The UK & the NHS

3 min readMar 16, 2023

Some minor thoughts and comments about the recent press around the UK’s National Health Service.

Photo by Hush Naidoo Jade Photography on Unsplash

The UK’s National Health Service (NHS) is currently grappling with numerous challenges, including strikes, backlogs, and funding issues, as reported by various newspapers. Although I firmly support public healthcare and appreciate the guiding principles and values embodied in the NHS constitution, it appears to me that the core problem with the NHS in the UK has little to do with the organization itself. Rather, it is a manifestation of the UK’s broader economic growth problem, fueled by political infighting, division, and short-term policy decisions.

Since the 2008 global financial crisis and more recently, Brexit, the UK economy has struggled to grow, while global healthcare costs have continued to rise. This cost inflation is driven by the inherent cost increases in service improvements, advances in treatments, therapies, care, and medicine, all of which necessitate significant upfront research and development investments. Brexit has further exacerbated the issue by causing an increase in medical supplies and equipment costs due to new trade barriers and regulations. Additionally, the UK health system faces global labor competition, and policies such as the 2012 wage freeze have made it more challenging to recruit and retain staff within the NHS. Compounding the problem are policy choices that have turned to private healthcare providers to fill gaps in NHS services. While this is a contentious issue, private providers have been accused of cherry-picking low-risk patients, leaving the NHS to handle the most complex cases. This has raised concerns about increased inequality in healthcare access, with wealthier patients having better access to private healthcare, while less privileged patients rely on the NHS.

Moreover, the COVID-19 pandemic has served as an exogenous shock, resulting in significant additional costs to a system and staff unprepared to handle a pandemic, as it was previously considered beyond the realm of possibility.

The charts below illustrate that the stagnant growth the UK has experienced since the 2008 financial crisis has caused the actual size of national output to lag behind the total increase in costs, placing increasing pressure on the UK’s national income and, consequently, the NHS’s budget allocation. Long-term policy decisions made with short-term political considerations in mind, such as Brexit and outsourcing energy production to foreign nations, have begun to significantly impact national stability and income. Additional societal factors, including an aging population requiring more healthcare and overall population growth, have increased the NHS’s necessity and the underlying acceleration in costs.

While there is no immediate solution to a complex issue like this, it seems to me that the government, politicians, and administrators should concentrate on stimulating broad growth in the economy to increase national output, which would, in turn, provide more resources and flexibility for policy makers and NHS administrators, rather than focusing on short-term, NHS-specific policies aimed at reducing current costs. This situation seems to call for short-term repositioning and cost increases in the NHS (higher wages, investment in telehealth, other productivity investments, etc.) to achieve future efficiency gains, while concentrating on expanding national output to reap the benefits in 5–10 years. However, adopting such an approach would require policy makers and politicians to look beyond their respective election cycles.