November 2023
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The NHS – the truth behind the politicians’ lies?

(Monday blog)

One of the biggest battlegrounds in the upcoming election is, of course, the NHS. In this truth-lite world in which we live, the NHS is above and beyond criticism and reproach and so all politicians desperately promise to pour ever more tens of billions into the black hole that is our NHS – supposedly the “envy of the world”.

As we once again face being wrung dry to pay more and more for our beloved NHS, I thought it might be worth spending today’s blog, suggesting where we are being told the truth and where we are being lied to about the NHS

More money, more staff

Claim 1 – The NHS is starved of cash

All parties hope to buy our votes by claiming that they will be fabtastically generous to our ‘wonderful NHS’.

But hold on a minute. Last year £140bn was spent on health across the UK – more than ten times the figure 60 years ago:

And this is after you adjust for inflation. Moreover, a much greater proportion of government spending is going into the NHS than ever before:

So the claim that the NHS is somehow having its budget squeezed is total and utter nonsense – unadulterated bollox (to use a technical expression)

Claim 2 – The NHS is desperately understaffed

It’s true that there are tens of thousands of vacancies for doctors and nurses and various specialist skills like radiographers. But the NHS currently employs 1,482,000 people, versus 1,300,000 in 2008/9 and 967,000 in 1999. So it is 53% bigger than in 1999, and 14% bigger now than its peak during the Labour years in people terms:

And although the population of Britain has been growing, the ratio of NHS staff to population is the highest ever. So how can the NHS be “understaffed”? The NHS may be “understaffed” in comparison to the numbers of staff it would like. But there are more NHS staff per 100,000 of population now than there have ever been.

As for the probably real shortage of nurses in some areas – this has been caused by incompetent NHS management and not by any lack of money. The crassly stupid decision by NHS bosses to change nursing from a (I think) 18-month practical vocational qualification, where teaching was done in teaching hospitals, to a 3-year much more theoretical degree qualification with teaching done in polys pretending to be universities (while also scrapping bursaries for nurses in training) has decimated the numbers going into the profession.

So, what is going wrong?

Claim 3 – the NHS is missing key targets

Absolutely true. The one target we constantly hear about is percentage of A&E admissions seen within four hours:

This has been falling in spite of record amounts of money being poured into the NHS and in spite of record staff levels. A lot of this is due to a breakdown in GP services due to the extraordinarily generous contracts offered to GPs by the Labour Government. This gave GPs huge salary increases for doing less work and has resulted in a surge in people going to A&E because they can’t get GP appointments any more:

Up to 2004 when the new GP contracts were introduced, A&E visits were stable at about 14 million a year. Labour’s 2004 contract prompted nine out of ten GPs to ditch out-of-hours care.This made it much harder for people to see a GP, except during working hours on a weekday. The result was increased attendances at A&E

By 2010, they had climbed steadily to 20 million a year and they have kept increasing since then.

Claim 4 – Britain’s ageing population is to blame

It is also true that Britain’s population is ageing:

And that health spend tends to increase as people get older:

Though none of those bleating and howling about how people who have worked and paid taxes all their lives are ‘ruining the NHS’ ever mention the catastrophic drain on NHS resources caused by some of our most fecund communities having 70% or more of their children being the unfortunate result of first-cousin marriages:


Claim 5 – The UK spends less on health than other advanced countries

It’s true that the UK is not a top spender on health compared to the EU average:

But the difference is really quite small and cannot explain away the under-performance of our health service compared to other EU countries.

And I don’t have space here to deal with another massive NHS management blunder – over £4bn squandered on a computer system which (as I explained in my 2006 book PLUNDERNG THE PUBLIC SECTOR) could never work.


Depending on your political views you can reach a whole host of different conclusions from the above charts.

Having written about the NHS in several books – including a book I ghost-wrote WHO CARES? by Amanda Steane – my conclusion would be as follows:

The politicians’ terrified reaction to every negative story about the NHS is always “more cash” to be poured into our wastrel, hopelessly mismanaged health service. Nobody dares suggest that the NHS’s over-paid, over-pensioned 35,000 managers (up from 25,000 in 1997) might be asked to improve the way they spend our money rather than always screaming for more.

But “Realpolitik” – the need for votes – means politicians never dare challenge how the NHS splashes our cash. Instead they continue to feed the monster they have created, lest it bites heads off, rather than just the hands that feed it.

6 comments to The NHS – the truth behind the politicians’ lies?

  • IanJ

    As usual, you nail the issues. From the required ‘degrees’ for would-be nurses that cost them so much, to the wrecking of the GP system, with three or four week waits to see a doctor. In my experience, Medical staff are generally superb, but the inflated bureaucracy, whether local or national, is holding the whole system back with its inefficiency, denying us appropriate and timely treatment.
    Development of IT systems follows the usual government pattern. Despite many millions spent, progress is piecemeal and isolated. It can be made to work in other countries, but apparently not here.
    The apparent drive away from localised resources, ‘in the name of efficiency’, makes life harder for many without transport, even if they could afford the parking charges (which apply to essential staff too!)
    Politicians may claim to support the NHS, but they are entrenched in the same bureaucratic trough and few have the knowledge or vision to improve the situation without spending more on ‘experts’

  • Hardcastle

    I am afraid we will have to wait until the inevitable financial collapse before there is any intelligent or realistic assessment and or re organisation of the NHS.It illustrates how successful socialist propaganda can be when no one in authority dare question its efficiency never mind its existence in its current form.It is clearly poorly managed,if managed at all in the true sense of the word.Time spent in any of its establishments easily exposes sloppy procedures and clear overmanning in certain areas and undermanning in others.How often have I sat waiting for an appointment and witnessed inappropriate behaviour in front of the ‘customers’.Long discussions about holiday destinations,trying on clothes from M and S etc.This does not apply to all NHS staff obviously but the type of behaviour I mentioned would not occur at all in a well managed organisation.I wonder how often managers leave their offices and walk the corridors and wards,talk to staff about concerns and ways to improve? Lots of meetings no doubt and written memos but physical presence and implementation and follow up,I wonder.Just an improvement in physical appearance,less obesity and smarter dress codes would be more reassuring.If it is the envy of the world why has no one else copied our system?

  • William Boreham

    Well worth downloading those statistics; one of the problems with having a service that is ‘free for all’ is illustrated by one of my neighbours who is in constant pain and on an NHS waiting list. I know he is very well off, three foreign holidays a year, but when I suggest he goes private to end the pain and discomfort right away, he was outraged! Unthinkable to him to go private when he can ‘eventually’ get the service for free. Personally, I’ve had no problem going private twice for the latest form of surgery on my prostate, unavailable on the NHS, my health more important than foreign holidays. How ironic that I bought a copy of the book, Who Cares. A wife’s story of how her husband went into hospital for a minor surgery and eventually came out a helpless invalid, unable to walk, communicate or even breathe properly, in such constant pain, he ultimately took his own life. I gave it to my sister so as to put the fear of Christ up her husband, who I dislike, as he was also going in for a minor operation as well! I must say that wife in the book is a living angel, what she had to put up with was the stuff of nightmares.

  • A Thorpe

    The NHS is the flagship of the Marxists and home to the unions. It cannot be criticised without outrage from the masses. This tells us everything we need to know about the UK and the direction it is heading. Also, the NHS cannot be considered in isolation from the care of the elderly. In general, this is really about provision for future needs and uncertainties.

    The result of our individual failures to provide is the is a continual call for more money and manpower to provide free services. This election has resulted in more promises that will never be achieved. This is what happens with socialist governments and that is now all we have in the UK. There was only one alternative and that was the Thatcher government. Socialist political parties, which is all of them, just end up in a bidding war for votes and always fail to deliver in the end. They have taken away the responsibility and freedom of people to live their own lives. They are destroying the foundation on which human success is based. The downward trend of the UK current account confirms the failure of socialism and the bleak future of the UK. Even the Chinese have realised that socialism does not work and the people are responding to their new freedoms.

    Humans have basic needs – shelter and warmth, food and water, health care. We have to take responsibility for these aspects and use them to set priorities in our lives. Now the trivial has become important and the essentials have been handed to the state to control. This results in all decision making being distorted; we spend money on the trivial and the state has to take money from us to give us essentials on a one size fits all basis. It can only result in failure through destroying the need and conditions to invest for the future.

    Families used to care for their elderly but now the NHS creates conditions that are impossible to care for at home and the elderly are left in misery. I do not know anybody who wants to end up in a care home. Socialism does not encourage saving and so very few have the means to pay for elderly care, just as few have sufficient pensions. We end with some getting state funding and others having to sell homes. Responsibility is punished and the irresponsible are rewarded.

    The only way to a continually improving society is through education and work with the objective of creating wealth and being independent of the state. This is what Thatcher realised. Home ownership and personal savings are the means to achieve this but the state will take everything we have worked for, even in death. We must be free to pass our assets to the next generations, but the UK governments are destroying the means to create private wealth and this has the support of the masses. We have not seen austerity but it is coming and the NHS is leading the way.

  • Mark

    NHS might have been busy in Brum at the weekend, did anyone catch the vibrant machete attacks at the cinema. Probably now in the regional section of the news.

  • leila

    @William I suggest you Google Joe Lippens as your prostate is acting up.

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