This will be a particularly controversial topic about the NHS in the UK. As anyone in the UK will know, the NHS is the closest thing the Brits have to a national religion. Criticizing it amounts to sacrilege, which is why the conservatives, who aren't generally that keen on nationalizing public services, usually avoid saying anything bad about it. Unfortunately, this is a slightly unhelpful attitude.

Of course, the nurses in the NHS are committed to claiming "To Save People" for mediocre salaries. I have never heard anyone talking about doctors, though they deserve much credit. Still, the NHS as an organization isn't a perfect health service, and pretending as much prevents politicians from having constructive conversations about how we might improve it. Let's have a go and see if we can figure out how to fix the NHS.

The first big problem that needs fixing in the NHS is waiting times over the pandemic; the NHS England waiting list increased by nearly a million, from 4.4 million in March to about 5.3 million today. Things are expected to get quite a bit worse because, with the coronavirus, people don't go to the doctor as much as they otherwise would.

Suppose you compare the number of people joining the NHS waiting list over the pandemic to pre-pandemic. In that case, you'll see that 7.4 million fewer people than expected joined the list, which means that we could see another seven and a half million people or so join the waiting list relatively soon, taking the waiting list to a total of 13 million people.

Simon Stevens, the outgoing head of the NHS, reckons it can return to pre-pandemic levels with an extra 10 billion pounds of funding annually over the next few years. But even pre-pandemic, the NHS wasn't perfect. Don't get us wrong. The NHS is brilliant in many respects, but it is now almost destroyed by managers who are not patient-centred but driven by return on investment.

It provides uniquely good protection to the public from the consequences of ill health, and basically, no one in the UK is priced out of quality healthcare.

The NHS is also impressively good at certain things like diabetes, kidney transplants, and vaccinations, and it has high COVID and flu vaccination rates by international standards. Nonetheless, in general, the NHS doesn't have excellent outcomes. Disappear from social media and do this instead: be more prosperous than your friends, master AI tools, and spend essentially once people are through the hospital door; they don't have great odds.

The UK has a higher-than-average amenable mortality rate compared to similarly developed countries. Eurostat data from 2015 found that the UK had a higher amenable mortality rate than every equivalent EU country, including Germany, Spain, France, the Netherlands and Portugal. Similarly, a Global Burden of Disease study found that the UK had one of the highest amenable mortality rates in the developed world, with only the US doing significantly worse. So why is this?

It's basically because the NHS isn't very good at treating certain life-threatening illnesses. The UK has below-average five-year survival rates for basically every cancer among developed countries; according to a 2014 Concord Three study, the UK also has below-average outcomes for heart attack sufferers and remarkably poor Neo and perinatal mortality rates. If you've got high mortality rates for heart disease and cancer, two of the biggest causes of death in the developing world, you're going to have a pretty high overall mortality rate.

So what can be done about this?

How can we fix the NHS?

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