My shock was that as the U.K. working population is around 50% of population 1:15 means that there is one NHS employee for every 30 people in the country. That is a way higher than I would have expected. I was thinking it more likely to be 1:200 or even higher.
The NHS hospital is more often than not the largest single employer in its area. If you add in the GPs and wide health and social care infrastructure, it is massive.
And why would it not be? Very few have taken on board the warnings, now many decades old, of Ivan Illich in Medical Nemesis that health is being expropriated and people / culture / society their ability to manage ill-health expropriated. While technology is the modern day equivalent of Marx's opiate of the proles, this helps to keep us all benign puppies when it comes to the poverty of our politics, but it doesn't keep us away from the doctor. Nope. Indeed, the technology makes us sicker, and the consumption culture that goes with it amplifies our demand for others to deal with our ill health, and has exponentially driven huge levels of NHS demand. Rights, something we once wanted to protect in others have become the thing to which we are entitled whatever our worry. Meanwhile, politicians and healthcare professionals give credence to a lie that you can eliminate demand. We will all die, and all a healthcare system can really do is delay demand, accumulating disease with years lived, amplifying complexity, and demand in the process.
Yes there are huge inefficiencies in the NHS, but in any business, do you not castrate your industry by demanding efficiencies when your processes have collapsed. The latter has been business as usual for the NHS now for almost >15yrs, and because we live in a county unprepared to put in the resources or ensure the people required from abroad to ensure our service, it is almost certainly at its end, because you can't efficiency your way out of process failure. That is true even if you do manage the 2 main inefficiencies driving NHS demand, which is failure demand from an incapable social care systems whose requirement to perform is only going to increase further, and the problem of silo account driven NHS management, where extracting the pennies from each bit of the NHS ensures by default that the system fails due to internally driven demand.
I hope to God that this gets turned around, but I doubt it.
