It's quite clear that the NHS has been underfunded, and under resourced, for the last decade. However the government still try to argue that the inefficiencies are a organisational problem rather than a funding problem. Which is still laughable when they have presided over it during the whole time period in question.
So someone with ethics might argue that if you are in an uncertain area between over and underfunding then it will kill fewer people to err on overfunding.
If management doesn't flow the extra funding to front line staff or resources, it can easily be wasted for zero added value.
Renationalising the NHS and limiting the private sector to those few expensive services that are essential would fix this.
But both political parties are working for the people who profit from this situation.
Something involving killing patients if you don't build some leeway into the system.
ex. How many ambulances at a few pounds in 1948, which were vans with a stretcher in the back and a couple of blokes to drive it. What about 2022? The cost, roughly £150K for the ambulance, goodness knows what to train up ambulance technicians and paramedics. If the kit is broken, the ambulance can be out of service, which means more units to provide cover (or not if you can't afford it!). The on top of all that, many more people go to hospital because the care is leagues above what you got in 1948.
Ditto for equipment costs like Digital XRays, MRIS etc.
All of that is not surprising or even undesirable but it would be interesting to see the additional tax that you should be taking per-person to pay for all of this additional equipment. If the NHS costs around 30% of expenditure i.e. 30% of my tax then roughly 7.5% of my income covers the cost of the NHS, maybe £6K per year. When we look at things that way, you can see why the Government doesn't want to take any money in tax because that sounds like a lot of money. You can also see how they can't reduce costs by going backwards in replacing high-tech with no-tech.
[1] https://www.kingsfund.org.uk/projects/health-and-social-care... [2] https://jamanetwork.com/journals/jama/fullarticle/2785479
I’m not sure I can take the report seriously after that. You can’t write a report on management in the NHS and refuse to give a definition of manager. Also, how many of these managers are directly employed by the NHS and how many are employed as consultants?
I’m not saying you’re necessarily wrong but that report is hand wavey.
What is a manager? Are you only including non-clinical staff? Or do clinical staff count too? If you're including clinical staff, how many hours of their working week are you counting as clinical hours and how many are you counting as managerial hours? Are you converting people who work part time as managers to Full Time Equivalent positions, or not?
If you want to poke the data it's here: https://digital.nhs.uk/data-and-information/publications/sta...
If you want more description of the complications of counting managers in the NHS I found these useful (if a bit old now):
https://www.kingsfund.org.uk/publications/future-leadership-...
https://www.kingsfund.org.uk/projects/general-election-2010/...
https://www.kingsfund.org.uk/projects/health-and-social-care...
"The NHS is full of bureaucracy" but it is a bureaucratic system so of course it is. People to charge hospital costs back to GPs, people to investigate trends and make sure that some GPs are not under-referring people to hospital, etc. but when I worked in the NHS many moons ago, it didn't seem particularly disproportionate to the size of the organisation. There were many more problems with people not doing their jobs properly but that was everyone, not just this nebulous "middle management" that everyone likes to cite!
Certainly, some hospitals under-perform and have issues with culture and discipline but that's the same as any business.
There are also some quite ridiculous cash handouts for little or no taxpayer benefit. Like the notorious £37bn that failed to provide an efficient Covid test and trace system. Or the >£100m in the Michelle Mone scandal, which seems to have been just one of many. Or the £45bn in tax cuts in Kwasi Kwarteng's recent budget, which were supposed to "promote growth" but have done the opposite.
The UK is one of the richest countries in the world. It has also become one of the most corrupt.
A penny or two on tax is not the problem.
i don’t think you realise how much the health service costs. you can tax all of the richest and it will represent a few days of the health budget. a new funding model is needed. otherwise there will have to be tax increases.
I can't help but think that efficiency should be a secondary metric when it comes to health care. If you can get the same treatment, capacity, resilence etc. cheaper, go for it – sure. But as soon as you start to save money by sacrificing those more important metrics the price will be paid in human lifes eventually.
Anything "unlimited" is impossible in a constrained physical world. So I am not sure what contribution you like to make by stating the obvious here.
For most economies delivering reasonable high quality care to everyone who needs it is totally a thing they can (and in some cases: do) afford. It is just a matter of priorities. You would be surprising what nations can sustain if they really want it. War is a good example. When a nation goes into a long war and changes its economy to support that war we call that a war-economy. It is an economy, that priorizes a lot of what it produces and outputs for the war effort. Nations can be years or even decades in war-economy mode without going under and that works because they priorize the nations existence (and thus the war) above other financial goals. And in war nations also make companies do things that would be otherwise unthinkable, e.g. make a company share blueprints with a competitor, favour certain industries with resources, etc. If any nation knows that, it would be the UK.
So if any modern western government goes all cheap and naive big eyes on health care, it is not because they can't do better, but because they don't want to. Not wanting to do better is a very easy opinion to have, especially if one earns money by being of that opinion. Those who suffer and die are also a different demographic than them, so even easier to pretend all is going well.
I am not saying that any health care system should be inefficient. It should be efficient in certain way (e.g. prevent funneling government money into pockets, prevent paying too much for medicine and equipment and so on). But efficieny is not the primary goal here, the primary goal is to have an adequate health care system. And you will always get unethical rich people saying private payer is adequate, because THEY are covered by it. But the fact of the matter is that everybody profits when a nation has a good working health care system for all, even the rich egomaniacs. After all they cannot decide where they will have a medical emergency as well.
Usually the way you achieve this is by reducing spending to reduce the deficit.
But you could also increase taxes.
Government spending will eventually be paid. It's whether it gets by the people now, the people in the future, or the bagholders (bond holders when the government or currency collapses).
Of course life expectancy is going to decline if you can't force your grandchildren to pay for your healthcare costs now.
But it's not clear to me that's the most evil thing in the world.
Back when most spending was infrastructure and growth was high, you could argue this would be around forever, and it should be financed to a large degree on future generations.
But now that a huge percentage of spending is entitlements and growth has slowed, it's less clear.
Oxford prof Simon Wren-Lewis explains it better than I could: https://www.lrb.co.uk/the-paper/v37/n04/simon-wren-lewis/the...
The tl;dr here is that there's a striking number of patients in hospitals (up to 30% in some areas) which are ready to be discharged from hospital, but cannot yet be discharged since they're waiting for the availability of social services that aren't handled by the NHS. I've mentioned it in all my comments here but this is the cost of austerity, and it's making healthcare not just worse but more expensive.