NHS,what went wrong?

I haven’t had to use the NHS since the late 80s so I can only speak from my experiences when I was in the UK system.
Apparently about 500 people are dying unnecessarily in the UK each week due to the NHS problems.
I can’t identify with this as I recall a super system, ok not perfect but pretty efficient delivering good treatment to the masses. I personally and we as a family received various treatments including maternity, mental health, bone breaks, dental care, GP everyday stuff.
As I said, not perfect but pretty good so, what’s happened over past 35 years ?
Did it start with Mrs T, closing wards etc to save money ?
I don’t know but there must have been a defining moment ?

From my perspective, things started to change dramatically after the introduction of the Public Private Partnerships


I wonder? I think it’s much more complex. Just a slow decline, but at the same time increasing expectations in terms of treatments (and costs thereof) coupled with an increasingly unhealthy and over-weight population, an increasingly aging population and different (and greater) expectations in the young about what kind of employment they want (in terms of remuneration and status).


Successive administrations installing layers of middle management to report on absolutely everything to the next layer of management hasn’t helped.

I suspect that the various private - public partnerships set up to build and operate hospitals that were then leased back the hospital trusts have been quietly siphoning money out of the system for decades.


Beat me to it.

Also too many chiefs and not enough indians plus women who seemed to spend all day walking about with clipboards (we had a neighbour who was one and spent all day just making notes and talking to patients). All I know is my dad was treated despicably in 2016 whilst suffering from spreading prostate cancer and was sent home with pneumonia only to be re-admitted two hours later and spent a day lying on a trolley in the A&E corridoor. The local modern hospital near to where we lived had shut down A&E five years earlier and urgent ambulance cases being referred a good 18-20miles to two other hospitals which caused much difficulty for both patients and families.

Quite. Something rotten.

Problem also lies in the state needing to fund, by imposing taxes presumably, an ever increasing population that lives almost double the span expected when the NHS was set up after WW2. That no great minds foresaw this is odd. Or, perhaps they did and trusted in future good governance.

What to do now that totally free healthcare in UK is considered a right? Rules out systems such as those in France, Germany and other EU nations, even without going to the extremes of the US.

I hope the good and the wise are thinking fast because the current state of affairs is surely going to be a tragedy.

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I don’t think there’s any one reason, if there was just one reason, something could be done about it. I do think the pandemic has brought the inevitable forward by a few years, but it was ,sadly , always going to happen

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In a previous life, I met John Major a few times and found him to be interesting and honest… how I wish that those in positions of trust in UK were more like him.


Could never trust a bloke that thought a tryst with Edwina Curry was a good idea.


I always fancied Edwina :smiling_face_with_three_hearts:

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Agree, plus in last few years the exodus of european staff and ageing hospital infrastructure have added to the problem.


It has to come down to mismanagement of one form or another.
There is a saying if it ain’t broke don’t fix it, but there is also a saying in business that you can never stand still because the environment is constantly moving, so if you are not moving forwards with it then then you are in effect moving backwards, You have to have somebody at the helm who keeps tabs on changes that are happening in the environment and tweaks the course as necessary.
I suspect that perhaps the UK got both of these things wrong. It spent money and effort on trying to fix things that were not broke, introducing dramatic headline grabbing initiatives that were not necessary and not helpful, and at the same time allowing themselves to get completely out of touch with the environment, failing to take an objective global view of the NHS and not seeing the gulf opening up between what had been adequate in the 1960s and what was needed in the 1970s, 1980s, 1990s etc.


A great problem is staff shortages. Not just doctors disappearing into the private sector, understandably, but essential nursing staff

Brexit, effectively shutting off recruitment from Europe, and even before to fill the demand, looks further afield, which in turn is causing problems with healthcare staffing in those countries

Unfortunately you can no longer rely on vocation to fill your vacancies. Vocation doesn’t pay the bills, put food on the table


And yet one might’ve assumed that someone who tucked their shirt into their underwear was a modest, retiring sort of bloke who took few risks and had little interest in matters sartorial.

However, not according to Steve Bell -


The NHS is a large and extraordinarily complicated organisation that has been struggling for decades - what we see now is just another phase in its development. There is no single problem, simply throwing money at it won’t fix it, and it may not even be fixable in it’s present format. Key issues:

Underfunding, compounded by
Silo-mentality regarding budgets (i.e. can’t afford extra tests run by biochemistry at £5/sample but will pay for ultrasound at £200+/scan).
Overly-complicated management
Poor systems (i.e poor appointments management, multiple letters with same information, lack of planning).
Inability to discharge patients ready to leave (failure of local services, poor internal systems)
Changing expectation of the public, with ‘whole person’ healthcare now enormously complicated and expensive.
Changing profile of employees (i.e. nurses now graduates rather than trained on the job, less qualified staff do more patient care). Healthcare now seen as ‘just a job’ rather than vocational (that’s nothing to do with money).

It’s STILL a good healthcare system, but badly in need of a reform that ignores political mantra. Probably the first thing requiring reform is general practice, to get patients seen quickly and early, to keep them out of hospitals as much as possible.


General Practice is an interesting one. They’re all private businesses under contract to the NHS. The surgery my girlfriend goes to is utterly useless. Never any appointments, poor services (can’t even get them to issue a repeat prescription properly) and pretty ropey advice if you’re lucky enough to get any…

My surgery, a mile away, apologises if you ring in the morning and they can’t fit you in until the afternoon. Excellent doctors / practice team and great communication.Voted one of the best practices in the city.

They must get about the same settlement. Similar size and similar populations. Maybe a little older and marginally better off at mine, but still a working class area. Why are they so different do you suppose?


Some businesses are run well, others not so much. Is it possible they have extra patients coming from outside the area?

Ours is good but struggling because of the numbers of new houses being built in the area, and although they keep expanding, they have to continually play catch-up. They will soon not have enough space on-site - when we moved here in 1990 there were just 3 GPs plus a couple of nurses, and now there are 7 GPs, many nurses offering various services plus a pharmacy.

So one thing that could be done would be to tie GP (and dental) services into planning permissions and ensure they were expanded in line with each other.