Need in the health system: The English patient is waiting for treatment

Ms. F. suffers from abdominal pain, goes to her general practitioner after bleeding.

The "GP" (General Practitioner) refers you to the gynecologist.

But the NHS doctor won't have an appointment free for several weeks.

Another woman gets an extremely severe headache, her vision is blurred in both eyes.

However, the specialist doctor responsible will only have three months' time for an examination.

After all, both of them pay for treatment with private doctors out of their own pocket.

Almost everyone in the UK can tell stories like this.

Philip Plickert

Business correspondent based in London.

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The state, tax-financed health service NHS has been advertising since it was founded in 1948 by the socialist minister Aneurin Bevan with the promise of "free for all". Many see it as a “national treasure”. During the Corona crisis, millions of Brits clapped on the streets for the brave NHS staff. Politicians from Prime Minister Boris Johnson to the Labor opposition threw themselves into praise for the “wonderful” health service. He has organized more than 90 million corona vaccinations. "Thank you" posters with the NHS rainbow symbol are stuck in windows.

But the NHS is struggling with structural problems that were already visible before Corona.

The worst part is the long waiting lists.

Millions of Britons do not receive timely treatment.

Is it the lack of money for the NHS, which is by far the largest employer in the country with around 1.5 million employees in practices, hospitals and administration?

Some find the large organization to be overly bureaucratic and inefficient.

300,000 wait longer than a year

The latest numbers on the waiting lists are once again an alarm signal. 5.6 million are waiting at the NHS England for a necessary examination or treatment by a specialist or in hospital. That is almost one in ten people in England. Before the pandemic, however, almost four million were on the waiting list. The long-term cases are particularly bad. Almost 300,000 have been waiting for more than a year without treatment, three times as many as before Corona.

The numbers brought "tears to your eyes," said Tim Mitchell, vice president of the Royal College of Surgeons. “Behind the statistics are patients who are in pain waiting for a hip or knee replacement or who also need heart, brain and other operations.” More and more citizens can no longer stand it and decide to pay for private treatment. Justin Ash, head of the hospital chain Spire Healthcare, says demand in its 39 hospitals has increased by 80 percent. He calls for the NHS to work more with the private sector.

Corona has caused a large backlog. An estimated seven million Britons have not gone to medical examinations, out of fear of infection in the hospital or out of resignation because of endless waiting. Thousands of cases of undetected cancer and heart problems are mounting. Health Minister Sajid Javid has spoken of scenarios according to which the waiting list could grow to 13 million patients in a few years.

This horror scenario is intended to prevent the now decided increase in funds for the NHS.

The NHS receives an additional £ 5.4 billion a year.

In addition, the Johnson government has passed a long-term care reform that puts a cap of a maximum of £ 86,000 on private costs for family members in need of care.

Nobody should be forced to lose their house in order to pay for the care, according to the Tory election manifesto.

To finance both, Johnson pushed through a 1.25 percent increase in National Insurance contributions, a total of £ 12 billion a year.

On the other hand, there are loud protests from business and from individual Tory MPs.

Costs are increasing faster and faster

The Johnson administration hopes that the majority of voters will ultimately appreciate the plus for the NHS more than they complain about the tax hike. To some, however, the NHS seems insatiable. Former Tory Minister Jake Berry speaks of a “bottomless pit”. The total NHS budget has risen to 159 billion pounds in 2021/22, since 2020 there has been almost 85 billion pounds extra because of Covid, shows an overview by the King's Fund. A recent study by the Institute For Fiscal Studies found that costs and expenses in the NHS have increased faster than planned over the past few years. An increase of 3.9 percent is now planned. IFS scientist Ben Zaranko believes that ultimately there will be little left for care.

Others ask whether it is really just about the money. According to World Bank data, Great Britain spent a good 10 percent of its gross domestic product (GDP) on health - before Corona. Germany and France were slightly above 11 percent, Italy below 9 percent. There are also Anglo-Saxon countries such as Australia (a good 9 percent of GDP) that pay less, but achieve better results with more private healthcare providers and more competition, says economist Kristian Niemietz from the liberal-market Institute of Economic Affairs. In a heretical study, the IEA described the performance of the NHS as "not special" even during the Corona crisis. The health colossus, nationalized since 1948, is inefficient, cumbersome and too expensive.

There are some indications that an administrative water head actually devours too much money. Almost half of the NHS employees (47 percent) are not medically trained at all. 629,151 doctors and nurses are compared to 568,596 administrators, i.e. secretaries, accountants, HR, buyers, planners and managers, according to the NHS data for England. The proportion of non-medical professionals is increasing steadily. The NHS is currently looking for more top managers, with a total of 42 posts with salaries of up to £ 270,000.