Around £98.6 billion in 2008-9 is spent on the NHS. It is the fourth largest employer in the world, and 70% of the NHS budget is spent on pay, a considerable sum goes to general practitioners, most of who have remained independent contractors and not salaried employees. Yet, many junior doctors and nurses still claim that they are underpaid. The NHS was originally a great system which was implemented after the war and as it was the only health service provider, it benefited from the economies of scale and hence average costs decreased costing the government a lot less money back then than it does today.
However, besides colossal labour costs there are other major problems currently present in the NHS which include Access controls, "Paying twice", Waiting lists and the 18 week target, shortage of beds, the outbreak of "Superbugs", computerisation, and Misallocation of resources which caused financial deficits in the past and with further injection of funding the NHS has resulted in a financial surplus at present.
Treatments that are determined by NICE to be cost-ineffective (i.e. drugs that have only minor effect at great cost) are simply not offered by the NHS though may be available privately e.g. cancer drugs and the new Alzheimer’s drug which have proven to be effective at the early stages of the diseases were not approved. GP referrals are needed to access specialist care. It has been argued that a nominal charge for an appointment with a GP could be introduced to prevent patients consulting their GP with trivial complaints. However, the danger of that is inequality as the poor people will suffer the most. Deductibles have been proposed particularly for US healthcare. However, charges appear to cause greater disparity between social classes. Charges for an appointment with the GP have never been introduced to avoid the danger of patients avoiding consultations (for financial reasons) for conditions which might be potentially serious. Instead, the British government seems to favour primary healthcare and there are reforms and enlargement of the primary healthcare at present, i.e. via the development of large medical centres (polyclinics). The problem with this is that it disrupts the hierarchy between GP’s and Consultants, as consultants have historically been seen as more superior within the medical profession.
Access to quality hospital care is also limited under the NHS. The NHS is often characterised by its inadequate equipment and services. The main reason for inferior quality is due to cost control. The NHS finds it difficult to keep up-to-date with medical advancements and most of the new medical technologies are pioneered and employed in the United States.
Taxpayers who choose to pay for private healthcare must nonetheless still contribute to the NHS via taxation, and in effect "pay twice", although the vast majority of emergency medical treatment is carried out by the NHS. This is not an effect specific to the NHS, and occurs whenever a choice between a publicly-funded and privately-funded service exists - for instance in private education. Some patients with complex illnesses pay for some medical services privately, while turning to...