We are very spoilt as a country to have such a splendid health care system that is free at the point of need – it is the
envy of many countries around the world – or was.
Most countries now see it as unsustainable in the modern age, and this is a lesson UK governments of all colours refuse to accept, or are too scared to mention it, as the NHS is regarded as an untouchable sacred cow. But the cost of the NHS is economically killing us and is totally unsustainable.
In 2021/22, the Department for Health and Social Care (DHSC) budget was £190 billion. The NHS is one of the world’s largest employers with around 1.26 million full-time staff with a wage bill of £66.2 billion. These statistics don’t include salaries for GPs (who are not directly employed by the NHS) or employees from the DHSC and other national bodies, such as NHS England. Each day 1.2 million people visit their GP; 260,000 attend an outpatient appointment; 37,000 will call 999; 44,000 people will attend A&E and 675 people will go into critical care.
This humungous £190 billion is not enough by quite some margin resulting in 7.7 million people on NHS waiting
lists as we have less than half the hospital beds we had in 1990. It is totally unsustainable.
We should remind ourselves that our delusions of Empirical grandeur have long faded and it should be accepted that we are a tiny island country, with limited resources, limited global power and a military so stripped down that it would struggle to invade your local pub.
The average council spends circa 84% of their entire annual budget on social care, leaving just 16% for everything else. This is due to central government passing more and more down to local councils as they can no longer afford it – on the assumption that local councils can. They can’t.
Why oh why can’t the government find courage and make a statement?
The fastest fix is to means test the NHS. If people don’t like means testing things then perhaps they should just get over it. Why does a millionaire get free NHS treatment? Why does a family with a household income in excess of £150,000 get it free? It makes no sense.
Simply connect the hospital computers to the HMRC. If you earn in excess of £150,000, you are not entitled. You can then pay the NHS for your treatment or go private. That would remove 789,450 people from the NHS immediately. Deprive all foreign visitors of using the NHS free of charge, and that would save £388 million a year, so that is circa £2.5 billion saved right there.
It would also give an enormous boost to the private health sector as patients would flood to private hospitals, increasing nursing opportunities and a tremendous boost to all levels of employment.
Then let’s go further. As in the US, private health insurance is part of most people’s employment package. Let’s copy that, change the law and make it mandatory for companies with over a certain number of employees to offer a level of private insurance. That would save circa half of the entire NHS budget and reduce it from £190 billion to £95 billion. We could also charge these people for GP appointments and greatly lessen the GP’s burden, meaning you might get more than 13.5 minutes with your local doctor. They could also pay for their prescriptions and that would save a further £17.8 billion a year
Now we would have a health service that is slimmed down and ready to deal with less than half the UK population, with the other half paying to use it or using private companies. The 999 system would still be free at the point of use.
No sane person can possibly think this little island nation can afford such largesse and if we keep the blinkers on and continue to ignore this fact, we are destined for an economic fall of such proportions that the NHS will go under anyway.
Any economist would tell you this, most experienced CEOs and CFOs might tell you this – the books don’t balance and when that happens, CUT THE FAT.
