Do You Know How Broken the NHS Really Is?

So, our country's 68 million population has record waiting lists and some of the worst outcomes in cancer diagnosis and management. Compare that to France, which has a similar population, and ask why they have better, faster access and better outcomes. Germany has an 88 million population yet still punches above its weight in healthcare.

The NHS is broken. Get that clear. The Labour Party trying to raid Farmer's land and raise taxes across middle-class working people to pay for NHS services is wasting your monies and isn utter rubbish. The tax income from such measures will barely pay for a few minutes of the NHS staff budget.

80% of NHS activities (Finished Consultant Episodes) are in the bottom 20% of the population who paid little or nothing into the healthcare system. Ask any Public Health specialist, he'll tell you two key things that Public Health teaches us:

1. The poorer you are, the more likely you are to need healthcare. These are the bottom 20% of the population that paid little or nothing to the system.
2. The older you are, the more likely you will need complex healthcare driven by multiple co-morbidities.

The NHS is a bottomless pit.

The NHS in England currently employs around 1.5 million people (on a headcount basis, counting each individual member of staff) and 1.3 million people on a full-time equivalent (FTE) basis. (source: The Kings Fund)

That is 1.5 million people to care for the 68 million population.

Imagine the waste with such a headcount covering hospital staff, mental health services, ambulances, community services, commissioning roles, and central bodies.

Let me put this into a sense of perspective for you.

The population of India is 1.45 billion (145,000,000,000). To protect that 1.45 billion population, the total defence staff numbers look like this:

The Indian Armed Forces have over 1.4 million active personnel, making it the world's second-largest military force. The Indian Armed Forces include the following branches: 

• Army: The Army has 1.25 million active personnel. 
• Navy: The Navy has 65,000 active personnel, including 7,000 personnel of the Indian Naval Air Arm, 1,200 Marine Commandos, and 1,000 personnel of the Sagar Prahari Bal. 
• Air Force: The Air Force has 140,000 active personnel and 140,000 reserve personnel. 
• Coast Guard: The Coast Guard has 12,000 active personnel. 
• Territorial Army: The Territorial Army is a reserve military force that provides support services to the Indian Army. 

The Indian Armed Forces also include border forces that monitor and patrol India's borders. 

So how come we have the same number of healthcare staff in the NHS for a population of 68,000,000?

With so many staff, why is there such a huge backlog, inefficiencies, poor diagnostic access, and poor outcomes in some areas of medicine?

Throwing money into the bottomless pit of the NHS is a waste of money. These figures put into context how much waste, administration, and bureaucracy there is in the NHS.

In February 2024, the NHS had 140,700 doctors, 377,600 nursing staff (including midwives and health visitors), and 39,800 managers out of a total workforce of 1.34 million (all figures are full-time equivalent, excluding general practice staff) (Source: The Kings Fund).

That makes a total of 518,300 doctors and nursing staff. Add 40,00 "NHS managers," so where are the other 840,000 NHS staff?

GPs who are independent subcontractors providing NHS services number are stated by the British Medical Association (BMA) as:

"As of September 2024, there were 38,124 individual (headcount) fully qualified GPs working in the NHS in England. In Full Time Equivalent (FTE) terms of 37.5 hours a week, this equates to 27,966 full-time fully qualified GPs".

The whole NHS is broken and does not work. It has to be demolished and replaced by a similar model to the EU's Sweden, France and Germany. I think it might look like something like this:

• Not free at the point of clinical need but based on co-pay.
• A government-underwritten insured scheme with medical history disregarded (no exclusions for pre-existing conditions). The premiums are paid from a hypothecated health insurance tax for those employed or deducted from welfare benefits for those unemployed.
• A first consultation for a stated condition is a co-pay with a fixed fee for a GP for 15 minutes (say £12) and a higher fee (say £25) for a hospital consultant for 30 minutes. Subsequent consultations for the same condition in that year are exempt from a consultation fee.
• A new condition triggers a consultation fee again.
• A capped annual contribution by the patient towards the cost of medications and diagnostic tests.
• Insurers provide their own ambulance service and operate through local "preferred providers" paid through the premiums with service level agreements (SLAs) agreed by the government with severe penalties if those SLAs are not met.
• Patients can opt out of this insurance-backed ambulance service for a lesser premium and elect to only use the (NHS) state Ambulance Service with its cr4p service levels with no enforcement or penalties imposed on the state service by the government.
• No visitor is entitled to healthcare.
• The granting of a visitor visa is conditional on providing proof of private travel insurance with a minimum health cover of £5 million to be produced at the point of entry to the UK border. Failure to provide this will result in the passenger being denied entry to the UK.

Consideration needs to be given to UK nationals who cannot work and/or cannot pay the insurance from their welfare benefits. For example, a tapered subsidy over three years with 100% premiums paid by the Government in year 1, 66% paid in year 2 and 33% paid in year 3 with no subsidy paid in year 4 and beyond.

And of course, that delicate subject - illegal migrants. Should they have access free of charge to the UK healthcare?

These are not answers but possibilities and the need to think differently.

We have had enough of experts like Lord Darzi and other henchmen proposing reviews and restructuring. None of them have worked.

It is time to slay the Medusa beast that is the NHS. Problem is that two-tier Keir, the Boy Wonder Wes Streeting and hair-bob Reeves don't know how to look at the NHS medusa without turning to stone. Perhaps they need a Perseus to slay Medusa?