From “envy of the world” to a sinking ship.
It’s a poorly-kept secret that Britain’s National Health Service (NHS) has faced crisis after crisis. But the latest scandal over 3 million “unseen patients” may be its worst yet. In fact, this omnicrisis is worsened by the fact that barely anyone is speaking about it.
Throughout the 2000s, headlines warned of an overwhelmed and underfunded healthcare system that was systemically failing, from facing “another winter of crisis” and bed shortages to a 2005 scandal forecasting that half of all NHS trusts would face hiring freezes due to a “cash crisis.”
These problems spilled over into the 2010s in the wake of the financial crash, worsened by the newly-elected Conservative–Liberal Democrat coalition government’s goal of cutting public services across the board. The austerity period saw a continued rise in NHS funding, along with warnings in 2015, and again in 2019, that the NHS was on the “brink of collapse.”
The Covid pandemic highlighted the perilous condition of Britain’s healthcare system. Some critics highlighted the apparent lack of funding, while others claimed that the crisis revealed the strength of the NHS in being able to respond under pressure.
Regardless of whether Covid revealed the contradictions or the strength underpinning the NHS, it has left a legacy of exploding waiting lists and what feels like a health service unfit for purpose.
The British Social Attitudes’ survey from 2024 revealed just 21% of respondents were satisfied with the state of the NHS, while 59% were dissatisfied. Perhaps more importantly, the majority want more funding for the NHS (69% say too little is spent) and think that the NHS is spending inefficiently (51%).
The latest NHS statistics revealed that 6.23 million people are on the waiting list, meaning they have been seen by a General Practitioner (GP) and been referred for treatment of some kind. A situation in which nearly 10% of the population is facing long waits is a damning indictment of the system.
Yet this is not the worst of it. The most terrifying finding from the survey is that 48% of those 6.23 million—approximately 2.99 million people—have not been seen by anyone at all. As Rachel Power of the Patients Association said, “The scale is staggering, as nearly half of all patients on a waiting list haven’t been seen by anyone. That’s not a healthcare service; that’s a breakdown.”
To put things in perspective, the NHS’s internal target is for specialists to see patients within 18 weeks (four and a half months) of a GP appointment. This standard was established in 2006, under the New Labour government, with the goal of reducing waiting times from “18 months to 18 weeks.” It was initially met in 2008. By 2012, the NHS started to miss the target, and since 2015, it has not been hit once.
In 2004, just under 1 million people were waiting for an NHS appointment. That has completely spiraled out of control.
Funding for the NHS is hardly lacking, so that certainly isn’t the issue. According to the Health Foundation, between 2025/26 and the end of the parliament in 2029, the Department of Health and Social Care (DHSC) plans to increase spending from £215 billion to £246 billion ($287 billion to $329 billion)—a real-terms increase of 2.8% per year.
Currently, the NHS consumes the majority of that budget, at roughly £192 billion ($256 billion), and, given that the UK’s total managed expenditure is expected to be £1.24 trillion ($1.66 trillion), this means that the NHS alone accounts for 15% of all government expenditure.
Spending on the NHS has only ever crept up: in the 1970s, funding was just shy of £50 billion ($67 billion), and has ballooned rapidly to £250 billion ($334 billion) in the 2020s, growing from 4% of GDP to an enormous 10% in the same period (though it has dipped to 8% since). Often, those who defend the rapid rise in spending claim that this has not kept pace with per capita spending, but this has been proven incorrect by the Institute for Fiscal Studies, which reports that “while health spending has grown by an average of 4.1% per year over this period, real per-capita spending has increased by 3.7%.”
All of this is fueled by the NHS’s place as the sacred cow in British politics. Nothing illustrated this better than the slogan in the Covid pandemic that we should “protect the NHS.” Shouldn’t a health service protect us? By treating it as beyond criticism, the NHS has been protected for too long.
