Per the Nuffield Trust NHS cost as a percentage of GDP has doubled 1950 - 2020, from 3.5% to 7%.

In the same period the population has increased 40% from 50 to 70 million.

With the increasing life expectancy by about ten years in the same period and advances
in treatment and the cost of treatment it is inevitable that the cost as a percentage of tax has/will increase.

Most European countries spend 10% ish of GDP, France and Sweden as examples, it is broadly acknowledged they both have better medical outcomes than the UK.

They also have systems that are not 100% free at point of service.

Somehow the politics has to be removed from the NHS debate but no idea how that would ever happen

Starmer and Streeting are now publicly saying things need to change, just not how.

If people have private medical insurance then going private is their decision, nothing political, frees up an NHS service.

If NHS services reduce because of doctors doing private work that is a systemic problem in how doctors are required to deliver services after training.

Similarly having a two tier nurse pay structure depending if they are NHS or agency also needs to be somehow reviewed.

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Responsibility Deficit Disorder is a medical condition. Symptoms include inability to be corrected when wrong, false sense of superiority, desire to share personal info no else cares about, general hubris. It's a medical issue rather than pure arrogance.

Too many chiefs, not enough Indians.
All to ‘protect’ from mistakes. Well sadly mistakes happen and that’s life.
Pay the compo and move on; don’t spend more trying to prevent them when the sums don’t add up.
Too much waste, too much lip service, too much keeping people alive instead of just treating them and letting nature take its course, too much nannying and forcing our lifestyle to enable a life past a natural age.
Five a day, don’t drink, don’t smoke etc etc.
Then when you reach 90 you’ve had enough and just want to go but arnt allowed to.
Life wasn’t designed to be coverted, it was designed to live, breed then die.

Agree with all above. Needs a complete re think. Can I throw in not offering certain services/procedures on NHS. Some of that wouldn't have been around 40/50 years ago. That list could be open to debate but it does stagger me some of the things on offer.
As to the arse covering that's correct but only because the Chief's impose it. By legislation limit when you can sue the NHS which would cut down the paperwork.

These are some of the issues that need to be addressed although I doubt the politicians have the balls to do it. If they fix these then fine give them a pay rise but it has to have strings attached.

- Too many people not paying into the NHS and I don't just mean health tourists. The older the population gets the smaller the taxpaying group gets. I am sorry but everybody should pay a minium amount even pensioners.

- Too many staff using the NHS to subsidise their private work from consultants to nurses. What would your boss say if you said sorry I am not available that day I am working for a rival company. A friend was unwell and couldn't get a GP appointment so went to a private clinic and who did she see? Yup her own GP who couldn't see her on the NHS, she went nuts.

- Bed blocking. The NHS needs to have short term care homes like they used to so frail people can be moved there for a couple of weeks before being discharged.

One more point

Convalescent homes they were called.

I don't understand why they cannot build a few 'Nightingale' type hospitals (or have used the original ones) for this.

As most patients are ready for discharge, they would only need a mininmum of 'qualified' staff and a few health care assistants, with the patients themselves helping with things like meal delivery and drinks rounds as part of their occupational therapy, preparing them for home (obviously only for those who are actually able to help in some way).

This and the 'community spirit' and companionship would probably be far more beneficial all round.

A stairway to Heaven and a Highway to Hell give some indication of expected traffic numbers

Not forgetting the 13,300 new NHS doctors and nurses this year.

Edited by Willo (13 Dec 2022 9.16am)