed it this decade.

Spending on health has shot up from 2019. At £180 bn this year, it is £56 bn or 45% higher than in 2019. It is true prices and wages have gone up. Adjusting for this the NHS is receiving more than 20% extra. That is a much bigger rise than the Brexit savings on the side of the bus. They and tax rises have all been absorbed into the NHS budget.

The NHS will each year need some extra  money.We want nurses and doctors to be well paid and the NHS to be able to afford new medicines as they become available. It would help reduce the strains on the service if there was a large reduction in legal migration, as recent years  have brought in plenty more patients.

It is also true that in recent years there has been a big increase in non medical staff numbers and an expansion of senior grades of management. There has been a big drop in output per person implying the extra management has made the lives of those doing the medical work more difficult and bureaucratic.

More money should only be committed to achieve better outcomes for patients. We need better management, probably with fewer managers.

 

170 Comments

  1. formula57
    March 28, 2024

    How far away are we, in years, before a prime minister has to tell the British people that they have not been producing the wealth so they can no longer afford the NHS?

    Is anyone sensible confident that the NHS will see its hundredth anniversary?

    1. Everhopeful
      March 28, 2024

      And to my mind the very worst thing is that there are no truly private doctors anymore.
      All is regulated and drawn into the NHS fold. Effectively neutering any alternative.
      I don’t think one can now see a “private” doctor without GP referral?
      If any govt. really wanted an effective NHS it would encourage a private sector.
      But no…we had to decline into a global system which just doesn’t work.
      And which neatly bypasses those who were bamboozled into funding it.

      1. glen cullen
        March 28, 2024

        …and every NHS Doctor is also a Private Doctor

      2. hefner
        March 28, 2024

        If one has a private medical plan one can see a GP affiliated to such plan within 24 hours. The GP will charge £70 for an online appointment, anything between £60 and £250 depending on what a subsequent test might be (if required). And your NHS GP is unlikely to be told.

      3. Lifelogic
        March 28, 2024

        Yes but the GP will do this promptly as they get a fee to do so (from you or your insurance). The are nearly always happy to see fee payers and people away from home.

      4. Lifelogic
        March 28, 2024

        Well plenty around in the UK really for most conditions, but plenty of good ones overseas too in, for example, India, Europe, China, Australia, South Africa…

    2. Hope
      March 28, 2024

      JR, I thought the World health service bill was &248 billion just over welfare at £243 billion?

      Either way how is Hunt getting on to stop health tourism? Of the 3.5 million your party imported how many pay for health and NI and how many get it free? Same for those criminals in hotels or prison?

    3. Lifelogic
      March 28, 2024

      Why have they not been producing the wealth?
      Government is far too large and very poor value
      To many feckless scroungers encouraged by Gov. benefit policies not to work.
      Net zero rip off energy lunacy
      Over regulation of everything
      Open door low skilled immigration legal illegal
      Restrictive planning.
      Vast corruption and crony capitalism.
      The net harm lockdown and net harm Covid vaccines.

      equality, diversity, and inclusion
      A duff healthcare system.
      Taxes far to high and complex
      Far to many people in law, HR, diversity, admin, green lunacy… doing nothing productive and living of the backs of the productive.
      Public services police, NHS, roads… that deliver virtually nothing of value relative to cost.
      Failure to take advantage of Brexit
      All the woke and diversity lunacy.

      1. Lifelogic
        March 28, 2024

        Official figures have confirmed that the UK economy went into recession at the end of last year, after the latest estimate found it contracted in the last two quarters of 2023.

        We hardly surprising as we have such anti-growth, net zero, tax to death, big state policies from Sunak and Hunt!

    4. agricola
      March 28, 2024

      There is no problem with the ability of UK citizens to produce wealth. The problem is government with its hand out eager to take that wealth to the extent that it destroys the incentives to create it. They then spend what they take on failure.

      1. Lifelogic
        March 28, 2024

        +1 they spend nearly 50% of GDP much of it wasted and much of it doing active harm. Covid Vaccines, Lockdowns, road blocking, moronic rent controls in Scotland, net zero…

      2. Lifelogic
        March 28, 2024

        Well one problem is Suank’s Net Zero lunacy, which is giving us some of the most expensive energy in the world circa 3 times that of the USA. Not so easy to compete given that, high taxes, daft employments laws, restrictive planning, very high taxes, poor public services, expensive housing…

    5. Ian B
      March 28, 2024

      @formula57 – how long will it be before a prime minister gets to tell the British people that their Government has trashed the economy as they didn’t think having a healthy economy was part of the job. When will they say to provide the services we/they desire, even the NetZero insanity, we must first have a strong, resilient economy.

    6. graham1946
      March 28, 2024

      The Tories never wanted it in the first place, so, no is the answer.

  2. Mark B
    March 28, 2024

    Good morning.

    The only people demanding more money for the NHS are those on the Left and the Labour Party. Why ? Because that is where their funding comes from via the unions – Simple. It is not about patient care otherwise there would not be the long queues to see a doctor or at A&E.

    Back in the 80’s we saw Labour fight tooth and nail for the miners and others in industry. Not so now. Today we see the Left / Green doing all we can to prevent coal from being used. They don’t need those former miners, their families and ‘communities’.

    It is time we started calling Labour and its apologists out.

    1. Michelle
      March 28, 2024

      ++++
      What a shame those Labour voting stalwarts can’t work that out.
      What a shame the Conservative party doesn’t point it out to those people.

      1. Berkshire Alan
        March 28, 2024

        Michell
        The Conservatives are absolutely hopeless at communication with the Public, both Government and at Local Authority level.
        The narrative is all from Labour and the LibDems, and especially the LibDems at a local level.
        Hence the reason this site and our host is an oasis of information !

    2. a-tracy
      March 28, 2024

      My surgery doesn’t have a long queue to see a GP. Telephone appointments are also a good addition to the service in my opinion. Senior Nurses to see people with verruca, ear infections, one-off sore throats, eczema, doesn’t trouble me either, we’ve had women’s clinics for years for contraception, smears, and maternity care provided by nurses.

      Have you personally had a problem going to see a GP this year?

      1. Berkshire Alan
        March 28, 2024

        A tracy

        Almost impossible to get an appointment here in Wokingham.
        Ring at 8.00am typically told you are 30th in the queue, hold for 45 mins then told all appointments for that morning already taken, suggest you ring back at 12.00 midday to see if you can get an afternoon appointment, same thing then happens, system will not allow you to book any further in advance, and they wonder why some people get frustrated and turn up at A&E with minor problems!
        If you are lucky enough to get through and ask for a telephone consultation you are advised, Doctor will ring you back sometime this afternoon, probably between 2.00pm – 5.00pm. thus you either need to wait in all afternoon, or be prepared to talk through your problems on a mobile phone, when you could be at work, or on a train etc.
        Above is a real life experience by a family member only 3 weeks ago, they eventually went into the office toilets to chat in some privacy !!!!
        What a fiasco of an organisation, hardly patient friendly is it !

        1. a-tracy
          March 31, 2024

          No, Alan, that is not patient friendly at all. I don’t agree with the 8am phone race, we have an app called patient access, people have been in the surgery helping people to load it on the phone and show how to use it, the more of those with smart phones can get onto that system the better because you can order medication on it without having to phone in at all, you can also view your own historic medical records and it says you can book a GP appointment, I’ve not tried it on there yet.

          I know the problem with the GP call back because not all workplaces allow you to have your mobile phone on at work and you have to ask for special permission to keep your mobile on to take that GP call.

          I used to be able to send in an online consult with myGP which I liked but my surgery has recently stopped this which is a great shame. I have not tried to get an appointment for several months, so I went onto my app today to see when the first appointment I could book is and there is one available on Mon 22 Apr! for a telephone appointment (you couldn’t book an in person appointment that way which surprised me) and there are seven available the following day, not much use if you need an urgent appointment.

          My parents seem to be able to still get appointments when they call but then they do have time to sit and just hold on the phone waiting for their call to be answered not possible if you work and they can just immediately take any appointment slot they’re offered.

      2. Wanderer
        March 28, 2024

        A-Tracy. Count yourself lucky. My surgery’s website has no free appointments for the bookable future. I will have to go in and face a receptionist. Can’t get through on the phone.

        1. a-tracy
          March 31, 2024

          I’ve discovered today the way I used to get an appointment has changed as my practice have stopped responding to the myGP online consultation. I’ve not tried calling for a while which is why I asked if Mark had a personal problem getting through to get an appointment or is just going off what is in the media.

      3. Everhopeful
        March 28, 2024

        If you were a turkey, you’d just love Christmas!

      4. Know-Dice
        March 28, 2024

        How do you get an appointment?
        Do you just phone or do you have to use an “app”

        We HAVE to use an app called Anima (should probably be called enima) it’s a useless piece of psudo AI that asks you the same question in a multitude of different ways to waste your time. But the biggest issue is that our GP limits the number of requests per day, which really is not on. No wonder A&E is the best choice.

        1. a-tracy
          March 31, 2024

          I used an app called myGP after this blog convo, i checked today to see if it is still available it isn’t. So I went on the new Patient Access the first telephone appt available on there is 24 April 24 not good.

          I’m beginning to wonder if phoning 111 is the only way if you are seriously poorly if people can’t get through to their surgery but I was told our surgery had a new phone system and if it was engaged you could request a call back and they would call you back rather than you queue.

          I’ve asked this weekend at a family gathering, when I asked people if they have problems getting to see a GP, the younger ones if they can’t get through use online GP appt that charge £39 and/or a private face to face appointment for around £45-120 (depending on date and time) which is a bit troubling I hadn’t realised they were doing that.

      5. Mickey Taking
        March 28, 2024

        You have got to be joking ….over 70 or whatever, we have a named Dr assigned. In Wokingham my wife and I have not met the last 3 assigned to us, and we didn’t have the same one anyway! That tells you how quickly they move on.
        I did get an appointment a couple of years ago (I suspect the voice on the end worried about UTI or sepsis) and a stand in was very helpful. I suppose we have better health than most late 70s, but hear about the lack of service to so many others.

        1. a-tracy
          March 31, 2024

          My husband will call and get an appointment. He prefers to call at 10am than 8am and he just goes to see any doctor they have available at a time to suit them. People in my office also call often after 9am and get appointments in different surgeries. The last time our family used emergency service cover was Christmas, called 111 seen quickly in A&E and prescription issued. I can only go off what I experience.

      6. Mark B
        March 28, 2024

        Two years ago when I had a clot in my leg it took 5 hours to see me and I ended up spending a total of 11 hours before I was discharged. The doctor and nurses were brilliant, but clearly overworked.

        If Labour did not get any money from their unions do you seriously think they would be banging on and on about ‘their’ NHS ? See my example above for a clue 😉

        1. a-tracy
          March 31, 2024

          The last time I used A&E I had a terrible experience, I called 111 they told me to make an online booking at the hospital, I made the booking it gave me a time slot for that same afternoon, I came out of work and drove there to meet the allotted time, the computer said no, when we got there and they said I hadn’t made an appointment, it was still there on my computer screen when I got back with appointment booked, date and time, I screen grabbed it and made a complaint, nothing came of it. However, I did get through to my doctors surgery, they gave me a referral to another hospital unit and they fit me in later that day and I was seen speedily.

          I really don’t like the way politics is tied into the NHS, we pay NHS managers to look after us. Considerable sums of money often more than the PM and cabinet MPs are paid. Yet take no responsibility. Health was devolved its just as bad in the devolved areas like Manchester and Wales so no I don’t believe Labour have any magic management either. They are just there to reward their union paymasters and doff out more money for less which is why we end up with less and less service for more and more cost.

  3. Peter
    March 28, 2024

    Agreed, but nobody has taken action to reduce the number of managers and boost actual medical work.

    So we are lumbered with useless roles like diversity managers. People grumble. Nothing happens.

    1. Dave Andrews
      March 28, 2024

      The diversity managers are demanded by the Equality Act. This is what needs reform, but the government isn’t interested in that. At least remove the vicarious liability element for employers. The thing is, the judiciary likes vicarious liability, as long as it doesn’t apply to them. Woe betide if they were held accountable for their part in condemning innocent postmasters.
      So employers need diversity managers to monitor and implement their policies, as there is a high probability a chancer will exploit the compensation claim industry, landing them with high administrative and legal costs.

      1. Lifelogic
        March 28, 2024

        Indeed – almost every thing seem to benefit largely parasitic lawyers and similar. People who actually do things of value, builders, doctors, shop keepers, farmers… however?

    2. Ian B
      March 28, 2024

      @Peter – their management their bosses, the ones that steal the money to distribute to them have all departed, they are off on road trips, the ‘look-at-me’ ego self-esteem stroking media exposure trips. Running the Country is not for them, they are to busy electioneering, then the best they can come up with is after 14 years we have a proven track record, and the other crowd would be worse.

    3. Peter
      March 28, 2024

      Meanwhile another privatised company in trouble, Thames Water up **** creek after investors decide not to put money into the firm.

      Thames Water want to continue to pollute, but still draw dividends and escape fines from OFWAT.

      I had credit on my account with them. They said they would use it against future bills. I demanded an immediate refund and a change in future direct debit amounts.

  4. Lemming
    March 28, 2024

    14 years. You’ve had 14 years. If the NHS is no working – and it is not – there is only place to put the blame. The Conservative party

    1. Lifelogic
      March 28, 2024

      An organisation that thinks making all ambulances electric by a certain date and is obsessed by diversity and net zero is clearly run by complete and utter morons. The health minister is a lawyer and the CEO has a history degree and has worked in the dire NHS for most of her life. The last one was a PPE graduate. Almost any of the doctors they have would do a better job.

      The first thing to do is to encourage more people to go privately with tax breaks and payments to people on waiting lists to go privately. This so as to take the strain of the NHS. We also have the problem that GPs are pushing patients on to A&E and A&E onto social care or 111 and visa vera. People pushed from pillar to post all the time but the pillars and posts are all government funded anyway. If something is free the only way to control demand is by delays, inconvenience, phone queuing systems, huge waiting times… so that is what we get. If an A&E in london got a reputation for under 10 minute queues they would get inundated by everyone needing care in London so they have to run 3 hour plus waits and all do.

      The system fails employees too. My relative a junior doctor in Central London with about £100k of student debt gets about £2600 PCM take home pay. He has zero disposable income to live on after rent on a small room, student loan interest, commuting costs, council tax, prof. fees… he does not even get parking at work despite often needing to worth long & antisocial hours when public transport commuting is difficult. Not even decent lunch facilities. His two flat mates are on three time the gross salary in banking and law and with far less student debt.

      The money needs to follow the patient. Ditch net zero, diversity and asking men if they are pregnant would save a bit. Fair competition between state and private is needed. Not a dire enforced state monopoly. We have you money already in advance so you will get what you are given if and when we choose to give it to you. So lump it mate or piss off.

      1. JoolsB
        March 28, 2024

        Your relative, my son, both Junior Doctors who can’t afford to live on what’s left of their salaries. £1,000 a month for a room with utilities on top is nothing in London but a huge chunk of their take home pay after tax and 9% student debt. STEMM subjects should not be coming out with any debt. What many don’t realise is they also have to pay for their own equipment, courses, BMA membership etc., things our greedy MPs would automatically stick on their expenses. (Along with their London accommodation and utilities).
        What the politicians also don’t tell us is Junior Doctors are leaving in their droves. Whilst they pay themselves above inflation pay rises year on year (MPs salaries have gone up 42% since 2010, Junior Doctors down 20%), they are too busy trying to turn the public against Junior Doctors and trying to blame them for the almost 8 million waiting list which was going up long before the strikes due to their ludicrous and disastrous two years of the NHS being nothing but a National Covid Service plus letting 1.2 million people enter the country every year.
        They are not militant as this Government is trying to paint them, or to be treated as naughty children, they are too highly trained for such insults, but they are struggling under the strain and at least they realise if they aren’t appreciated and paid better, even more will leave. Retention is as much a problem as pay.
        My son spent six years training and three working as a Junior Doctor in busy London hospitals and yet we as pensioners are still having to help him financially. He has now decided to quit and starts a better paid non medical job in the city soon. Out of the one college he went to in Cambridge, three of his fellow students studying medicine have now also left the profession and two have gone to Australia. If this is replicated across England, then we are in dire trouble. And what a waste of talent and it is all down to this ignorant Government who refuses to even talk to them. Their answer instead is to keep importing more and more from third world countries. I live in rural Cornwall and couldn’t believe my eyes recently when attending an appointment at our main hospital in Truro. They were having a recruitment day and there must have been 200 applicants waiting in the reception. I was told they were all from Nigeria. They had been bussed in, probably from the airport. They would rather spend our money on flying people in from around the world than look after our home grown talent.
        Your clueless out of touch Government disgusts me John.

        1. Paula
          March 28, 2024

          Jools

          That 20% cut in doctor pay (by inflation) means that the standard of living that my son was promised at the start of his six year course has not materialised.

          The Tories are keen to slate junior doctors over the odd strike day but never praise them for the 20% of hours they do free of pay.

          He and his fiancee (also a doctor) have applied to Australia as have many in their cohort.

          The Tories must never be allowed in power again. Certainly not the born-to-rule Etonians.

        2. Lifelogic
          March 29, 2024

          MP also, unlike doctors, get there commuting on expenses, free parking, subsidised bars, restaurants and childcare.

      2. Cynic
        March 28, 2024

        Ll, very good analysis and sensible improvements. Trouble is it needs a sensible government to enact them.

      3. Lifelogic
        March 28, 2024

        “payments to people on waiting lists to go privately” is a win win. You give them say 40% of the costs thus saving the NHS 60% they get treated sooner and perhaps get back to work and paying taxes. Others on the waiting list get earlier treatments too as the waiting list is reduced. Plus you expand the overall medical facilities in the UK attracting more doctors and surgeons and other medical facilities and encourage innovation in the sector.

      4. Mickey Taking
        March 28, 2024

        Do you not realize ‘encourage more people to go privately ‘ merely halts the long wait in the queue so that the patient who has the money can jump the list often using the same consultant/surgeon? So that will improve NHS service to the ordinary person with needs?

        1. Lifelogic
          March 28, 2024

          Well the NHS need to ensure they are getting the right level of work from their consultants if they are doing private work this obviously need to be in their own time. Many might use overseas consultants.

      5. Lifelogic
        March 28, 2024

        Rishi Sunak: “I inherited ‘worst hospital pass’ for a new PM in decades”

        But Sunak, most of the problems were caused by an earlier Chancellor on Rishi Sunak who together with the BoE caused all the inflation, botched Covid with net harm lockdown, vast waste and net harm vaccines. Further problems caused because nearly all your policies are 180 degrees wrong:- Government too large and delivering little of any value, energy policy and net zero insane, taxes way too high, lies about having cut taxes, Covid Vaccines being unequivocally safe, stopping growth, growing the economy, housing policy, cutting NHS waiting lists, repaying government debt, cutting crime, controlling legal and illegal immigration, all the woke and diversity insanities…tell us one success Sunak?

        Even the dire Teresa May delivered one positive – opt out organ donations alas everything else she did was a disaster.

        Sunak must go as must all these policies. No one trust a word he utters or any promises he makes. He is a dim head boy – totally out of touch with the people and reality. So dim he has not even worked out just how much net harm the Covid Vaccines have done or how to stop the boats or reduce crime by using suitable deterrents.

        1. Lifelogic
          March 28, 2024

          Plus Sunak you had a decent majority. It is nearly all your own fault and the fault of Gove types and your MPs whom, like yourself, are mostly deluded, green crap pushing, tax borrow and piss down the drain socialists.

      6. Paula
        March 28, 2024

        Indeed. A doctor’s student loan amounts to an extra £200 a month tax on someone still living in student type digs aged 26.

        And no. An eventual £120k a year salary after 22 years in post and huge amounts of training does not cover for this, the extra years of study without pay and nor the extra ten year’s of time off the housing ladder that a plumber or a train driver would have avoided by the age of 30.

        In terms of wealth it is a damaging career for both parents and doctor.

        1. Lifelogic
          March 28, 2024

          Indeed no chance of buying a small house in London even with a pair of doctors without huge parental assistance before say 45. After the women is usually well past her fertility period.

        2. Philip Haynes
          March 28, 2024

          And future generations, as many simple cannot afford buy a flat or house and to have children until it is too late for them (or the women) to do so. Fertility drops off very rapidly indeed after about 34 for most women.

    2. Berkshire Alan
      March 28, 2024

      Lemming.
      Not much else to say really is there !
      Just add it to the list of other failures.
      Illegal and legal immigration.
      Waste water pollution.
      Failure with power generation.
      Highest taxes in 75 years
      Highest debt in 75 years
      Criminal justice system broken.
      Social care system broken.
      Net Zero farce.

      1. Lifelogic
        March 28, 2024

        +1 UK Defence dire too. We even have a UK general who actually tells the World that the UK military ‘couldn’t fight Russia for longer than two months’!

      2. Everhopeful
        March 28, 2024

        On the bright side though…ah hem!
        Les jabs can now be bought on the High Street for £98.95 a throw.
        Open to all over the age of 12.
        A fire sale?

      3. Lemming
        March 28, 2024

        Exactly Alan! But let’s be fair, we should also list all the successes …. oh!!

    3. Lifelogic
      March 28, 2024

      The NHS has needed reform all my adult life. Thatcher did at least have tax breaks for company and private health care cover but she failed to reform the NHS sensibly. Now to take private healthcare insurance you have to pay four times over. In taxes for others, then in extra taxes to earn enough more for the medical insurance, the. the insurance premium itself then 12% IPT on top. Will be the same with private schools under Gove & Starmer thinking but with 20% VAT. They might even start putting VAT on private healthcare too – so obsessed with the evil politics of envy are these mad socialist and Con-socialists .

      1. Berkshire Alan
        March 28, 2024

        Lifelogic
        Indeed and the stupidity of those in charge forget that those using/going privately, both school and health, leaves more room and shorter waiting times for those who need or want to use either the NHS or the State School system.
        Difficult to make it up really !

    4. MFD
      March 28, 2024

      No mate! It is not that clear cut, we now have too many visitors who come to Britain solely to use the NHS. We MUST start to charge these people, there is the ability in the system but the leftie administration personnel do not use it, this attitude encourages more.
      A big part of the recovery would be to start charging those who have not supported the NHS during their working life.
      Admin does need tightened but they must stop the charity to the rest of the world. For instance, we cannot afford Saudi wives draining our maternity departments!

    5. a-tracy
      March 28, 2024

      I blame the NHS management, health has been devolved to other regions and mayors, they welcomed the responsibility but don’t want to be held to standards. We need to know precisely which trusts are failing because I know some areas are getting excellent services.

    6. graham1946
      March 28, 2024

      What we have now is the Tory version of the NHS. It was re-organised by Lansley in 2012 and made worse by Hunt in succeeding years. Politicians should butt out, it is not their plaything, neither is education. Know nothing politicians should not be allowed to meddle. Get some good quality industrial experience people in and we may get somewhere, otherwise the NHS is doomed.

      1. a-tracy
        March 31, 2024

        Graham, I agree the NHS management are a doomed lot. They have no ideas, they blow money willy nilly on bank staff rather than getting more staff trained in shortages that we require, agency staff are all NHS staff that use the opportunity to do the minimum for the NHS whilst retaining the very good pension then get overtime at double the hourly rate without the pension contribution or NI to top up their income. They don’t train enough UK doctors, they need to train more working class brightest of the bright kids.

        John, when I read about Junior doctors after five years difficult training often requiring 3 As at A level to get on the course so you’re only training the absolute top, expecting them to take a starting salary only £1000 above a 3 year degree qualified nurse who could get on to that course with much lower educational levels is insulting and not sustainable, when the very bottom rung at age 21 is guaranteed £22,308 for 37.5 hours per week or £23,795 this give you the floor of expectation. You should have put this FY1 and FY2 grade up in line with the NLW have you?

        I noticed that lawyers after 3 year degrees and a 4th year law MA pay is £22,550 for first-year trainees. £26,125 for second-year trainees… this whole thing is about to go 💥.

  5. Everhopeful
    March 28, 2024

    It is constantly being put about by the far left ( you can see it in videos) that the “cruel” govt. starves the NHS of funds.
    Surely the rebuttal would be ( in the high profile press) EXACTLY how the money is spent?
    I bet the vast majority of people have no idea!!
    But I have yet to understand why the present govt. doesn’t fight its corner robustly.
    It rather suggests that all is going according to plan?

    1. Lifelogic
      March 28, 2024

      But the government is pushing this vast waste on diversity, net zero and other lunacy. They also pushed the net harm Covid vaccines (even for people who had zero need of them) that have increased demand hugely, especially for Cardio Vascular, strokes, cancer and other treatments. Far more on long term sick now too.

      But Sunak still says they are unequivocally safe. So either he has not looked at the clear cut stats. or got anyone else honest and competent to do so or he is just lying.

      1. Everhopeful
        March 28, 2024

        Yes. That’s what I meant by “all going to plan”.
        Plus various “treatments” never dreamed of by Attlee.
        He would say that wouldn’t he?
        Not going to “do a Ratner”.
        And I guess if the mask slipped for one mo into even the slightest doubt…all Hell would break loose?

    2. Michelle
      March 28, 2024

      ++++

    3. a-tracy
      March 28, 2024

      Quite right Everhopeful I agree.

      Greater Manchester had a £6bn ‘devo health’ experiment in 2016, Tony Lloyd the then interim mayor believed it allowed the area to tailor services on a hyper-local level, you know the sort of thing Starmer wants to do ‘Labour will shift power from Westminster to local communities” yet when we do they still don’t take responsibility for the failures.

    4. graham1946
      March 28, 2024

      It is not helpful for govt. or JR to simply state a big sum of money which is meaningless. We need to know how much per capita is spent on health, but they shy away from this as they probably don’t even know how many people are here. I’d say it is well north of 70 million already, but they only cater for 68 million. The supermarkets probably know the truth better than government does.

  6. Sakara Gold
    March 28, 2024

    If it is government policy to ship in up to 1.5 million migrants each year plus an indeterminate number of illegals – and then provide them with free health care – of course the NHS will be overwhelmed.

    With waits of 10 hours in A&E, two weeks to see a GP, junior doctors constantly on strike because they can’t afford to pay their student loans and shortages of many medicines, little wonder the electorate has had enough.

    The public tolerate the insane tax levels that they are subjected to because of their NHS.

    1. Michelle
      March 28, 2024

      I agree fully with your first paragraph.
      This is not just the illegals but the legals too.
      That has gone on since Blair opened the borders coupled with a refusal to provide for training of our own medical students.
      The mainstream media never make this a point and the Conservatives don’t seem to want to make it a point either because they have carried on the policy.
      Bring staff in from outside, and often with unpleasant consequences for patients.

    2. Mickey Taking
      March 28, 2024

      It all starts where triage doesn’t exist. Most can’t get through the telephone call roadblock. Then pressurize the diary fixer to offer an appointment, but usually just a call back by a Doctor. A brief discussion mostly a prescription but if ‘lucky’ an actual visit to see a GP – often a duty doctor not the one you might have assigned to you. Then an opinion is offered ‘take the pills, give it time’ – you have to INSIST on a referral. Grudgingly you might be lucky, often offending the GP. Some weeks later a clinic appointment at a hospital, another wait – they are running late. If the problem needs intervention you might be told, but there will be a queue normally felt to be unsatisfactory. Finally something gets done and you become aware that ‘it should have received attention a while ago’.
      In some cases it is unoperable, and even terminal. This is the experience more and more have.

    3. Lifelogic
      March 28, 2024

      Exactly but the main people “tolerating” the insane tax levels are those circa 50% of households who are on low incomes and pay far less in than they get back in immediate benefits for rent, council tax, prescriptions, schools…

      1. Lifelogic
        March 28, 2024

        Many of the others, the higher tax payers, are leaving the UK, stopping working or spending more time tax planning.

  7. DOM
    March 28, 2024

    Throwing more cash at this dinosaur is not a serious proposal but another act of politics. What is required is a leader with political will.

    Maybe employ a diminutive Argentinian with big cojones and a chainsaw cos the entire public sector that is now a Socialist haven and heavily unionised will fight tooth and nail to preserve its privileges?

    1. Everhopeful
      March 28, 2024

      It does seem that with their clodhopping ineptitude that man WILL come!
      Exactly what all the post war years of govt. have been dedicated to stopping!!
      What a tragic waste.

    2. Lifelogic
      March 28, 2024

      Political will a working compass, someone who is trusted and has some leadership ability. All are lacking with Sunak and indeed with Starmer.

    3. a-tracy
      March 31, 2024

      Wasn’t that supposed to be Dominic Cummings job! They destroyed him over a drive during covid.

  8. Everhopeful
    March 28, 2024

    Apparently one can train to be a phlebotomist for £150 or so on an online course.
    They want to expand ( no doubt following orders) all these tests and things with digital possibilities like blood reading and blood pressure etc.the better to further upset and worry us.
    So ( never having learned a thing) they bring in loads of scarcely trained people….

    1. Everhopeful
      March 28, 2024

      Also the medical tracking will make ID tracking/imposition easier…everything ready in place. My sister spends every waking moment looking anxiously at her phone texts to see the latest diktat from her surgery. She was a proper nurse back in the day and she takes all the lowered thresholds seriously.” Yes last week we wanted your bloods to be xyz…this week we want zyx or it’s medication for you! Hop on the scales…a bit more humiliation….”

  9. agricola
    March 28, 2024

    First I would like to say that in recent personal experience that in a medical sense the NHS is a highly competent and compassionate service. The problem for the waiting patient is being allowed close enough to experience it.

    I judge that the GP service, apart from being a sensible filter for patients into the hospital service, is also used as a delaying mechanism to reduce pressure on the hospital service. The nett effect in many cases is that the problem to be dealt with has been allowed to grow more severe and the outcome less successful.
    That the service is over burdoned with costly administration, with 47% of all those the NHS employs being none medical, is beyond question. That many are now the woke fashionable Diversity and Inclusion parasites is very PC , but politically and criminally incompetent that such a debilitating disease should have been allowed to infect the NHS.

    Comparisons around Europe and the civilised world should be made to judge, efficiency, outcomes, and value for money. Is National Insurance to continue as the faux way of paying for it, or would ring fenced insurance be better. Is the purchasing of capital equipment and consumables as professional as it should be, does it involve value analysis. Has waste ever been audited as it should be.

    Are the pay and conditions of the medical staff consumate with their training and responsibilities. Should all the support services to the NHS be contracted out or in house. Are we training enough of our own medical staff from those who are academically capable and wish to train. Are we right to burdon them with debt for such training when the country needs them. Should we offer good quality accommodation in the training years to full qualification. All this chapter’s remarks apply to all the the parallel medical professionals, radiographers, pharmacists, physiotherapists who support the front line.

    In such an investigation nothing should be sacred or party political or for that matter be private and last more than six months. You could manage it before the next election, so action today outside the influence of the civil service, who no doubt have their wet sticky fingers in the running of the present disaster.

  10. Hat man
    March 28, 2024

    I quote from a government web site:

    ‘it is the government which sets the framework for the NHS and which is accountable to Parliament for its operation.’

    Your party has been in government for 14 years, and has had a healthy majority in Parliament for much of that time. It may well be that the big increase in non-medical staff and the drop in productivity were the result of some bad decisions being taken, presumably by NHS Boards of governors in appointing unsuitable people. But then, isn’t it in the government’s powers to deal with that? Couldn’t the government have introduced an NHS Bill in Parliament to reset the framework accordingly? It didn’t do that, so the impression conveyed is that it was broadly happy to see a lot more money being spent on jobs for the managerial class, and on outsourcing work to private agencies. Now your party in government is being judged on its record, and if a majority of people are dissatisfied, it’s not surprising.

    1. IanT
      March 28, 2024

      “it is the government which sets the framework for the NHS and which is accountable to Parliament for its operation.” And in many ways this is the problem HM

      The “Govermment” does not actually manage these health ‘businesses’ – either at Central NHS or NHS Trust level. I’ve had dealings with managment at both levels, albeit many years ago now but I very much doubt anything has changed too much.

      The Trusts (there are now 219 in England) operated as their own fiefdoms, quietly ignoring policy (such as central purchasing advice) when it suited them. There were also patent differences between Trusts in the quality/style of their management, something that anyone who has dealt across the NHS should be able to confirm. It is a very big mistake to see the ‘NHS’ as a single unit. It isn’t and management standards vary widely across Trusts in my experience. Some were very capable and straightforward to work with, others really dreadful (managers effectively hiding behind endless Committee meetings for instance). Service levels are therefore very much a post-code lottery in my view. We need the media and public to be very much more critical of both Central and Local NHS management, as we would with the management any other commercial service provider.

  11. Ian wragg
    March 28, 2024

    The NHS forward staffing proposals suggest that in the next few years total employed will be 1.5 million.
    How can we afford such a monstrous entity whose productivity us so poor.
    We still can’t get to see a GP only telephone appointments if your lucky. Then it’s with nurses or pharmacy staff. The GPs have gone into hiding.

    1. Roy Grainger
      March 28, 2024

      And yet GPs are paid so much in the UK (compared to the EU) that they’re having to have special pension arrangements to stop them retiring early. And junior doctors demand a 35% pay increase otherwise they’ll move to Australia. What they don’t mention is that the reason Australia can pay them more is they have exactly the type of public/private insurance based system that they explicitly campaign against in UK.

    2. agricola
      March 28, 2024

      Ian,
      And on current divisions of employment in the NHS 705,000 of them would be scribes. Utterly insane.

  12. Javelin
    March 28, 2024

    Bidenomics and The UK UniParty’s unelected, undemocratic policies of Wokenomics and NewSocialism is heading for a market meltdown in the USA and then in the UK. Interest rates globally will rip and drive the world into recession.

    Wokenomics as part of the NewSocialism needs the money to keep paying for Diversity Equity and Inclusion, NetZero, mass migration of low income uneducated multicultural people, Authoritarian Lockdowns and a Censorship Industrial Complex to keep a lid on it all has taken the USA from a steady 400 billion debt interest annually (2006-2020) and now up exponentially to 1.1 trillion debt interest in 2024, and its going up by 300 billion every year.

    You can’t buck democracy with the new virus signalling ideology of NewSocialism and wokenomics.

    1. Mike Wilson
      March 28, 2024

      You think interest rates will go up? Everyone else is expecting cuts. What’s your thinking? Given the huge government debt in the USA, surely they will be cutting rates soon.

  13. Sir Joe Soap
    March 28, 2024

    Unfortunately another failed subject for the Conservative government 2010-2024.
    Enormous cash injections for a worse service. The simple point is that unlimited demand from worldwide patients largely paid for by about 4 million UK better paid loyal funders and companies doesn’t add up.

    Somehow the funders need to be more aligned to the recipients, and a closely monitored insurance scheme like the Swiss one seems to work well.

    1. Bloke
      March 28, 2024

      Joe Soap:
      Funders being aligned to recipients points to each patient being awarded their own ‘NHS’ budget.
      Instead of being charged tax, they could spend it privately on the best healthcare available, including NHS services if any are worth buying.
      Competition and consumer choice pull more efficiency into action than governments can force.

  14. Narrow Shoulders
    March 28, 2024

    Broken record time – the NHS is paid for being not doing. It’s funding model means it gets paid even if it performs not procedures or offers any appointments.

    Change the funding model to payment by procedure and appointment.

    1. graham1946
      March 28, 2024

      With the millions of consultations and procedures done each day, we would need another 100,000 pen pushers to vet, pass and pay up. Sounds good, but not feasible.

      1. Narrow Shoulders
        March 28, 2024

        Disagree Graham. Payment by procedure and invoice would be a simple procedure. Wicked manages to invoice by delivered product as does Bupa. Actual invoicing is easier to track than grant funding

        1. Narrow Shoulders
          March 28, 2024

          Wickes not wicked

        2. graham1946
          March 29, 2024

          And the size of their businesses in comparison is?

  15. Cliff. Wokingham
    March 28, 2024

    Sir John,
    I shouted hooray at the tv when I heard the satisfaction with the NHS figures yesterday.
    The population has, at long last, come to realise that it’s not the envy of the world nor a world leading health service.
    You are correct Sir John that there is plenty of money sloshing around within the NHS. Rainbow signs are appearing everywhere, rainbow pedestrian crossings are appearing in NHS carparks, difference and diversity staff positions and courses are breeding like rabbits,this is hardly like an organisation that is short of money.
    For the amount of money put in, we seem to get very little return. It is not how much money is put in that’s important, it’s how it’s spent.
    The NHS is supposed to be a health service and therefore providing healthcare should be it’s core function. It needs to concentrate on providing both treatment for health conditions and emergencies, as well as prevention of those conditions.
    We need to train more doctors and nurses and once trained, retain them. I suggest we look at refunding course fees over a period of say ten years. They stay for ten years, the taxpayer refunds their training fees.
    The problem we have is that politicians are afraid to be critical of the NHS in case there is a backlash against the party saying it. The NHS has become weaponised and that must be stopped.
    We need all parties to get together and agree a long term plan to sort the NHS out once and for all. We need to discuss just what we want the NHS to do for us.
    We hear a lot about banks and other organisations being too big to fail, well it may be that the NHS is too big to work.

    1. Paula
      March 28, 2024

      Jeremy Vine was nothing but phone callers saying how great their NHS treatment was. It was nothing but a BBC propaganda broadcast yesterday. The NHS is our state religion.

      1. Mickey Taking
        March 28, 2024

        yesterday he (Vine) ate a whole Easter egg while talking to a Dr/ dietician – – -who claimed we might have a diabetic coma doing the same. Well for decades we have allowed kids (and some older people!) to scoff down an egg – I’ve never heard of a diabetic coma as a result?

      2. miami.mode
        March 28, 2024

        I know of two fairly recent cancer cases and the NHS treatment has been exemplary, in fact as good as any money could buy.

        1. graham1946
          March 29, 2024

          I would concur in my own case. The problem was late diagnosis due to Covid, when the NHS did virtually nothing else and we are now paying the price with more advanced cancers. This may not become apparent for a few years, but in my case it was the year after Covid ended and treatment is now much more aggressive and unpleasant.

          1. miami.mode
            March 29, 2024

            One of these cases was during Covid which was almost advantageous as the hospitals concerned, apart from Covid, were concentrating on cancer to the detriment of “routine” treatments which was demonstrated by the fact that the car parks were generally just over half full. Additionally the GP immediately recognised the seriousness of the symptoms after a triage phone conversation.

    2. Ian B
      March 28, 2024

      @Cliff. Wokingham – This Conservative Government has created the disconnect, every penny they throw out to all and sundry is presented as their personal money, them personally rewarding the good ole boys that toe the line. Then as they don’t care as the money grows on trees all those they manage follow in their image.

      If the NHS knew it was our money, only coming to supply the service we would wish to pay for things would be different.

      Instead of throwing National Insurance in the bin, it should be reinforced, serve a purpose along side private providers payout when service is delivered. Oh… isn’t that what all the Worlds top notch health providers do?

  16. Javelin
    March 28, 2024

    In answer to your question about the NHS.

    If keep importing a million people into the country every year the. you are going to get a crisis in the NHS. I pointed out 10 years ago and kept pointing out that you are DILUTING government services.

    You will also find an ageing population using the NHS and you will find that Europeans have evolved over thousands of years to this culture and climate. People from India are six time more likely to get diabetes and from africa are four times more likely to get diabetes or prostate cancer. You find people with families with health problems come to the UK to get treated.

    The NHS is being overwhelmed.

    To stop the criticism the Government have imposed censorship on the population and a survey out this week said that 70-80% of the population are living in fear.

    This is not a political party that deserves to exist any longer.

    1. Dave Andrews
      March 28, 2024

      Just one aspect of what you describe.
      Number of midwives in the UK – 57,600
      Midwife shortage in the UK – 2,500
      Percentage shortfall – 4.1%, not bad
      Percentage of babies born to women born abroad – 30%
      One example of the International Health Service.

    2. Paula
      March 28, 2024

      From what I’m hearing in my own family and circles the Tories won’t exist any longer. Short of a miracle the general election is going to be much worse than predicted for them.

      They catered for people who are never going to vote for them in a million years and abandoned their core vote.

    3. Mickey Taking
      March 28, 2024

      You don’t mention immigration for childbirth, those wanting families flocked here, certainly over the last 50 years. Then its Primary, Secondary education, now student Loans for a degree. Family allowances, etc the gravy train continues.

  17. Roy Grainger
    March 28, 2024

    But Jeremy Hunt said just the other day most of us think the NHS is the thing that makes us proudest of Britain ! So no hope of any change under the Conservatives who are far too scared of upsetting Guardian readers by proposing any market reforms of the NHS. The only slight chance of improvement is under Labour and Wes Streeting who has actually visited Australia and Singapore to see better systems in action, something no Conservative minister would ever dare do. I note he is already being attacked by NHS vested interests – it’s a good start.

    1. Bloke
      March 28, 2024

      When he was Health Sec, Jeremy Hunt often posed and worked as a porter to claim he understood how staff and patients felt. Repeatedly neglecting his management task to push chairs and trolleys was like steering Titanic’s deckchairs.

      1. Mickey Taking
        March 28, 2024

        Is that any different to Johnson sat on a JCB (J.C. Bamford Excavators) – man of the people, assisted by one of the biggest Tory donors ever!

        1. Bloke
          March 29, 2024

          In that they both involved photo opportunities Mickey, those are virtually the same.
          The difference is that Johnson did a quick photo finish; not driving JCBs as a regular job like a labourer. Hunt worked as a porter for longer, labouring, yet doing little anything more useful in control throughout many years as Health Secretary.

  18. Everhopeful
    March 28, 2024

    Is it widely known that despite the very good enquiry the Liverpool Pathway is allegedly still thriving?
    No family fight back is allowed because all is dealt within a closed court.
    Terrible.

  19. Nigl
    March 28, 2024

    HMGs response to this report total denial accentuating the amount of money poured in and blaming other factors, pst Covid/strikes etc. as ever ‘nothing to do with us’ and this is endemic across all the departments.

    When justified criticism needs a response without exception it is total denial, we have put more money in/this is what we are doing now etc.

    Do you not realise that no one believes you and these defensive responses just confirm our view how out of touch you are.

    I read NHS employees to get up to £3k for reducing waiting lists, Err isn’t that their job and no surprise, Trusts under pressure to do the easy stuff to get quick wins and so Sunak can crow about them.

    The DT shreds, that automation is the answer route, I bet every politician has private/direct line in to Dr healthcare and has zero experience of mums with kids or the elderly trying to get past an NHS chatbot.

    And in a similar vein of denial you are allowing genuine whistle blowers to be bullied, threatened etc to support a culture of cover up.

    Of course the NHS is a metaphor for the of this government. We have had years of spin, blame, denial about illegal migration/porous borders. This quarter sees the highest number ever across the channel and a whistle blower sacked and more denials issued over border force failures.

    ‘Who will get rid of this accursed government’

    1. Clough
      March 28, 2024

      I can strongly recommend Lord Frost’s recent speech at the Danube Institute in Hungary on how the Conservatives can find their way again. A lot of nettles will need to be grasped, however, before that can happen. He sets out very clearly what they are, and his speech should be a blueprint for Conservatives who actually want to win any future election. I agree with him when he says that “there are large numbers of British people who still want to see traditional Conservative policies, who still believe in the traditional virtues of conservatism, economic, social cohesion, and want a party that delivers them”. Under its present leadership, they won’t get them from your party, SJR, so a lot of them (I should say ‘us’) will vote Reform. If that’s a problem, it’s a problem of your party’s own making.

    2. Mickey Taking
      March 28, 2024

      answer: the voters will! Assisted by the previous supporters who can no longer tolerate the shocking decline in just about everything, so will stay at home.

  20. Jude
    March 28, 2024

    The main issue with NHS is too many Chiefs & not enough (workers ed).
    The majority of Chiefs are jobs worth empires. Not contributing positively to the daily output. But like blood clots blocking the arteries of communication. Which just wastes time, money & creates confusion & division.
    The NHS used to have 450k beds pre-2000. Today 180k ….that says it all! Less capacity stifled by more beurocracy! Aggravated by the majority of roles now being covered by 2 or 3 people, part-time. Who then claim top up benefits. Rather than 1 full-time employee!
    The lunatics are definitely on charge of the asylum!

    1. The Prangwizard
      March 28, 2024

      And Mr Redwood’s approves of their control of words. See how afraid he is and controls what we read.

    2. Ian B
      March 28, 2024

      @Jude – and who is the Boss, the Management, the ones calling the shots for all the distribution of ‘our’ money, it the Health Secretary our 2 Chancellors Sunak/Hunt. those below are just following the lead from above

  21. Wanderer
    March 28, 2024

    Just live and work a while in Austria or France. You’ll soon see how much better the health service could be if the insurance/ medical establishment models were different. Costs are about the same, health outcomes infinitely better.

    1. Ian B
      March 28, 2024

      @Wanderer +1 – privatization is not the dirty word this Socialist Government makes it out to be.

    2. Mike Wilson
      March 28, 2024

      I keep hearing conflicting stories about the French health system. How does it work? Is it true that if you feel unwell you can see a doctor? Wouldn’t it be great if that was true here.

      1. Berkshire Alan
        March 28, 2024

        Mike
        I have not used the French health system myself, but certainly know of others who have.
        As I understand it, You pay to see a Doctor of your choice, he recommends treatment or not, you pick a Consultant of your choice, in a location or hospital of your choice. All treatment is paid for by the patient, and the patient then claims a large percentage cost of the bill back from the State system on completion.
        At all times the patient is in charge of every aspect of the treatment system, and has to chase up the various parts and people involved themselves.
        Thus administration by the actual system is reduced (as you do most of it yourself) and those not in the system pay the full amount/cost, unless they can claim on their own self funded insurance policy.
        Happy to be corrected if any of the above is incorrect, but this has been explained to me by patients who have had hip, back ,and Cancer operations and treatment in France.

    3. Chris S
      March 28, 2024

      I have to say that in our area of Dorset, the GP service is pretty well faultless.

      I requested a repeat prescription for some antibiotics this morning at 09:30 for an infection that reoccurred after 6 months. I had a call from the surgery two hours later and was put on a list for a Doctor I know to call me back. After half an hour she phoned, asked some sensible questions and said the prescriotion would be with our pharmacy overnight.

      She also said she would arrange an appointment with a specialist nurse to review my regular medication which might be causing the infection. It’s hard to see how this service could be improved. We have friends with far more serious problems, including one who has had a kidney transplant and is similarly well looked after.

      If the NHS in Dorset can work so well, why can’t it in the rest of England ? Scotland and Wales are different, of course. Despite much higher per capita funding across the board, their healthcare services are abysmal thanks to mismanagement by the SNP and Labour.
      A hint of things to come for us ?

  22. Bloke
    March 28, 2024

    A substantive part of the NHS failure is the incompetent government spending vast sums on waste in the absence of simple efficiency.

    1. Nigl
      March 28, 2024

      +1

  23. Old Albion
    March 28, 2024

    If legal immigrants (too many of whom are arriving here, still) were compelled to pay into the system for (say) five years before being allowed to use the NHS. That would reduce the burden and increase the money available. Accidental injury/sudden illness could be covered by incomers having their own insurance.
    Bring an end to ‘health tourists’ flying in to the UK for free treatment. Another huge saving.

  24. Nigl
    March 28, 2024

    And in related news recordings of conversations allegedly confirming the Post Office cover up have emerged. Lord Arbuthnot who comes out with a lot of credit, unlike the slippery Ed Davey, asks how could that happen in a British institution?

    Err, it’s endemic across the whole of government.

  25. Sharon
    March 28, 2024

    Nigel Farage spoke to a former NHS consultant on his show last night. He was explaining that in his given time of eight minutes he couldn’t touch the surface, but referred all the audience to a documentary entitled ‘The Great NHS Heist’ by Dr Bob Gill. The NHS has been deliberately run down, assets stripped and sold off for some time, since Tony Blair’s time but has continued under the Tories. Beds in 1970 was 400,000, now there’s less than 150,000. I haven’t yet watched the video, but suffice it to say, the aim is for it to be just a kite mark for services provided by doctors etc provided from outside and all private.

    I plan to watch it today on You Tube.

  26. Rod Evans
    March 28, 2024

    Now come along Sir John, the answer to the difficulties is well known tried and tested.
    Who could forget the effectiveness of standing on the doorstep every Wednesday at 8.00 pm bashing those pots and pans together, that really achieved a result, back in the Covid era.
    No one attended the NHS the places of treatment were like morgues (sorry no pun intended) but hey bash those pots and pans to show how fantastic the service is/was that was off limits to all except those literally dying.
    The NHS is over size, over indulged and over funded. We are expected to cheer for a service that is appalling in too many areas. Whatever you do don’t mention obesity.
    Everyone that has taken a look at the options for national health care knows what the answer is, but the political class once again are too frit to do it.
    Oh, one other point, It is no longer ‘Our’ NHS it is ‘Their’ NHS.

  27. Nigl
    March 28, 2024

    Sorry third post today. I cannot help thinking that the government and public sector see said public as a nuisance that should be fought/pushed back against.

    That culture together with zero performance management/consequences and utter negativity throughout the workforce with no political leadership,(inexperienced, weak, self absorbed) has led us to the low productivity/high cost situation that we are now in.

    The frightening thing is that at a macro level there is neither acceptance nor understanding tying us into a spiral of decay from which recovery looks increasingly impossible.

  28. Michelle
    March 28, 2024

    From a friend who has recently retired from a lifetime of nursing in the NHS – ‘this is nothing to do with lack of money’
    How nurses are now trained with emphasis on a degree, spending more time in class has not in her and her peers views been helpful to the profession. Certainly not in suitability for the role, which is being found out later rather than sooner given less time now spent learning on the ward, and more in the classroom.
    I have a relative in mental health nursing, who says that drug use is a major factor in a lot of problems and now with everyone being diagnosed with some sort of mental health issue, on the flimsiest of pretexts it’s becoming overwhelming. We always hear how mental health nursing is underfunded, but, is it not more down to being over used and unnecessarily used. What is this fixation with making everyone think every minor hiccup in your life is down to your mental health???

    There is also the issue of interference from managers who know nothing about medical issues.
    There is the issue of where and how money is spent. Example being on fancy carpet and chairs for admin. staff rest rooms while surgical staff have to fill in reams of forms for a basic request. With a sharp intake of breath and slow shake of the head from the bean counter.
    All these things have come from actual medical staff, that I personally know or know their relatives.

    Then of course the NHS like all out institutions is stuffed to the gills with left wing political activists.
    The Conservatives have appeased these people and put themselves out of office.
    Finally, and probably one of the most important, mass immigration has put a strain on all services, not least NHS.
    With refusal to train our own, bringing in more foreign medical staff then adds to the merry go round of more people needed to service the last intake.

    1. a-tracy
      April 1, 2024

      When women started training on the wards at 16 they often got around 10 years work in before they started their families, those that decided to dedicate to a career first were the ones volunteering for the extra qualifications funded by the NHS to get to a higher rank before they started their families.

      We need a lot more men training as nurses not just paramedics but on ward medics, once women start their families they generally do not want to do more than three days. The older experienced nurses are choosing to retire from 55 to 60 unless they had big gaps in their pension when they often then work on with lots of sickness due to bad backs and nerve problems.

  29. Ian B
    March 28, 2024

    Sir John
    As inferred the NHS has become a hot bed of empire building on superfluous to purpose activities. The model is flawed top to bottom, leading to the situation the consumer, the patient is being punished, the clinical staff are being punished.
    Yet we have a Health Minister in charge, that calls the shots, that directs the outcomes. There is also a Chancellor along with the PM that throws money at the NHS without ever considering purpose and delivery, controlling expenditure. I start out blaming those that locally are running these thiefdoms’ then I remember that the ‘manager’ of the NHS, the one that on paper would normally take responsibility and be held accountable – this Conservative Government has gone AWOL. This Conservative Government has gone missing on every area it was empowered and paid to do.
    So should we be surprised that those areas that this Conservative Government is paid to manage just follows the trends from their bosses, make noises do nothing.

  30. Paula
    March 28, 2024

    Immigration isn’t the solution to the NHS either or by now – with the rates of immigration since 1997 – we’d have the best health service in the history of civilisation.

    Britain is finished. This is evident whichever way one looks – the potholes being the most visible sign of a country that is fast becoming third world.

  31. Rodney Needs
    March 28, 2024

    I totally agree the answer is not about more money its also about reform and simplication. Take my wife and injections in here knees . Every time she needs further the following procedure needs to be followed
    Referal from hear GP to knee clinic.
    Visit to knee clinic with a view to look at physio in spite of her history of this not working.
    Then approval for a injection to the hospital.
    This has to be done by a consultant as she is on a blood thinners in spite of history of no bleed problem. Taking up a consultant valuable time when it could be done by a doctor who has been trained. The service you get on front line is good but admin is poor.

  32. glen cullen
    March 28, 2024

    Who knew all that public clapping for the NHS would result in strikes and demands for 25% wage increases ….vocational career my arse

    1. Mickey Taking
      March 28, 2024

      Our neighbours made pointed remarks a couple of times to my wife, standing outside banging something or other.
      She basically said I didn’t go along with this pathetic hero-worship. Yes plenty were heroes but there are endless examples of workers sticking with arduous thankless jobs for breadline pay. When do we do the public hero adulation for them?

  33. Keith from Leeds
    March 28, 2024

    The answer is clear. Freeze NHS budgets for 3 years and make these highly paid Chief Executives do their jobs.
    If they have money for DEI staff and training, too many non-clinical managers, and electric Ambulances at twice the cost of diesel or petrol ambulances, they have too much money and are not using it efficiently!
    But, as has been said earlier, if you bring in 7 million immigrants over 20 years as well, no wonder the NHS can’t cope. So stop all immigration, legal and illegal, for at least three years!
    But neither will happen because we have a weak PM, Chancellor and Government. If you don’t make decisions while you have the time and choice to make them, decisions you don’t want to make will be forced on you by circumstances and finances. We are heading for painful reality a few years ahead.

  34. Chris S
    March 28, 2024

    The country pays NHS management lots of money to run the system. The fact that revenue has increased by a massive 45%, far in excess of inflation, yet outcomes are far, far worse, is proof that senior managers are not functioning as they are paid to do. They need to be replaced.

    Where has all of this extra money gone? It seems unlikely that most of it has gone on excessive pay rises, as happened when Brown spent huge extra sums without insisting on any performance improvements being specified.

    What is the real effect of the large increase in population over the period ? Net inward migrants are younger people who we can assume require less healthcare than the indiginous population?

    Has the government actually analyses what is going on or are they just wringing their hands in the knowledge that they will only be responsible for this lumbering edifice for another few months?

    I have to say, Wes Streeting is saying all the right things and is clearly under no illusion about the service. He certainly isn’t sentimental about it, unlike Hunt and his constant reference to “Our NHS.”

    Somehow I doubt whether Streeting will get the job, or he will swiftly be replaced when the Unions and other vested interests that abound throughout Europe’s biggest employer start flexing their muscles. That would be a pity. He seems, on the surface, exactly what it needs. The problem will be the weakness and inability of Starmer to back his ministers, make decisions, and stick to them.

  35. Ian B
    March 28, 2024

    Sir John
    No should loose sight of the fact the ones taking our money, then buying services from the NHS on our behalf is this Conservative Government. They as the holders of the ‘purse strings’ have been empowered and paid by us to manage how the money taken from us is spent. They are the only ones at the top of the tree, the boss, the CEO, the MD.
    If the NHS is running Discrimination staffing and departments (DEI) and other politically motivated WOKE activities rather than delivering medical and clinical services it is at the behest of the Health Secretary, the Chancellor, the PM and generally this Conservative Government. If that wasn’t so there would be know other way of the NHS getting the money to fund these empires

  36. George Sheard
    March 28, 2024

    Hi sir John
    Stop the mangers perks taking early retirement with massive lump sums on top of their pensions then going back doing the same job part time getting paid more money this also applies to other positions such as senior radiographers taking early retirement and then not actually leaving because they haven’t replaced them
    And getting pay more on top of their pension

  37. Bryan Harris
    March 28, 2024

    The inefficiency of the NHS is a recurring theme, because nothing is ever done to implement the findings of those that understand where the NHS is going wrong – It’s obvious the NHS is wasteful and top heavy in terms of staffing.
    Take a survey to the streets and ask ordinary people what should be done – you will hear plenty of horror stories, and there will be plenty of different ideas to make the NHS work, including:
    – cut out the woke;
    – vastly reduce management – set a realistic target of how many people each manager should have personal responsibility for;
    – reduce the reports and statistic the frontline is required to provide;
    – review if all medical procedures and projects are appropriate;
    – reduce the enormous drugs bill by using more natural solutions.

  38. Wokinghamite
    March 28, 2024

    “More money should only be committed to achieve better outcomes for patients.”

    How will better outcomes for patients be achieved without committing more money? Patients’ welfare is more important than financial considerations. The Conservatives have had 14 years in which to improve management and productivity. The man in the street does not understand such issues and expects easy access to a GP and timely specialist treatment when required. It is obvious that the public is very dissatisfied with the NHS.

  39. Derek
    March 28, 2024

    It’s true, the country, namely the NHS and the Welfare State, has become ‘too big for its boots’. They have too many ‘customers’ to ably cope, efficiently. That is reflected in the long waiting lists for NHS treatments and huge amounts of tax money spent on the numerous benefits now handed out like confetti at a wedding.
    We cannot afford this to continue. Mass unfettered immigration has exacerbated the problem, for many of them are not working and thus do not contribute to their own welfare here.
    Similarly, some 3 M people now receiving medical benefit money for “mental problems”, a new phenomenon created out of Covid lockdowns, apparently.
    Given the continuing poor productivity figures from the civil services, they should be treated as would a failing factory. Staff will have to be laid off to reduce the massive overhead. The public sector wage bill is huge, £235 Billion in 2022, and regarding staffing, the NHS is in the top ten employers in the World, with over 1 million employees for a population of 67 M. Surely far too many just for medical purposes?
    The solution can only be to adopt the financial policies for cutting overheads in the Private Sector. The NHS surely could be trimmed down by losing those nonmedical empires which have popped up over the past decades. Equally, the Civil Service can be trimmed down by removing those taken on to cover the Covid crisis and all those who are no longer required because there is no viable job for them. Pushing paper is not a proper job, is it?
    It’s way past time, the antiquated working practice methodology used throughout the Public Sector is rejected in favour of a modern version now successfully utilised within the Private Sector.
    Mr Blair, when PM, was keen on modernising, but he never managed to push that very far in Government Departments. I cannot remember how Mrs Thatcher managed the Civil service, but right now we need a new leader with at least her qualities to get us out of the deepening mire into which, we’re fast sinking.
    There is a huge demand on limited supply resources and, financially, such a market position would accelerate inflation.
    If we relate the NHS to a product, then its costs are always going to soar, as they have been doing, so it’s time to adopt some supply side “adjustments”. Like Now.

  40. Bert+Young
    March 28, 2024

    The solution to the NHS is a complete re-organisation . It is far too large a body to be managed centrally ; it must be broken down into regional groups and its key personnel must be qualified and experienced medics . Years ago I was in a position to recommend this change to then Government ; it was heeded to but never adopted . The mess has now expanded to a rediculous proportion and at the expense of lives .

  41. miami.mode
    March 28, 2024

    Whenever something is offered for free, there’ll be a queue for it.

  42. MWB
    March 28, 2024

    In a tweet on 24/11/22, shown on the side panel, you said that
    “If we invite in an extra 500,000 people a year we need to build a city the size of Liverpool every year to provide the homes, schools and hospitals they need. No wonder we are short of GPS, energy, water. Government needs realistic plans about what we can manage”
    WE did not invite them in and WE do not want them.
    Why do you use such terms as “invite” ?
    Your figure of 500,000 is now incorrect, the real figure being about 1,300,000 and rising.

    Reply All the legal migrants were given visas

    1. mancunius
      March 29, 2024

      Reply to reply: Giving migrants visas is not ‘inviting them’, it is merely *allowing* them to reside on the conditions of the visa. ‘Inviting’ implies they are welcome.

  43. Bob Dixon
    March 28, 2024

    If you do not have a national insurance number then before any treatment you pay by debit card.

    1. a-tracy
      April 1, 2024

      In advance.

  44. mancunius
    March 28, 2024

    The NHS is completely unaffordable. I have experienced the health systems of four other European countries, and the tiered insurance-based scheme works by far the best. It also prevents abuse.
    If we move to such a scheme, at a stroke it would 1) lower the government’s debt pile 2) reduce the ‘push’ of unskilled migration, which is very largely directly and indirectly targeting the NHS (the ‘pull’ of employer demand would still remain, and only AI and greater automation can solve that) 3) reduce congestion in the GP and hospital system.
    One thing i did notice in all these countries, and it applies here too – the faults in any health system are frequently faults in the medical profession – in their specialized training and financial expectations. If doctors were really upset about congestion of treatment, they would demand more staffing. They do not, because they are concerned that a greater provision of medics would lower their individual market value.
    Obviously, their union, the BMA, needs radical reform with the rest of the system.

    1. a-tracy
      April 1, 2024

      Only Labour will get away with this tiered insurance with co-payments and it’s coming. Wasted appointments are a big problem apparently so I’d guess there will be a £20 Surgery booking fee with a £10 rebate when you show up. Opticians, Dentists, Podiatrists, physiotherapists if you want to be seen quickly, all co-pay now, only surgery appointments left.

      There is no other degree that gets limited numbers taking the course, governments allowed thousands to do sports science, thousands to do the arts, drama, with no expectation of a job at the end of it. One year the course at one location went up from 16 trainees to 35 trainees now no-one can get frequent work because where the one provider lead the others followed and flooded the market. So why aren’t we training nurses on the wards from age 16 on credited courses A level equivalent at 18 and degree equivalent with day release taking five years instead of three to age 23 but earning all the while they’re training.

  45. Kenneth
    March 28, 2024

    We should conentrate on NHS output, not input.

    There is no point in continally pouring more money in while it is so badly run.

    The first thing to do is to replace the management and make sure the new management are paid according to output success.

  46. Sea_Warrior
    March 28, 2024

    ‘That is a much bigger rise than the Brexit savings on the side of the bus’: something that your party should be imprinting into the minds of every voter, but isn’t.

    1. Mickey Taking
      March 28, 2024

      I think the unspoken truth among the rank and file Tory MPs is that they can no longer Govern, an admission that they are beaten and we are to endure another Labour run of at least 2 terms.

    2. glen cullen
      March 28, 2024

      Agree – we’re about to endure a labour government because this tory government couldn’t keep faith with the referendum, their own manifesto and the tory voters …we just don’t trust them any longer

  47. Bob Dixon
    March 28, 2024

    At 83 I am using the NHS more often. I consider my self living in Cambridgeshire lucky where we have 4 excellent hospitals.
    In the last 20 years hernias, Pituitary gland,cataracts,eyes, abscess, COVID infections have been dealt with.
    Junior Doctors and nursing staff should get their 35% pay rise.

    1. a-tracy
      April 3, 2024

      Bob nurses got two one-off payments worth over £2000 for full time nurses.
      The current starting salary for a qualified nurse (typically aged 21) is £28,407 (+ full sick pay, 35 days holiday, late and weekend enhancements, and fantastic pension, which is the equivalent of 28-30% of the gross to get the defined benefit levels).
      Compared to the NLW at age 21 of £22,308 + SSP + 3% pension contribution + 28 days holiday.
      Do you think someone at 21 years of age, fresh out of training, should be on £38,349? Are you also willing to pay extra for the national insurance tax that carries on after retirement and income tax to pay for that level of increase?

  48. Mike Wilson
    March 28, 2024

    The government takes – but gives little in return.
    Health – no.
    Police – no.
    Roads – no.
    Justice system – chaos.
    Prisons – a scandal.
    MPs’ terms and conditions – YES!

    1. a-tracy
      April 3, 2024

      Gives little?
      We have a welfare state – universal credit, attendance allowance, pension credits, income support, employment and support allowances, carer’s allowance, personal independence payment, disability living allowance, housing benefit, universal credit, bereavement allowance, maternity allowance, incapacity benefit, child benefit, cold weather payment, etc. https://www.gov.uk/benefits-calculators

      They are expected to do a lot. Whether they do it well or not is down to those national service heads and leaders and how much more they want to do what they do better?

      The Ministry of Justice’s (MoJ’s) – I believe this includes Prisons, total expenditure in 2022-23 was £13.2 billion.23 Feb 2024

      In 2022/23, the last year of confirmed final spending data, total health spending in England was £182bn, having increased by an average of 5.5% a year in real terms since 2019/20.19 Mar 2024

      Government spending on roads https://www.statista.com/statistics/298667/united-kingdom-uk-public-sector-expenditure-national-roads/

      How much more do you want them to have and who do you propose pays the extra in what way? Extra in housing taxes, income taxes, wealth taxes, pensioner taxes,

  49. Mike Wilson
    March 28, 2024

    Mr. Redwood – I picture as one of those toys that you push over and they get back up again. Day after day you post here and your loyal supporters give your government a serious, verbal kicking. I’m amazed you bother. You appear to have no affect on your government.

  50. acorn
    March 28, 2024

    The Treasury has no idea where all the money goes in England and Wales health services. In 22/23 there was no level 2 COFOG data available. The Treasury just split it into Medical Services £200 billion (bn); Medical Research £2 bn and Central and other health services £9.7 bn.

    Terry Smith (Fundsmith) said a while back, if you want to know how a company is doing, follow the cash. The same is even more important for a currency issuing government; alas, impossible to do in the UK. The US has a daily Treasury statement of cash in and cash out of its accounts.

    Suggestion. Convert the Whole of Government Accounting (WGA) department to following Sterling currency units from creation to cancelation in conjunction with Exchequer Funds and Accounts department. WGA uses the IFRS accounting system. It just shows the UK government makes a loss every year; is heaped in debt, insolvent, but never goes broke.

  51. Keith Murray-Jenkins
    March 28, 2024

    Sir John, what you tell us is spot on. There’s a lot of ‘waste’ and a lot that’s superfluous going on in the NHS. Every thinking person agrees with you. Flabby ways, poor management, too much bureaucracy abounds as you point out. So Waddoo we do? Bring in a good CEO ie a good corporate business person who has proved him/herself and delivered efficiency (profits) elsewhere. Common sense. Let that person carry out the procedures (and cut down the bureaucracy). One anecdote to relate here: A few moons ago I was talking with an NHS middle-management chap who at the time was on his 4th or 5th break with the organisation. He’d been sacked several times. He’d been replaced several times too..in pretty much the same role, he said, under a different role-heading. He wasn’t at all concerned for his future. He knew he only had to wait a month or so for the right role for him to crop up. Multiply this arrangement many times and you have more examples of waste. After all, he – and many others like him – had been paid off ie golden hand-shaked several times. Gravy train galore? (You bet. And whose hard work and taxes is paying for all this rubbish?) It goes back to that (and my) ever-consistent, reliable notion : ‘No skin in the game’ hurts us all. Public and quasi-public servants cannot expect shoddy – even mediocre – work to be acceptable and their employment sacrosanct. Allowing this creates more shoddiness/mediocrity. It would be good of us to have them see what life is really about and start living it.

    1. Mickey Taking
      March 28, 2024

      If only we could go back in time and ask Sir John Harvey-Jones MBE (16 April 1924 – 9 January 2008) to examine the NHS. He was the chairman of Imperial Chemical Industries from 1982 to 1987. He was best known by the public for his BBC television show, Troubleshooter, in which he advised struggling businesses.

  52. Ian B
    March 28, 2024

    From the MsM

    ‘State pension triple lock ‘wiped out’ after Jeremy Hunt ‘stealth tax’ raid
    Resolution Foundation has found that the much-lauded triple-lock increase will amount to very little. The think tank discovered that pensioners will end up just £20 a year better off thanks to Jeremy Hunt’s “stealth tax” raid.

    NHS – Two-thirds of patients at England’s busiest hospitals have been waiting 18 weeks for treatment. Waiting list in 2010 where 2.5million, now in 2024 they are 7.5million. risen 300% due to lack of Government interest or/and management

    This Conservative Government is about slight of hand and misdirection, controlling expenditure is not managing the actually spend balanced to delivery. The services are just not there because the management(the Conservative Government) are perusing other interests but the manage to make the ‘take/tax’ grows ever higher

    A bit like the PM’s criminal ‘boat’ people claim, he says it has gone down because of him and yet it has never been higher because of his management. The UK no longer is expecting to have the electricity to keep the lights on, so the authorities are seeking to price people out of the market so as to ration it. Everyone including all members of this Conservative Government knew the situation 14 years ago and as the managers of the UK they are still sitting on their hands. Empowered and Paid by the electorate but refuse their duties. The Conservative Campaign HQ says if we don’t vote Sunak(and the mean just Sunak) we will get the others – that’s a threat! I would like to vote for a Conservative to be my MP, but they have been hung out to dry by a Conservative Government that has gone AWOL

    1. a-tracy
      April 1, 2024

      How was the state pension trip lock ‘wiped out’? The state pension is lower than the personal allowance? If you mean the state pension has gone up so high your second pension gets a 20% tax on it then take care because Labour is discussing charging you more wealthy pensioners NI too and you can bet they’ll put the NI rate back up from 8% to 13.5% for all, even if they wrap it up as a payment for social care which of course they say rich boomers use more.

  53. forthurst
    March 28, 2024

    Are we the only country in the world in which the hierarchy of a monopolist health system is staffed by Arts graduates who by definition have inherently no useful skills including that of intelligence since these are not taught nor tested as part of their degree courses? It is obviously difficult for Tory MPs who in the main fall into these categories themselves to recognise this.
    The doctors will know what is going wrong but they are never asked as the Arts graduates imagine that people with low I.Qs like themselves are more capable of administering the health service than high I.Q medically qualified people who work within it.
    The whole Arts graduate ethos in this country needs to go otherwise we will continue to fail in the provision of important constituents of a first world economy.

  54. Sir Joe Soap
    March 28, 2024

    Now they’re in a muddle over no-fault evictions. Is there anything this government can’t make worse via a complete cock-up of wrong headedness, indecision and U-turns?
    By going down with this ship full of lunatic muddlers our host, however well-meaning, will be seen to be sitting alongside them.

  55. Ian B
    March 28, 2024

    Rishi Sunak PM has created an open goal, and he just keeps digging.

    One year ago, on 4 January 2023, Rishi Sunak set out his five pledges. These were to:
    Halve inflation
    Grow the economy
    Get debt falling
    Cut NHS waiting lists
    Stop the boats

    The Office for National Statistics confirmed its preliminary figures showing Britain entered recession at the end of last year with GDP contracting by 0.1pc in the third quarter and by 0.3pc in the fourth quarter.

    Asked by broadcasters about the Prime Minister’s growth promise, the Chancellor said: I don’t think any of us were expecting the economy to actually grow last year, the Bank of England wasn’t, the Office for Budget Responsibility wasn’t,

    Debt has risen to 88.3% of GDP in November 2023 from 85.1% in December 2022.
    NHS elective waiting lists have continued to rise, with numbers in October 2023 almost 500,000 higher than in January 2023.

    Rishi Sunak PM and his Conservative Party are not at work, again – they are out pleading for you to vote for them

  56. iain gill
    March 28, 2024

    the NHS is crap

    I have seen some emails the last few days from Diabetes Specialist Nurses threatening to take insulin pumps away from patients in the most brutal ways, with no idea what the patient is going through. Evil would be the word I would use.

    Hopefully Reform will win the next election and do something about the poor management, organisation, metrics, and incentives in the NHS.

  57. Geoffrey Berg
    March 28, 2024

    I’ve done some approximate calculations based on Sir. John Redwood’s cited N.H.S annual cost figure of 180 billion pounds per year.
    That is about £2,500 each for every man, woman and child living living in Britain – how much of that per person do General Practitioners ( who for most people are the main health providers and are private operators) get? Not very much.
    Inpatient stays in hospital are the main other activity and cost within the NHS. As roughly 100,000 people are in hospital each average night and as it is fair to suppose that is just over half the cost of the NHS, that makes an astounding about one million pounds per year for each occupied bed. Even intensive care beds (which are a handful in each hospital) should cost nowhere near as much but most beds are in wards of 20 or so mainly convalescing people with little individual attention in hostel type accommodation – how can that, how dare that cost taxpayers about £20,000 a week each? Compare that to residential care homes (where residents at least have their individual rooms) which might cost £600 or, if expensive £1,000 per week. And the N.H.S., aided by left wing politicians, are claiming the N.H.S has too little money and about a million pounds per year per hospital bed is somehow not enough and being starved of money! I say the truth is the NHS needs a lot more efficiency and a lot less of our money, our money which would be much better used in facilitating lower taxes, leading to both economic growth and more freedom for individual people to spend far more of their money as they choose rather as the state chooses!

    1. a-tracy
      April 1, 2024

      I agree with you Geoffrey the figures are just made up. There is no way a convalescing patient is getting £20k worth of care and food per week. Do they even get a doctor’s visit? I don’t know why we patients allow them to get away with some of the claims on costs.

  58. Donna
    March 29, 2024

    The NHS needs fundamental reform and to move to an insurance-based system, not tinkering around the edges of the current failing model.

    As the people traffickers are demonstrating every day, if you give out “free” goodies, people will take advantage of it. The same applies to the NHS. The services are “free at the point of delivery so they are abused by people taking advantage.

    In both cases, the goodies aren’t FREE, they are very expensive but because they are paid for by others those abusing the system can ignore it.

  59. Margaret
    March 29, 2024

    Totally agree – and not only in the NHS !

  60. Robert Pay
    March 30, 2024

    A reduction of managers and the way it is managed is key. Also, it is run by ideologues who have been left alone by the government which seems to support the DEI regimes. I hope that, unlike my two Tory MPs, you will be aware of the Marxist roots of DEI which has a different understanding of the concepts that have been sugar-coated for consumption by our less aware political class. Rooting out this ideology from our civil service is long overdue. It will become orthodox after the coming election.

  61. Reform_Now
    March 31, 2024

    I have long realised that the dissatisfaction shown in the recent survey is an essential prerequisite to the demise of the necessary NHS and its replacement with a better system.

    As long as the NHS is seen as a sacred cow, a religion, there can be no sensible public debate. Once that sacrosanct status is gone, then can we discuss how we might do better.

    That time seems to be coming, perhaps soon.

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