Whilst the celebrations of the NHS’s 70th birthday hit the headlines recently, it’s important to question how the NHS continues to serve a country where the population is at a high of 65.6 million [1]. Although the NHS is a much loved and respected service of the UK, the issue is whether it will continue to provide the level of health service required for the increasing ageing population and higher demands for A&E care because taxes will surely not be sufficient to cope with the increasing demand. The demand for private medical insurance in Britain rose by 2.1% in 2015 with over 10% of the population choosing to be insured [2], so perhaps it’s time to look at other healthcare options.

The Five Year Forward View

The NHS is the biggest employer in the world with a reported 1.7 million staff, but with the challenge of facing 1 million patients every hour [3], this may not be sustainable due to the increasing population. Since the NHS launched, the UK population has increased by 17 million due to natural changes and net migration. The population is ageing which also puts a strain on the NHS and its resources. The 2014 NHS Five Year Forward View forecast that there would be a £30 billion funding gap by 2020/2021 if the 2014 trends continued. Yet the challenges facing the NHS continue to grow with funding cuts in social care, staff shortages, additional funds used to sustain existing services, all of which may not fill the public with hope for their health.

The Prime Minister’s view

In her June 2018 speech, Theresa May praised the NHS, the staff and the superior service it provides. She promised a commitment to funding and instead of offering a one-off injection of cash, the proposal would be a steady growth on average of 3.4% each year from 2019/2020 to 2023/2024 meaning an increase in the NHS England budget of over £20 billion by 2024 [4]. Some of this funding will be due to the savings from the withdrawal of the EU. Yet with the current Brexit negotiations still lacking transparency this funding, like a lot of the Brexit detail, is still not guaranteed. Even if the funding the Prime Minister discusses is given to the NHS, according to the Institute for Fiscal Studies [5] this unfortunately does not cover equipment, buildings or medical training. Furthermore, it’s still unclear where this funding would go and how exactly it would cover the increasing population.

Issues facing the NHS

The A and E department has a target of patients being dealt with within four hours, but this target has not been reached at 95% or higher in England since 2015. Yet with the Guardian reporting a record 2.2 million people attending A and E in England this July, the wait time may have further increased [6]. The ageing population is growing and 18% of the country are now aged 65 or over, meaning the NHS is gaining patients. In addition, caring for a 65 year-old costs, on average, 2.5 times more that an average 30 year old. An 85 year-old costs an astounding five times as much. According to the National Health Executive, [7] the cost of drugs are increasing and GPs are becoming more restricted in when they can offer medication. In addition, with advancements in medicine, more treatments and medications are being created, the costs are further increasing. They are not suggesting that the NHS will stop, but the treatments offered will reduce and the waiting times will increase.

Private Healthcare as an option

Many individuals may receive subsidised private healthcare through their work, so their reliance on the NHS is minimal. However, there is the option for individuals to invest in private healthcare not just for themselves but also for their family. Healthcare consultancy LaingBuisson reports that pay as you go private healthcare is currently growing by 10% per annum. Such healthcare will offer shorter waiting times, options of locations and consultants and access to facilities the NHS may not be able to offer.

The funding the NHS will receive in the future still remains uncertain and with the increased pressure on the NHS it’s likely that services will be affected. With no prospect of the population remaining as it is or reducing, it does not seem probable that the timeframes for NHS treatment will shorten. Private healthcare offers the comfort of medical care with minimal, or no, waiting times and specific treatment for individuals.