Is the NHS any good compared to other countries and the past?

Is the NHS any good compared to other countries and the past?

This is a simple question that is surprising hard to answer.

It depends on whether you are comparing itself to itself, over a time period; or compare it to healthcare systems in comparable developed countries ‘now’. Lets look at its performance in regard to itself first.

NHS compared to healthcare in other comparable countries

This is harder to state as its never clear whether we are comparing like with like. The best information comes from the OECD. This is a recent OECD health report that compares us to other European countries.

So, according to this data, the NHS can be compared to comparable countries. It shows:

1. Funding – average, about 11% of GDP (your taxes)
2. Bed numbers – slightly below average
3. Doctors – slightly less of them than average, but more specialists
4. Nurses – average numbers
5. Efficiency – good (e.g. hospital length of stay, lack of use of second line antibiotics).

NHS compared to the NHS in the past

This is easier to answer. According to its key performance indicators alone, the short answer to this question = not great.

COVID-19 has not helped. But the ‘tipping point’ seems to be about 2017. Before that, the NHS was achieving most of the key targets most of the time.

Extended waiting times for treatment is a serious issue for the NHS. We will now go through the key NHS targets with current performance data mainly from the House of Commons library (July 2024).

1. 4 Hour A&E Target
   • Known as ‘4 Hours’, this is for emergency care. 95% of emergency patients should be seen, treated if necessary, and either discharged or admitted, within four hours from arrival at A&E
   • 4 hours was last achieved in July 2015
   • Currently 60% achieve the 4 hour target. This means almost all patients going through ‘majors’ – where the sicker patients go – will breach the 4 hour target.
2. 18 week Referral-to-Treatment (RTT) Target
   • Known as ‘18 weeks’, this is the key target for elective (planned) care, especially operations. In other words, 18 weeks is the maximum waiting time for non-urgent, consultant-led treatment in NHS (e.g. CKD or a hip replacement). 92% of patients should achieve it.
   • It is measured from the day from when the GP refers the patient to the start of treatment (or the decision not to treat).
   • 18 weeks was last achieved in February 2016.
   • Currently (Feb 2024) 58% achieve the 18 week target.
3. Cancer targets: 2 week wait, and 31/62 Day Targets
   • In England the cancer targets are now changing. The 2 week wait (2WW) target was changed for a 28-day faster diagnosis standard in Oct 2023
   • If a GP suspects cancer, at least:
     • 96% should wait no more than 31 days from receiving diagnosis to first treatment plan (31 days)
     • 85% should wait no more than 62 days to have ‘First Definitive Treatment’ (e.g. an operation or chemotherapy or radiotherapy) from arrival of original referral letter (62 days)
   • Currently 92% of patients achieve the 31 day target, and 66% achieve the 62 day target.

All of this poor performance leads to poor outcomes and huge frustration amongst patients.

Summary

We have discussed whether the NHS is any good. We have compared it to other countries and the past. It is performing poorly at present. We are very sorry and trying to improve.

Other resource

This is a good article from the Nuffield Trust that addresses this latter question. It was published in 2018, on the 70th anniversary of the NHS.