Just one billion more

If putting more money into the NHS solved its problems we should see much reduced difficulties now. Record amounts and large increases in cash have been provided since 2019.

The truth as Labour acknowledges is you need reform, improvement in how it is spent, as well as extra money.

In this election various parties offer a few billions here and there to solve problems in the NHS or other public services. They offer to “pay” for this with tax hikes that they hope will just hit the rich, leaving most voters unaffected. It is nonsense to suppose these modest sums in relation to the total will make much difference.

In order to properly fund the NHS we need large sums, tens of billions, to pay the big bills. In recent years there has been plenty of wasteful spending.

The government paid a large sum to provide Nightingale hospitals, then scarcely used them. If they had been used for COVID the main hospitals could have done other work, providing more timely treatment and keeping waiting lists down.

The government spent a lot on taking over the capacity of many private hospitals. The NHS then failed to use all that capacity for non COVID cases, wasting much of the spend. Worse still the private sector couldn’t perform operations in its own hospitals, adding further to waiting lists.

PPE was in short supply worldwide. Taxpayers had to pay large sums to get PPE from worldwide suppliers where they could. Why didn’t the NHx have bigger stockpiles?  Why didn’t the NHS have flexible contracts with long term suppliers that allowed bigger deliveries in a crisis?

The NHS has been underpaying some medics. As a result expensively trained staff have got medical jobs abroad where pay is higher or have left for other occupations. The NHS hires staff back as contract staff at much higher rates.

There is no easy answer to improving management. I am not proposing another expensive reorganisation, What we immediately need is to make key managers more accountable and to get to tackle the staff, property and supply problems which are still widespread.


  1. Mark B
    June 20, 2024

    Good morning.

    I have covered this subject here before but will do so again.

    1. Stop allowing non-UK residence the use of the NHS.
    2. Make all persons coming into the UK purchase private medical insurance BEFORE they enter.
    3. Remove the ‘Benefit in Kind’ tax for private medical insurance.
    4. Remove all Diversity, Inclusion and Equity legislation. It is bureaucracy that is eating into the NHS budget.
    5. Stop importing doctors and nurses, especially from countries that specialise in providing fake degrees. This is a FAR BIGGER problem than is being admitted to. *
    6. Make treatment of certain conditions no longer available on the NHS. It is doing too much and resources are being thinly spread.
    7. Charge the cost of treating diseases and conditions that are result of ‘inter family’ marriage to the local council. There are certain sections of society that heavily indulge in such practices and I do not see why I have to pay for this backward practice to continue and their offspring.

    I am sure many will come out with more and better. But it is a start that should have been made 14 years ago.

    1. Mark B
      June 20, 2024

      * There is a reason why Pakistan International Airlines is no longer allowed in UK, EU and USA airspace. Up to a third of their pilots were found NOT to be pilots.

      1. Hope
        June 20, 2024

        Landsley was going to reform the NHS under Cameron, Hunt was going to sort out health tourism etc.

        JR once again knows the failings of the NHS but does accept responsibility for his party making it worse not better over 14 years! Worse they added to the problem by mass immigration and illegal immigration where the latter goes to A&E because they are not registered.

        We have dullards running the NHS, like other public services, because Tories built on Blaire’s DEI, ESG for quota appointments rather than merit or ability! Examples, Post Office, Crown Prosecution Service and many police forces. Not satisfied wrecking public services Tory party built on Blaire’s S.172 Company Act to force the same woke rot into the private sector. Recently we had Sunak implementing EU Equality law into domestic legislation! Instead of scrapping EU laws as the public and business demands by leaving Sunak introduces more left wing EU law! We voted take back control of laws, borders and money that is what the Tory party promised! Sunak has,done the opposite and stopped,scrapping the 4,000 EU laws. Labour not held him to account because they want t
        Exactly the same!

        Both Tory and Labour need ousting. Reform Party is the only option to break EU vassal state status for our country.

        I am going to see a GP this morning, I only had to wait 2 weeks!

    2. Peter Wood
      June 20, 2024

      Rather a confused piece today. On the one hand the NHS needs tens of Billions more £ to . ….., on the other hand it already wastes tens of Billions £. So the solution is…..

      1. John Hatfield
        June 20, 2024

        Peter, John didn’t say needs ‘more’, just biillions to maitain the status quo. At least that’s how I read it.

    3. PeteB
      June 20, 2024

      Good list Mark. I’d add a more substantial one. Look at how the successful health services operate (France & Australia to start) and adopt their models.
      Our wonderful NHS is broken and no amount of tinkering will fix it.

      1. Christine
        June 20, 2024

        This is what Reform wants to do.

      2. Hope
        June 20, 2024

        Hospitals have large boards with the nationality of staff emblazoned on it! What a waste of our taxes, how does that improve service? Nil. But it complies with DEI and ESG diversity rot that another inspectorate body, at huge cost to taxpayer, will tick a box, at huge cost to our country.

        Sunak then employs another non job minister McVey to look at woke rot when he continues to embed left wing DEI into society. idiot not clever.

      3. Wanderer
        June 20, 2024

        +1. Austria is another good one
        Spain is good for gp and a&e. Outcomes better than the NHS.

    4. Peter
      June 20, 2024

      It’s all rather academic. Labour will be in government soon. Making ‘key managers accountable’ is not really their thing. Staff, property and supply issues will be tackled by throwing more money at them.

      Grim predictions for the Conservative Party and Reform in the latest poll. Trouble in France too. I am not sure that everything will be resolved in parliament and by government decree. The French have a long history of taking to the streets. We might see that happening here too.

      1. Mickey Taking
        June 20, 2024

        The NHS management has become rather like the Civil Service – don’t put individuals in a position to be forced to make decisions and rise or fall by the outcomes! Delay, obfuscation and committee buck passing in a multi-divisional structure ensures avoidance (but sadly little direction).

        1. glen cullen
          June 20, 2024

          Liz would sort them out

      2. Hope
        June 20, 2024

        No, do not give up. Do not let the establishment gets it way to convince the nation in defeat by accepting Labour. Thereby allowing continuity EU vassal status.

        Sometimes I wonder if pollsters try to persuade public to vote a certain way by steering people into a certain direction. Vote Reform and oust both.

      3. Mitchel
        June 20, 2024

        And Niall Ferguson tweeted yesterday:

        “I first pointed out we’re in Cold War II back in 2018.But it only recently struck me that in this new cold war,we-and not the Chinese-might be the Soviets.”

        Well,Rip Van Winkle,I’ve been saying that for at least ten years – and intimating it was coming since Vladimir Putin’s epoch-defining 2007 Munich Security Conference speech.

    5. Ian wragg
      June 20, 2024

      Well said Mark. These same families you allude too are the ones who generally don’t work(a cultural thing innit) and the ones most likely not to have home or car insurance according to the industry watchdog
      We keep Importing benefit scroungers and failing to deport them but the genie is out of the bottle all over Europe and it won’t go back in.
      We are being taxed to death to provide a cushy lifestyle for all and sundry
      This is going to come to a screeching halt very soon
      All those who have been promoting these policies must be held to account.

      1. Berkshire Alan
        June 20, 2024


      2. Timaction
        June 20, 2024

        Indeed they must vote Reform. Everyone out here beyond the bubble are saying time to end the unwanted Uni Party. Time to elect a Party that will look after British people, particularly white English people. The UniParty has betrayed us. 10 million imported people since 1999. 6 million by the Tory’s.

    6. Jim+Whitehead
      June 20, 2024

      DEI? The CQC are leading proponents of this claptrap, as well as much else by way of diversions from clinical care and in favour of piles of protocols and bureaucracy.
      Of course the politicians like the foil from responsibility that the CQC affords them.

    7. Christine
      June 20, 2024

      A good list. I would add a few more:

      1) Clamp down on the abuse of sick leave by NHS staff which together with the Civil Service is the highest in any sector.
      2) Stop paying for translators. Other countries don’t do this. You have to either bring your own or pay for this service.
      3) Improve pharmacy dispensing. Every person I know waiting to be discharged waits hours for their prescription, blocking much-needed beds.
      4) Improve the roadblock of ambulances by providing more NHS beds. It is unacceptable for anyone to wait up to 12 hours for an ambulance. My aunt was left on her floor for this long with a broken hip!

    8. a-tracy
      June 20, 2024

      MarkB, you don’t need to stop non-UK residents from using the NHS. You just need an administrator to create a bill and get credit card payment or travel insurance details. The UK chap in Turkey who owes £40,000 didn’t bother getting travel insurance, who is crying over him, but how many Turks have been treated here without paying a single 1p in NI or tax?

      All those expensive diversity managers on over £60k pa could be replaced with two administrators on £30k it would save the NI and pension contribution too. If the NHS can’t do it, put a contractor in and let them just take a cut, a commission on each bill like a factor company but don’t go with one nationwide, use a local small business and compare their success rates.

    9. Kathy
      June 21, 2024

      Sadly, all your excellent suggestions are far too logical for today’s third-rate politicians.

  2. Sakara Gold
    June 20, 2024

    The Johnson administration’s response to the Chinese plague virus crisis was incompetence in spades. Books have been published using Britain as an example of how not respond to a public health crisis of this nature. Our expensive NHS QUANGO’s ran around like headless chickens, getting it wrong time and time again.

    The saddest thing for many was the completely unnecessary deaths of thousands of old folk and their carers in the care homes

    Partygate is repeatedly coming up on the doorsteps across the country as election candidates canvas for support.

    There are other reasons why the nation has turned against the Conservatives at this election, but for many folk, not being able to attend the funerals of their loved ones is the decider

    1. Lifelogic
      June 20, 2024

      Indeed but the net harm Covid vaccine killed or harmed is a huge issue. Sunak very foolish or dishonest to make his “unequivocally safe” statement to the house and country clearly he either has not looked at the overwhelming stats. or worse he is just lying.

      Passing through Gatwick Airport yesterday I picked up a free copy of the i newspaper. An article by Emily Maitlis:- “Britain is Broken and Farage Broke it”, “Farage hates Brexit because it is out of fashion and the country now hates it”. Farage may quite rightly dislike the way the Tories and May dithered for years, tried to kill Brexit, failed to even try to cut immigration & failed to take full advantage of Brexit perhaps. What planet is this silly “BBC think” woman on? A language graduate it seems.

      1. Lifelogic
        June 20, 2024

        So base rates stay at 5.25% but bank margins also very much higher than they used to be. So even solid businesses are often paying 9% to 15%+ with inflation at just 2% is it any wonder the economy is in such a mess? Sunak said yesterday it is important to control borrowing. But many sound businesses with good investment plans are finding hard to obtain funding at sensible rates or at all.

      2. Lifelogic
        June 20, 2024

        Matt Ridley is exactly right in the Spectator today. Whomever you vote for, the Blob wins.

        Parliament is largely an elaborate charade… The toolmaker’s son heading for No 10 is not just the bureaucrat’s friend but a knighted quangocrat…

        The last think this country needs is more and ever worse socialism from Starmer’s Labour party and the Blob at 14 year of total disaster from the Conservatives.

        Yet Hunt in a further attempt to kill the Tories says he thinks the public (voters) have “a total failure to appreciate the Tories superb record”.

    2. formula57
      June 20, 2024

      + 1 – although it is disappointing that the electorate seem willing to back opposition parties that agreed in substance with Johnson’s approach or wanted worse.

      As for funerals, the whole country will be able to attend two that are forthcoming: that of the Conservative Party in two weeks and that of the NHS within two decades (for it surely will not see its one hundreth anniversary).

    3. Michelle
      June 20, 2024

      This is true. The whole covid debacle was just that a debacle and exercise in terror and power over people.
      Where was all the hand wringing about Human Rights when this was all going on?
      More importantly where was Labour or any political opposition when this was going on?
      Labour were, and would have been just as bad, in fact it seems Starmer wanted harder and longer lock down and the Welsh and Scottish governments went full on too.
      So as I see it the whole political establishment are equally guilty, it’s just that Starmer is able to pretend he had little to do with it and of course mainstream media being full of Labour, no one will press him on it (and I see no difference in his social gathering to the Johnson one personally)
      We know what to expect under a Labour government when someone decides the next survivable illness is the plague/and ebola in one !!

  3. David Peddy
    June 20, 2024

    Stop wasting money on EDI, LGBT, woke, Period Officers and other nonsense

    1. Lifelogic
      June 20, 2024

      Net zero offices too ditch that in full for the country, the vast levels of pointless management and legal officers… also limit compensation low fixed levels, payable without needing to prove negligence. Similar to air travel limits so x for an eye, y for a leg, etc. You either accept these, go elsewhere for your op or buy more cover insurance privately yourself in advance of treatment if you can and wish to.

    2. Lifelogic
      June 20, 2024

      Stop asking men if they are pregnant perhaps. Stop all the diversity questions on NHS forms unless genetically relevant. A waste of time for the NHS and patients too.

      1. graham1946
        June 20, 2024

        Yes, I was asked just last week if I could be pregnant and had to sign the form. Not only am I obviously not a woman but I am 78 years of age and had already been asked for my birth date as a confirmation of identity for treatment. Wish I could have a baby, the book rights etc. would supplement my lousy pension just when needed.
        I also was phoned the week before asking why I had not kept my radiology appointment. Never had an appointment, no phone call, letter, text or email, nothing. The Radiographer said she was not surprised and made the appointment for a week later, so we had highly trained staff and multi million pound machines standing idle for half an hour for want of a phone call.

        1. Lifelogic
          June 20, 2024

          Entirely typical I got an appointment I could not make as I was away on business – but the letter gave to contact details that worked switchboard could not help. In the end I had to call in at the hospital to find the right person to change it even then it took about an hour to sort this! A sick joke in admin terms despite all the admin employers. This was 16 years back when it was better.

    3. Timaction
      June 20, 2024

      Plus add nutty zero posts.

  4. Geoffrey Berg
    June 20, 2024

    I was told several days ago in a long conversation with a national negotiator for pharmacists that the overall costs for dispensing for private pharmacists have been capped and have not been increased for many years and when they complained the Minister just told them to become more efficient. Let’s do the same with the rest of the N.H.S. such as hospitals – privatise their operation (making some money from the capital sale) and cap payments to them.

  5. Javelin
    June 20, 2024

    Several reasons why the NHS is suffering and it’s not taxes. Everyone comes down to weak leadership.

    Soft men create hard times

    – Covid Weakness. I said the whole thing was a nonsense. You needed to protect the vulnerable and let the healthy live. I was proven completely right. All these feeble minded people mumbling about hindsight, if only we knew. If you followed the actual science you would have found covid was just another Hong Kong or Asian flu from the 50s and 60s. Now you have massive backlogs and high interest.

    – Mass migration of unhealthy people. Not only does mass migration add an additional 15% to the population and dilute the NHS and public services, the people coming into the country are MUCH less healthy. For example diabetes is 6x more in Indians, prostate cancer 2x more in Africans, congenital abnormalities 10x more from muslim cousin marriages. The 10 million migrants suddenly LOK LIKE 40 million migrants to the NHS.

    – Not planning and relying on importing foreign doctors and women doctors. Foreign doctors are hard to get hold of. Women have a biological imperative to look after their own children rather than you or your children. It’s obvious they are not going to be full time. If they are half the work force and take half their time off then that’s a 25% reduction. It’s simple maths.

    – Making student doctors and nurses pay for to work for the NHS. Nurses should not be treated as worse than slave labour and have to pay for their own degree. If student nurses work the NHS then the degree should be free.

    We also have a huge problem with obesity. The food industry creates problems and the lack of exercise creates problems. Ironically the lack of investment in the police and punishment means children are not safe and their parents keep them locked up.

    The problems with the NHS boils down to feeble leaders who are too scared to point out the structure of the situation.

    Covid was a flu, immigrants get ill in a British climate, immigrants are much less healthy, women have children and love them, training doctors and nurses is an investment, children get unhealthy locked up. m

    It’s not rocket science. It’s feeble minds.

  6. Donna
    June 20, 2024

    How about we enforce the principle that it is a NATIONAL Health Service and anyone who is not a Brit has no right to access it except in an absolute emergency, ie the result of a traffic accident. Flying into the UK from Africa “7 months” pregnant is not an accident. All visitors to the UK should be required to have medical insurance.

    I think it would be far more effective just to sack many of the “key managers” who are responsible for the chaos in the NHS and bring in some of our abundance of Generals, Admirals etc to run the place. Not least because there are far too many of them for the reduced Armed Services we now have, so put them somewhere where they might be useful.

    Finally, Reform UK has the right idea. Change the funding model. What we have doesn’t work and probably never will.

    1. formula57
      June 20, 2024

      @ Donna – the principle you want enforced of foreigners being denied NHS access except for casualty treatment was a government priority in the 1970’s. Ho hum!

    2. Peter D Gardner
      June 20, 2024

      You can’t change the funding model because for the majority their healthcare is paid for by someone else. they’ll never give that up.It will have to get a lot worse and for far longer before the right to free healthcare is seen for the delusion it really is.

    3. Hope
      June 20, 2024

      Hunt was going to sort out health tourism years ago. He was health secretary for six years so had plenty of time! Hunt wasted billions, could not run the NHS. An abject failure so now he is chancellor!

    4. a-tracy
      June 20, 2024

      Which airlines are allowing people to fly for seven months without travel insurance? This could be clamped down on immediately, so you have to ask yourself why the Tories didn’t. What stopped them?

  7. agricola
    June 20, 2024

    Once more you ask the questions but fail to offer a way forward. Mark B offers many valid points. My experience of the NHS 2018 to 2020 was of a very compassionate, competent service, but my entry into it was via my private dentist who knew who to speak to, to open the door. I don’t believe the route via my GP would have worked so well.

    Comparisons with the spanish health service leave us wanting in terms of a problem presented to a GP and entry to a hospital and resolution. The fact that the UK service is 47% none medical is a point of failure. Their inability to administer and manage is at the centre of our failure. The practitioners suffer this as much as the patients.

    Solutions involve looking at systems that work in Europe and Australia. We need to remodel our service fundamentally, to reflect best practice in these countries and abandon all quasi religious properties the NHS has gained since Nye Bevan laudably created it. It is beyond the capabilities of politicians we have recently experienced because they put politics before results and few have the ability to recognise best practice and outcomes, let alone put them into effect.

    1. Lifelogic
      June 20, 2024

      “The practitioners suffer this as much as the patients.” Exactly – the dire NHS fail both patients and their medical staff too.

    2. Peter D Gardner
      June 20, 2024

      Lord Hannan wrote an opinion piece in The Telegraph a few months ago advocating importing the Australian system lock, stock and barrel. You will never get the majority of Brits to give up on ‘free at the point of delivery’. Since the net contributors to the state are in a minority, the majority will always vote for others to pay for their healthcare. Mention private enterprise and Brits turn into Socialists like chameleons confronted by a Serpent-eagle.

  8. David Andrews
    June 20, 2024

    The question marks hanging over how to finance and operate the NHS apply to the rest of the UK’s state funded social security apparatus. The cash is not there nor will it be despite the “manifesto promises” to raise yet more taxes. Politicians are making “promises” they cannot keep. The UK state’s business model is broken. Neither Conservative nor Labour nor Liberal Democrats have a clue how to mend it. One way or another the rationing of social security services will become more acute or they will cease altogether. Yet more taxation of a stagnant economy will not deliver an answer.

  9. DOM
    June 20, 2024

    The NHS is now a propaganda exercise whose only purpose is to create a perpetual series of fake and concocted crises designed to extract ever more funding from politically sensitive Ministers who fear damaging press headlines, refuse to expose the scam and pass on the cost to the taxpayer and the patient. Simple political cowardice. We see this across many important issues.

    When you see the headline ‘Tory austerity killing the NHS’ then it’s a given that the NHS is on the scrounge for more cash it doesn’t need. It’s become nothing more than a political game to protect and expand future budgets. We see this Socialist parasitism across the state.

    The damage to this nation and its future by the self-serving scum that run the Tory party cannot be underestimated. It is an existential issue. The only thing the Tory leadership had to do was expose Labour and its destructive plan to realign our nation along very different demographic and cultural lines. Jon Powell’s now infamous threat ‘to rub the right’s nose in diversity’ could lead to the fall of a once great nation

    1. Michelle
      June 20, 2024

      ++++ Agreed

    2. Mickey Taking
      June 20, 2024

      Criticism of NHS is treated as if blasphemy.

    3. Paula
      June 20, 2024

      It’s over.

  10. agricola
    June 20, 2024

    A second post because its valid. My dentistry costs about £50 per month in insurance. For this I get a practice of 12 dentists, supporting hygienists, and secretaries. All equiped with state of the art facilities in a beautifully appointed centre. All dentists have vehicles of their choice, live in nice houses and have nice holidays. In relation to their training and the service they offer, i begrudge them nothing of this.

    NHS dental practice would provide nothing comparable, because government is not prepared to pay for it or to devise an insurance scheme to pay for high quality basic dentistry to keep the teeth of the nation healthy. Needless to say politicians of all colours use the same practice as me.

    You need to kill the election lie that X thousand dentists can be produce from the back room of the pub to become NHS dentists and solve the dental problems of the UK without accompanying radical change, just like that !!!

    1. Clough
      June 20, 2024

      What you don’t say, Agricola, is the first step to get to the kind of health service you would recommend. It would surely have to mean introducing some form of personal insurance, which people would have to start paying for. Unless at the same time taxes were reduced correspondingly, the cost of living would increase. Which politician is going to advocate that? I’m not sure I would trust the government to work out the figures correctly so that we weren’t paying more, nor I suspect would you.

      I’ve had experience of other European health services when I lived abroad, and I tend to agree with you. I’d just like to see a roadmap for how we get out of the current mess.

      1. Lynn Atkinson
        June 20, 2024

        They can use their NI contribution to pay for real insurance instead. And the Government can pay for those who can’t out of taxes.
        Insurance companies can bid for blocks of patients (based on constituencies for example) and they have to take all in the block so they can’t Cherry-pick.
        Insurance companies would keep the delivery of medicine straight because they have a financial interest in ‘good results and a healthy population’.

      2. Berkshire Alan
        June 20, 2024

        Why not simply allow all of the cost of personal medical insurance to be set against their income tax.
        Simple and effective and does not require much policing, just an accredited insurance ref number. should the tax man want one. Doctors/Dentist could check insurance certificate on arrival at an appointment.

        1. Clough
          June 21, 2024

          Most employed people are on PAYE and don’t deal with ‘the tax man’ as such. Who in practice would set the cost of medical insurance against income tax?

    2. Lifelogic
      June 20, 2024

      £600 PA and of that £65 is insurance tax probably about £200 is insurance company overheads and admin cost for claims and perhaps another £100 going in fraudulent claims. So you are usually rather better off cutting out the government and the insurance company, saving your time too and skipping the insurance and putting the £600 in a tin and spending it as you need too. That way you will generally be far better off on average. Even if you do have a big claim one year you may think you have gained but they often charge more next year. Cut out the middle man. You probably do not need to cleans the check-ups every year anyway and insured people tend to use these.

      All insurance is just gambling and the casino nearly always – wins even without the 12% IPT tax (and fraudulent claims).

  11. BOF
    June 20, 2024

    ‘The government paid a large sum to provide Nightingale hospitals, then scarcely used them. If they had been used for COVID the main hospitals could have done other work, providing more timely treatment and keeping waiting lists down.’

    I was in hospital (4 in all) for a year and seven months during the Covid scam. They were not overrun and staff were doing ticktock dances, ambulances stood idle. Nightingale hospitals were never needed and could not have been staffed!

    £450B spaffed for nothing while I watched victims of mRNA genetic jabs come in and out. One retired chemist I befriended now dead as a result.

    my wife never allowed to visit. The economy and country severely damaged. I will never forget and never forgive.

    1. Lifelogic
      June 20, 2024

      +1. The Nightingale Hospitals (7) were clearly a stunt and expensive but pointless photo ops just to show that the Government were doing something (something pointless and expensive as it happens – rather like net zero in fact). One was opened by Prince (now King) Charles as I recall. All PR, photo ops and spin distraction from any real and valuable health care.

    2. Michelle
      June 20, 2024

      Sounds as if, like my own family experiences, you’ve been more traumatised by NHS than healed. My sympathies.

      1. BOF
        June 20, 2024

        I was healed but that was due to the most amazing and brilliant neurological team in Birmingham. My survival was down to them.

  12. Roy Grainger
    June 20, 2024

    I’ve heard Labour in the form of Wes Streeting say the NHS needs reform, but I haven’t hear any Conservative Health Secretary or Prime Minister say that.

    1. Everhopeful
      June 20, 2024

      Why are we wasting ££billions on a system which shut down when the first plague since the Middle Ages ( or whenever) struck?

    2. MFD
      June 20, 2024

      It was a slip of the tongue Roy! What he meant to say was “ The NHS needs Reform UK”, they are experienced managers , not oxbridge useless graduates.

    3. a-tracy
      June 20, 2024

      They can’t say that Roy, they had 14 years to do it and chose not to.
      Who allowed them to hire all those diversity officers.
      Who set the numbers of GPs allowed to train without any payback clauses if they don’t work in the NHS. A simple change would be to work in the NHS for 40 hours per week on average over a month, and each month you do that, you don’t pay your graduate tax. Leave, and the student loan transfers into a private loan, and at least the rate of an FY doctor’s salary will be charged to you unless you provide evidence you are not working.

  13. Narrow Shoulders
    June 20, 2024

    NHS Trusts get their money through grants. If they do not see a single patient they still get paid.

    Change the funding model so that they claim per appointment or per procedure.

  14. R.Grange
    June 20, 2024

    You ask why the NHS suddenly found itself having to spend huge sums on PPE. Was it not because Tory government-appointed public health ‘experts’ claimed PPE such as gowns was needed because the SARS2 virus was spread by surface contact? When in fact it was an aerosol that was breathed out and breathed in, like other cold viruses. Perhaps that long-standing knowledge was why the NHS had not wasted money on stockpiling PPE for its staff. A more intriguing question is why in advance of Covid it stockpiled so much Midazolam, a powerful tranquilizer.

  15. Berkshire Alan
    June 20, 2024

    Family member could not get appointment for a persistent cough ( five weeks and getting worse) at the local Wokingham GP practice.
    After many failed telephone attempts, eventually requested an appointment by e mail, responses promised a telephone consultation within 48 hours, but no response, further e mail sent, but again no response.
    Eventually I turned up at the Practice in person, gained an apology but was told they were busy and no appointment slots available, eventually after I said I would take them to A&E at a huge cost and inconvenience to all including the the NHS, they suggested an emergency walk in Clinic at Reading.
    Visited the walk in Clinic waited 2 hours to be seen, but family member got an excellent consultation and examination.
    Result prescribed antibiotics, steroids, nasal spray, and they also picked up a heart murmur which would need to be investigated further.
    Great service in the end, but what a farce and huge inconvenience, wasted time and suffering to get it.
    During the previous 5 weeks family member had seen 2 different pharmacist and taken prescribed and suggested medication to no avail.
    The system is well and truly broken.

  16. Rod Evans
    June 20, 2024

    Sir John, the NHS in its current form is a failure. As time moves along it will continue to fail and will simply consume more and more pf the nations financial resource, while delivering less and less.
    The NHS has become the sales force for big Pharma over recent decades. that is its main function. Little will change while that demanding role is continued unabated.
    The waste, the NHS is famous for, will simply continue until there is a direct feedback mechanism introduced that curtails the indifference to cost that pervades the minds of all who operate (no pun intended) within the NHS.

    1. Francis J
      June 20, 2024

      As far as I know about half of European countries have tax-funded healthcare systems free at the point of use. In the other half you pay for treatment and can claim all or most of it back, or low-income people may have a card that avoids the need to pay up-front.

      Many countries’ so-called ‘health’ systems seem to have become drug-pushers. It’s not just the UK. One apparent difference is that people in Spain, France, Italy or Switzerland eat more healthily than we do and consume less ultra-processed food.

      People in these countries live about four years longer … to about 84 instead of 80 for Brits. Any connection? I see better food as much more use than peddling patented pills to a stream of chronically-ill patients.

  17. jerry
    June 20, 2024

    But it is not about how much money is spent but _how_ the money is spent, £1bn more directly funding front line services and staff, or £1bn funding back-office, PFI, and the extraction of profit.

  18. majorfrustration
    June 20, 2024

    All very good points but remember that any change will be dictated by the NHS Unions – so dream on

  19. Everhopeful
    June 20, 2024

    I bet that drug companies are the root cause of escalating costs in the NHS.

    1. Lynn Atkinson
      June 20, 2024

      No it’s the Government, they agreed to buying our medication at a premium so that Africa could be supplied free of charge.
      More ‘off balance sheet’ aid.

  20. Everhopeful
    June 20, 2024

    NHS = micro Communist state within a state.
    Was there ever a communist country that worked?

    1. glen cullen
      June 20, 2024

      It needs the army man-management, disciple and structure

  21. formula57
    June 20, 2024

    A £ sign in today’s title might be considered please, to avoid startling readers like me whose initial thought was this was the replacement pledge to “we will cut immigration to the tens of thousands”.

  22. Dave Andrews
    June 20, 2024

    Maybe we as a country need to be realistic about how long someone with extensive comorbidities can be kept alive. I don’t know how much is spent on geriatric medicine, but something tells me it’s a considerable part of the budget.
    When someone can be discharged from hospital, they are kept there because there is no care package available for them and the council doesn’t have the means to put one in place. I suggest an obligation on anyone cashing in their pension pot that they should buy an insurance policy that will pay out should they need care provision or go into a care home, out of the 25% tax free handout. Deal with the bed blocking.
    For younger working age people, allow employers to implement an opt out medical insurance scheme with tax incentives. There will then be a more direct incentive for preventative action so people don’t get sick in the first place and are encouraged to follow healthy lifestyles; financial rewards for following medical advice.

  23. Richard1
    June 20, 2024

    What we actually need is more market mechanisms to improve the whole supply & demand structure. No other industry works well where the state is a 95% monopoly supplier and no other developed country has this level of nationalised state monopoly, so why should healthcare in the U.K. be the exception? (Canadians just use the US private system when they need to).

    But this is obviously heresy for all parties including the Conservatives so we may expect nothing to be done about it. The position will get worse and worse – more and more money for a (relatively) ever worse service until one day there is a politician or party brave enough to say the unsayable.

  24. Bloke
    June 20, 2024

    Proposed Solution for a simple start:
    Allow every person living legally in the UK an NHS Budget each year.
    Deduct the cost of their treatment and show them their account balance.
    Individuals can donate their unused amounts to children or others they wish to help.
    Charge people tax on their balance if it is minus.
    Allow exemptions for disabled people, & no tax charged for under 21s.
    Transfer all balances in credit to each person’s pension at age 60.

    Intended Outcome:
    People will spend their own money most carefully, and assist those they care for.
    Wasters see the errors of their ways and improve.
    Those who maintain a healthy lifestyle will help us all.
    Lower cost and higher efficiency achievements.

  25. Michelle
    June 20, 2024

    Over use.
    Poor management
    Capping of our own students wanting to go into medical courses
    Forcing of degrees for nursing (now policing as well I believe!!!) which will deter those who would make great nursing staff because of it being their desired profession, as opposed to just being academically capable. Let’s return to the old standard on entry and training.
    Union influence for political means
    Inability to spend funds efficiently and spending funds on politically motivated issues
    Incompetent, uncaring and downright brutal staff, leading some hospitals, ultimately the tax payer, to have eye watering sums outstanding on compensation (and it’s the devils own job to get them to even care about the brutality even when you are not asking for compensation, just recognition of the trauma it has caused)

    Just some of the things wrong that do not require billions to be put right.

    1. Dave Andrews
      June 20, 2024

      Absolutely right no need for RGNs and RMNs to have a degree. A degree in nursing might still have its place for those wanting academic advancement, say in training or research.

  26. Ian B
    June 20, 2024

    If there was anything that was easy and straight forward to privatize it is the front end of the NHS. Choice of GP’s Practice’s, Hospitals and so on exists – they are not chasing the money so don’t try to hard to do their job. To ensure that everything is Free at the point of service we have a compulsory National Insurance.
    The fact that every Government of every complexion in the UK dances around the subject is why what is now prescribed to serve us is appalling. Governments use NI as a Political football, not a provider.
    Farage of all people pointed out recently that in France the system works, you pay in and get service when its needed. Which as far as I am aware is all that the Consumer of the service requires.

    1. Lynn Atkinson
      June 20, 2024

      Oh France is an example all right. A British friend who lives there needed a shoulder replacement. She had been admitted and then to secure payment they signed her into ‘health insurance’. If the medics are in charge of the ‘health insurance’ rather than the insurers, there will be trouble ahead.
      She went in to have both hips replaced too – free, gratis and for nothing, in France.

  27. William Smith
    June 20, 2024

    Having worked in the NHS for 42 years I categorically agree that throwing money at this behemoth is not the answer to its ills, it requires better, constant management. For example numerous changes of Service Names costs lots of money to change signage, headed paper etc. Health Ministers and Managers changing every year with new ones wanting to make changes in order to make their stamp, again costly. Lots of reinventing the wheel. Monies kept to the last months of the financial year then wasted on non essentials otherwise that sum is deducted from the following years budget as ‘not required’. Many beds are blocked in hospitals because services are not provided in the community, if that were changed there would be a more rapid turnover on waiting lists. What exactly are GP’s for? Most appointments at surgeries are dealt with by Healthcare Assistants, Nurses and other specialists. GP’s mainly refer on to Hospital Consultants. The public need to be made aware of exactly what GP’s do and don’t do. There is no such thing as a Family Doctor now, if you’re lucky enough to see a GP you will usually see a different one at each appointment, no continuity. Everything needs close scrutiny and managed seamlessly if it’s to succeed.

  28. glen cullen
    June 20, 2024

    The continued polls this morning suggest a total wipeout of tories….maybe you need policies that the tory voters want ….a bit like reforms policies

  29. glen cullen
    June 20, 2024

    *Porters, Ambulance Staff, Nursing Staff, Admin Staff, Auxiliary Staff, Junior Doctors & Consultant Doctors (self-employed) and GPs (self-employed) all on the same terms & conditions of employment with a single pay spine
    *NHS car parks free
    *Build care homes on NHS property
    …..don’t know why I’m bothering today, the tories are in such a mess, they’re not going to any change policy nor leadership, they’ve realised that they’re not going to be the next government …they’re stopped fighting

  30. JayCee
    June 20, 2024

    P&L reports in the public domain of all parts of the NHS based on invoicing of services provided and costs incurred would be a start.

  31. Donna
    June 20, 2024

    Two thousand criminal migrants shipped over in just two days. And every one of them now awarded a life of “free everything” including swift NHS treatment and NHS dentistry.

    No wonder taxes are increasing; there’s a massive housing crisis and the NHS can’t cope.

    1. Timaction
      June 20, 2024

      They should be stopped and returned immediately to France. Simple. Why not? Gutless? Secret agreement? Illegals Human Rights? No rights for Brits? Reform. Everyone is saying it.

  32. ChrisS
    June 20, 2024

    Because of our rare “free at the point of use” healthcare system, it only makes sense to insist that every foreign resident arriving in the UK provides proof of health insurance. Is that so difficult to understand ?

    But the other side of the problem is that every patient-facing part of the NHS needs to demand proof of entitlement or insurance before granting “free” treatment. In the long run, this can only properly solved by issuing ID cards to UK residents with a crucial healthcare entitlement identifier that can be machine-read.

    The biggest problem is that currently, staff working in the NHS think it’s beneath them to ask the essential question. The first thing Wes Streeting should demand is that this hole in the bucket be firmly closed.

    1. ChrisS
      June 20, 2024

      I somehow suspect that NHS management would say that the cost of treating those not entitled to “free” treatment would be less than the cost of identifying the freeloaders and charging them ! That is not the point. If we make it impossible to obtain free treatment, the health tourists would stop coming.

    2. Lynn Atkinson
      June 20, 2024

      We have already issued NIC numbers – they don’t work, why do you think ID cards would work? You can get beautifully faked ones from Karachi – £20 a dozen.

      1. Chris S
        June 20, 2024

        If they are machine-readable, ID cards cannot be faked, only cloned.
        We should adapt our well-established driving licence system to double as ID cards, so they can be issued to everyone at minimum cost. The photo would confirm the identify the bearer. A fake would immediately show up.

        1. Lynn Atkinson
          June 20, 2024

          I will NEVER carry identification papers.
          Anyway, cloning is easy and replacement of the picture. If the reward is big enough the key to any lock will be devised.

  33. Bryan Harris
    June 20, 2024

    What we immediately need is to make key managers more accountable and to get to tackle the staff, property and supply problems

    Yes – Make all managers accountable.

    Time to bring in a practice from the real world where people are assessed annually on how they performed and whether or not they reached their goals….and it’s long overdue that everyone in public operations were treated as individuals. Time to do away with national pay bargaining which gives unions so much power.

    Personal responsibility is key to improving any organisation.

  34. The Prangwizard
    June 20, 2024

    I would prefer to start by addressing hospital practises and who is accepted. Difficult though for anyone promoting this because of the horrendous attacks promoters would get.

    I’d look at the list of all the hospital treatment /surgeries currently given, and publicise ‘we don’t do this/that’. Whilst I don’t know the extent of what you can get I have seen reports of what seems to me trivial.

    Not only would there be money savings it would stop selfish and trivial demands.

    Who dare do this beyond saying a few words only and leaving it at that? Where are the courageous and determined?

    There needs to be an examination of equipment use. Only observation, but in hospitals I have seen lots of equipment sitting about unused for long periods.

    Additionally, staff use. I have noticed large numbers if nurses gathering around screens in the general area, almost none with patients showing close caring.

    Small single improvements in thousands of places will make a big difference.

  35. David+L
    June 20, 2024

    Being open and truthful about effectiveness and safety of the very profitable drugs that we are pressured (even mandated) to put in our bodies is surely a basic requirement of any health service. But raw data on drug adverse reactions is “confidential”, with even the UK statistics on Covid Vaccine harms being supplied to the makers but not to us. It seems more money gets poured into our NHS and the pharmaceutical industry profits skyrocket yet no Ministers nor any Party seems to question what is going on.

  36. graham1946
    June 20, 2024

    Sir John, you say the NHS needs reform. True enough, but have you forgotten that your party completely reformed the NHS in 2012, introducing the ‘internal market’, Trusts, all with their directors etc. and that Hunt tinkered about with it when he was S.o.S. for Health for years to produce what we have now? God preserve us from another scatter brained experiment by some dopey politician. Take it and education out of party politics, get some professional management in from industry and we might get somewhere.
    The NHS needs reform. We need Reform the party. The rest is all just more of the same whoever governs.

  37. Christine
    June 20, 2024

    If telephone appointments are acceptable and bringing in thousands of foreign doctors is acceptable why not save a massive amount of money by missing out the middle stage and outsource digital consultations to vetted doctors aboard? This would free up UK doctors to concentrate on face-to-face appointments where they are needed.

  38. Bert+Young
    June 20, 2024

    I have argued for years that the NHS should be managed by medically qualified individuals and on a regional basis .

    1. Lynn Atkinson
      June 20, 2024

      Medics are not managers.

    2. glen cullen
      June 20, 2024

      There’s a reason why welders aren’t managers of engineering/fabrication companies

  39. Iago
    June 20, 2024

    There was no covid, just as there was no conservative government.

  40. Ian B
    June 20, 2024

    Governments wanting to be seen doing the day-today hands on running of everything.
    Hospitals get money to run as efficient enterprises. Then? we have Government or lately the PM negotiating the pay for doctors. What’s the point, were is the joined-up thinking and budgeting taking place? Where is Hospital management the ones that demand the money figure in that? What does Hospital management do to protect itself it creates a different sort of Empire – one focused Diversity, Inclusion and Equity, apparently because this Conservative Government legislated and told them too. So, the Hospital management recuses them self from all clinical activity and delivery.

  41. Ian B
    June 20, 2024

    GP Practices are nowadays businesses run by larger organization. Delivery of service and its funding is no longer based on patients seen but how many people are registered with the practice. As such the ‘wiley’ pen pushing management see that a GP is an expense and trainee clinician is a cheap option. What has that to do with good medical care?
    We will get a good health system when the money we pay in, is used for the service delivered.
    Governments need to be divorced from the day-to-day running, something to date they have clearly failed to do. They are too worried about elections and being seen to do something. Is our Health that trivial?

  42. Ian B
    June 20, 2024

    “Labour will need an “effective opposition” in Parliament if it wins the general election on July 4, Jeremy Hunt has said.”
    He knew what his uncontrolled spending and high tax would achieve. When did he first conspire to cause this implosion of Conservatism to happen?

    1. Original Richard
      June 20, 2024

      Ian B :

      A good question. A large Labour majority, an “opposition” composed of Lib Dems/SNP/Greens together with a Civil Service, MSM led by the BBC with its 8 TV and dozens of radio channels, judiciary, academia and police all Left supporting we will experience a Left one party state.

  43. Derek
    June 20, 2024

    In short, the NHS administration and the Government Health Department obviously has been run by amateurs. Any FTSE CEO worth his salary would have been able to put them on the right lines but they were either too arrogant or too ignorant and incompetent to consider calling in the Private Sector to aid them.
    Is it not possible for the NHS to contract more Private Hospital beds and treatments to cut waiting lists, while saving money by cutting down on the huge number of non-medical administrators who add very little to the smooth running of the Service?
    Perhaps they should consult the Singaporean Health authority for new ideas, as they are rated the World Number One Health Service. There has to be a definite change of policy else those long waiting list will never fall to acceptable levels.

  44. Ralph Corderoy
    June 20, 2024

    Oncologist Karol Sikora, probably no introduction needed, writing a couple of days ago in The Telegraph about each party’s plans for the NHS: ‘And then I read Reform’s plan. I could have written it myself. Sharp, concise, controversial and radical. We do need something different to get us out of the mess we’re in, and it’s certainly that.’ — https://www.telegraph.co.uk/news/2024/06/18/reform-nhs-plan-nigel-farage/

  45. forthurst
    June 20, 2024

    The NHS is underfunded by international comparisons although not substantially so. The only advantage of the NHS over international models is that it is free at the point of arriving on English soil which obviates the costs of administering multiple insurance-based systems. Despite this, there appear to be far too many people who are not medically qualified involved in the administration of NHS at all levels. Furthermore these people seem rather more keen to tell the doctors how to do their jobs than doing what they themselves are paid for.
    The shambolic mess of COVID with daily briefings by the Chief Medical Officer or the Chief Scientific Officer, Nightingale hospitals to replace the isolation hospitals which were all closed down demonstrated the shear cluelessness of the government apparatus in preparing for and tackling a national medical emergency.
    We don’t need CMOs and CSOs. They exist for the sole convenience of lazy and stupid politicians and in the COVID case to churn out government propaganda without any basis in ‘the science’ as has been admitted by Anthony Fauci in the USA.
    Despite its additional cost overhead, insurance-based systems would be better than the NHS.
    Private healthcare in this country is simply a system for patients to queue jump NHS waiting lists to see NHS consultants moonlighting for extra dosh and is not a proper healthcare system as those in Germany which do get substantial subventions from the taxpayer without the inchoate meddling of politicians.

    1. Dave Andrews
      June 20, 2024

      The NHS isn’t so much underfunded as oversubscribed. Too many reporting with lifestyle diseases. Perhaps the NHS could be relieved of the responsibility of treating these, so it can concentrate on the genuinely sick.

    2. forthurst
      June 20, 2024

      Apologies for the length of that post which I posted without checking its overall length.

  46. Original Richard
    June 20, 2024

    “In recent years there has been plenty of wasteful spending.”

    Of course, the NHS, particularly the admin, is stuffed with fifth column Marxist saboteurs and consequently will be following Robert Conquests 2nd and 3rd laws of politics.

    This is the inevitable consequence of a monopoly which results in wasteful spending, failing CEOs getting moved to another CEO job in another Trust and medical staff petrified of any whistle blowing for fear of being sacked and never being able to get another medical job in the country ever again.

    Under Labour DIE (Diversity, Inclusion & Equity) will be taken to its conclusion where for even top medical staff, such as surgeons & anaesthetists, diversity will trump meritocracy.

  47. Iain Hunter
    June 20, 2024

    How about sacking at least half of the managers and doing away with their rôles? We don’t need DEI ‘leaders’ on £90k salaries. Get rid of them. Then introduce a part insurance-based system. The NHS concept has run its course.

  48. Ian B
    June 20, 2024

    News latest
    “Russian hackers who targeted NHS hospitals have demanded a £40 million ransom.
    The group, called Qilin, claimed responsibility for the cyber attack on computer systems run by Synnovis, which provides pathology services to hospitals and GP surgeries in London.”

    At least the NHS has enough money sloshing around to pay up!
    Another example of this Conservative Governments failure to take our security serious. If they were not so hung up on themselves being able to spy on the people we might have a secure system in place. Why is this Conservative Government so afraid of the People, that they have to put peoples lives at risk?

  49. glen cullen
    June 20, 2024

    BBC website reporting the decision of the Supreme Court on climate impact ….the courts are again in charge of government oil & gas policy

    1. Berkshire Alan
      June 20, 2024

      Yes utter madness, they will bankrupt the Country as Companies go overseas to manufacture, and then we will purchase the imports, those who still have a job and are left in work that is !

    2. paul cuthbertson
      June 20, 2024

      GC – Who introduced the biased Globalist Supreme court? Why do we need it?

  50. Margaret
    June 20, 2024

    I just can’t understand why many district hospitals were closed.We needed the space.Rationalising the NHS into larger hospitals centrally was always a bad Idea.These hospitals are difficult to access with one way systems and pedestrianisation.
    The money could have been used wisely to upgrade older hospitals and keep the experienced staff, who were efficient and effective,but the only thought in the minds of management was to bring in partially paid European staff and put the experienced out into agencies to create business.Health doesn’t work like that.Many were travelling miles every day and every year simply to get a few hours work.Tge money was diverted into agencies which now don’t exist.

  51. Linda Brown
    June 20, 2024

    I thought one of the earlier ideas was to give doctors and nurses control over GP surgeries and hospitals. What happened to that idea which was the best so far. If anyone knows how to run a business the ones that do the work do. Where did the idea for all these useless managers come from? They never take responsibility and are always missing in times of crisis but they still take the money. Capitalism does not work in the NHS I am afraid. Like it hasn’t worked in the Post Office and I know as I worked there in days past for 18 years. A crime has been committed in both these areas which needs acknowledging and putting right.

    1. Berkshire Alan
      June 20, 2024

      Linda, That was how the Hospital’s were run until Labour in the form of Barbara Castle completely changed the system back in the 1960’s, and installed managers who had little medical experience, and the management function was removed from the Matrons and Doctors.
      Speak to very much older and retired NHS medical staff and they will agree, that is when the NHS started to go downhill, and it has continued ever since, because all political Parties have built and expanded on that original mistake, thus making matters even more complicated and expensive.

  52. Sir Joe Soap
    June 20, 2024

    Yes another reason chalked up to not vote Tory again.

  53. Joan Sawyers
    June 20, 2024

    Why do we let each hospital purchase it’s needs from different suppliers, surely a more cost effective way to keep costs down would be to have a central supplier so that hospital A pays the same for equipment etc. as hospital B. The Government could oversee this and make sure that there was a plentiful supply when needed and no one hospital had to pay more out of their budget than another. It needs to be pruned from the top, get rid of all the non jobs and let hospitals do what are supposed to do, make people well.

  54. dixie
    June 21, 2024

    Just one billion more ..
    is that money, invading immigrants or lifelogic comments?

  55. paul
    June 21, 2024

    Need to start analysing efficiency and publicising results. Need to look at processes and simplification.

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