NHS hospital facilities are not used 40% of the time. But doctors constantly ask for more staff and investment.
Let’s go back and start with a simple question. How much does the NHS cost?
It is actually very hard to say, as it is surprisingly difficult to define the NHS. For example, does it include all the 4 nations? As there are really 4 NHSs (as healthcare is devolved in the UK). Does it include healthcare for the armed services? For prisons?
Does it include arms length bodies like NICE, HEE, MHRA, CQC,and UKHSA? What about public health (UKHSA)? It is not clear. Who pays for the costs of the DHSC? Is that part of the NHS?
Either way, the NHS is not cheap .. and the NHS is not free.
So. What does it cost? Total UK central government funding for health (including spending by central government departments and devolved administrations) in 2023/24 was about £182 billion – about 1/2 £billion a day. With a population of 67 million, that’s about £2700 per person per year, or £225 a month.
That’s about 11% of total GDP (Gross Domestic Product), i.e. about 11% of your taxes. This is in line with other developed countries, and above the OECD average (comparable countries).
True. It’s poorly organised with lousy IT, has poor productivity despite significant increased investment, and its senior doctors are very well paid but locked into traditional work practices (like refusing to work properly at weekends or on bank holidays).
How well are hospital facilities used?
For example, for an average hospital consultant, if you combine absence due to generous annual and study leave allowances (8 weeks per year), bank holidays and weekends, they are not there for 40% of the year – that’s a staggering 40% of wasted productivity.
Hence 40% of possible operating and procedure lists, xray interpretation sessions, and new clinic appointments could (but do not) happen. They are cancelled when consultants are away.
GPs are not much better and also refuse to work properly at weekends and on bank holidays. But they do use their facilities better during the week.
How could productivity be increased?
If hospital consultants had something called annualised contracts (agreeing to a set number of patient contacts/events a year), and worked at weekends and bank holidays, 40% extra productivity would be found. They – via their union, the BMA – constantly blocks such reform.
But all we hear from the doctors – hospital and GP alike – is ‘we want more’ (money, beds, CT scanners, staff etc) and then all will be alright. We have tried that.
Either way, it’s certainly not underfunded. And certainly it’s facilities are not used well.
Other resource
How many hours does a consultant work?
Is the NHS any good compared to other countries and the past?
