The UK's National Health Service (NHS) has been facing winter crises for years, with problems ranging from bed shortages to under-treatment of patients. These issues are not new, as
headlines from over a decade ago show. While government policies may exacerbate the problems, the NHS's underlying issues suggest a more fundamental sickness.
Established in 1948 to provide free healthcare for all, the NHS has expanded to meet changing needs. However, demand for healthcare in Britain has grown more extensive and intensive as the population has aged and new treatments have become available. Although the NHS's budget has increased to keep up with demand, the organization has struggled to turn its inputs into outputs.
Data from the Organisation for Economic Cooperation and Development (OECD) show that the NHS ranks low among rich countries in the number of hospital beds per 1,000 people, and while it ranks high in hospital staff, it ranks lower in the number of doctors and nurses. This problem is not unique to the NHS; other programs like state pensions also face challenges as the number of younger contributors falls relative to the number of older users.
The NHS needs radical reform to become more productive, but it is a politically sensitive issue. The NHS is often described as the "closest thing the English people have now to a religion," and even when criticized by politicians like Donald Trump, the UK government has defended it. However, faith alone will not heal the NHS. The healthcare system must be more productive to improve the health of the population, and that may require acknowledging that the NHS may not be the best tool to achieve that goal.
Britons should be less sentimental about the NHS and recognize that it is a means to an end – better health outcomes – rather than an end in itself. Fiscal reality may ultimately win over sentimentality, and the NHS will need to adapt to survive. The Office for Budget Responsibility predicts that government spending on the NHS will rise to 13.8% by 2067, highlighting the need for reform to ensure that the NHS can continue to meet the changing healthcare needs of the UK population.