The NHS has provided free healthcare for the people of the UK since 1948. It’s a national institution that is highly valued by British citizens and is regarded as one of the best healthcare services in the world.
However, the NHS has faced increasing difficulty in recent times. Services are stretched to breaking point, and staff are faced with incredibly long hours and mounting pressure. Many point to underinvestment as the reason behind the struggles faced by the NHS. What does this actually mean? Let’s find out.
How is the NHS Funded?
If we want to understand what underinvestment means, first, we need to learn how the NHS is funded in the first place.
The majority of NHS funding comes from national insurance contributions and general taxes paid by employees, businesses, and self-employed workers. In England, the NHS is also partially funded through patient charges for certain services like dentistry and prescription medication. However, there is no charge for prescriptions in Scotland, Wales, and Northern Ireland.
In England, the Department for Health and Social Care (DHSC) grants the NHS budget, which the NHS then spends across the organisation to fund hospitals and healthcare services. In the 2023/2024 financial year, 85% of the DHSC budget was granted to the NHS.
The money is spent in a range of different areas. Staffing accounts for the biggest portion of the budget, followed by procurement, which is the purchasing of equipment such as protective clothing or innovative instruments like a self-retaining surgical retractor.
What Does NHS Underinvestment Mean?
When you look at surface-level NHS spending, you could be forgiven for thinking that all seems well. There has been an 11% increase in day-to-day spending when compared to 2020, and there are more doctors, nurses, and ambulance staff.
However, despite this growth, the NHS is admitting and treating fewer patients, and waiting lists are growing by the day. How can this be? The answer is that while general health spending has remained relatively steady, capital spending has been significantly cut back and neglected, leading to a serious shortage of beds and severe infrastructure issues.
Research has revealed that, when it comes to capital spending, the UK government has underinvested to the tune of around £100 billion over the past 40 years. The effects of capital spending are often delayed, and we’re now seeing them come to the fore in massively outdated services and facilities, with 43% of NHS buildings more than 30 years old and an incredible 18% that have been in use since before the health service was founded.
Not only does the constant repair and maintenance of these facilities divert funds away from frontline resources, but they can also pose a direct risk to patients and are regularly found to have serious health and safety failings.
Underinvestment is crippling the NHS. While the funds may be there for staff and procurement, the service will never be able to truly modernise unless proper capital investment is made and buildings and facilities can be upgraded to adhere to modern standards.
