everyone has one of us here says pipe top immediately and says this is american economic car wash. what would you say about the wash and light target either, but it's only going to be me is targeting vulnerable, but it's, it's important to have this conversation. we need to talk about and not about narrative. the street on algae 0. the new k is national health service turned 75, but the n h s is facing serious challenges and a great deal of criticism. so how did it get to this point? and how does this revolutionary health system compare with others in the west? this is inside story, the hello and welcome to the program. i'm several then yay. but you case. national health service has been

a source of pride for millions of britons. it was created 75 years ago with the goal of providing quality health care paid for by the government through the tax is collect. but the british public now is worried. the british medical association has worn the dna chest is collapsing, access to health care is getting worse, and the qualities are also worsening and stark. differences across the country, leaving large sections of the population behind so can be in a chest prosper without drastic changes. we'll put that to our guests shortly. first though, this report never far from the spotlight. u. k is national health service, better known as the n h. s. is under even more scrutiny as it turn 75, the officials warrant as many as 500 people could die each week because of delays and emergency care. and the demands placed on the chest today far surpassed those during its early years. this something that was revolutionary when it began, and in many ways it was absolutely revolutionary to provide universal health care.

that was comprehensive cover, basically everything that the founders could think of and almost everything they couldn't think of. and for everyone at the point of need, no bills to pay, you already paid for it in your taxes. that was revolutionary. did a just as a state funded health system found in 1948 back then it costs around $20000000000.00 a year in today's money to operate. last year the government spent more than 350000000000. but as of last january, more than 7000000 people are on a waiting list, a record number. the government is committed to reducing waiting list, but little progress has been made. rising energy costs and inflation mean the health surface must do more with significantly less the an h. s is also coping with an aging population. a large number of people now live with chronic health

conditions like heart disease and diabetes. and there's also a short of staff and proper equipment. the king son recently compared the interest to 19 countries around the world, including a tobacco european countries, the u. s. and japan, the sonata leader or la god, really, it comes in the middle and last areas. but it does do poorly. pa had compared to countries like france and germany on the number of hospital beds, and the number of doctors and nurses on the number of seats in m. r. i scanners, the coven, 19 pandemic severely tested dna chess at aftermath is still posing many challenges . health officials and experts for and for the u. k is national health service to survive. it needs to innovate and reform. vince and monahan for inside story. the. alright, let's bring in our guess we're all joining us from london today, sir. and then to see the chief on the list of the kings fund, an independent

u. k. health charity organization, which put out a report on the state of the an h. s. recently we'll be talking about that dr. sonya out of sorry, joins us to you are an a chest doctor and a campaigner. and jenny hale is ceo of pathfinders, neuromuscular alliance run entirely for and by people with physical disabilities and your organization offers social and support services. a warm welcome to all of you to the program today. thank you very much for coming on a civil that start with you. is it a happy birthday to the in a chest at a 75 years on? i think it's a really mixed best thing to be honest with you because as your report highlighted, the image just finds itself on it. something's 5th birthday, i'm moment of real real strain. i mean, wasting time tockets for how long you should be in a 90 department or how long you should wait for a con costs total procedure would routine and you might even as recently as 10 years ago. and now those targets being routinely felt up and down the country. they used to be a credit, it was historical, even one clinical stock grant to go out on industrial action and now and every,

every significant start for me i'm a chest is going out on industrial option. so it's very clear that the chest is under tremendous pressure at the moment. i'm so mixed birthday celebration at best on the side. sonya dr. out a saw or what's the conversation among health practitioners on this, on this 75 year anniversary? the image as well because of the straight edge of the image as well cuz often feel i'm angry, i'm not because they know able to deliver the cabinet. we know our patients deserve . so i'm a g p a but i can general practice unlike money, but it's a straight thing in the upsets when i see that my patients. so having to wait sometimes 6 months, sometimes a year, sometimes 2 years to get the car that they need. and i don't think there was a distraction there because as you know, as soon as said, we've seen dna testing the cabinet. we are giving the klein over the past decade and not to them. it just because we have been speaking out about they've been

speaking out about this and they would let the suspicion out saying that it's a stand zip code to aging the conditions of deterioration. and it's becoming more, more difficult for us to give the cat that we want to deliver to our patients. and, you know, i think there is the fact that you see so many image as well because now course the image transform into consultants to on business drive is the fact that people everyone is getting on strike. that's just, that's it. we've been driven to that. and i think that we've been driven to the of speeding or what else can we do? doesn't seem to be any, was listening. we're seeing had to, to age and, and, and it just works of going out and strikes, trying to get in for this government to listen to me. your thoughts on this. i think your perspective is mixed right on the, on the states and the benefits versus the disadvantages of the n h s. and so i think we need, say benefits. this is disadvantages. i would say it's more the benefits of that make just the ways in which the amount guess is being filed by government and the

funding and therefore is not able to weigh a lot is or if the potential benefits from a patient is active and from the respective of running an organization that represents a number of people with quite significant physical impairments. there's an enormous sense of rectitude and an awareness that we wouldn't be why we without the at 8, just saving lives, sustaining lives, giving us the fun thing we need to live in the community. it's also a series of horror stories of appointments being canceled, whites engagement, particular appointments that says just being best slide. people don't being given the funding. they need to have the cab. they need to live in that writing times. the sense that we are all on the staff towards with a stretch medical professionals. and it's very clear to me as a patient that the medical professionals i see often calling to give the kids that they want to be giving effective the hospital grabbing. and how did the sit down

and just best to because she's so restrained, overstretched, and watching on it on the staff was no medical professional wants to be in that position. civic your organization. the king's fun just produced the report on the state of the n h. s. what were the main findings of hearing from all 3 of you? clearly there's under funding, there's understaffing and there's long waiting lists as the main symptoms of the, the deterioration of the an h s. what did your report? fine so you're right. what we did was look at how the u. case health care system, which is a cost on there to buy. the nitrous compares to the health systems of 18 of the countries and other countries to acquire incomes industrialized nations. and we found a few things, i suppose that says sophia's thing is that in the u. k. health care system has fewer key resources that you need to go to a good quality healthcare with just the average and how much we spend per person on

healthcare in this country. we have few hospital beds, we have to, as has the cabinets. we have few a, c, t and i'm or i scholars, i'm probably most and for me we're very, very though on the number of doctors and nurses and all the key professional groups compared to other countries. now i need health care system in the world is going to struggle under these conditions. and so it's on surprising the and it shows the struggling to get the high quality health care outcomes. so how long patients wait for kind of the quality of care they receive when they are in the system is not as good as op hughes. i'm obviously, i'm not taught that's because of the got to have resources that the health system is given was when you say or appears to be clear because our viewers will be watching this from all around the world with and, and, and they will be experiencing and their countries very different health care systems, depending on where they're watching from your study compared the u. k. to a group of about 20 or so comfortable countries is that find it. i read it. there were a lot of western european countries, new zealand, the us, canada, those are the countries you were comparing the u. k. 2. yeah,

you're absolutely right. so it's, it's countries like from the countryside suite in the united states, canada, australia, and he's even countries that off your coast political, economic neighbors or possibly youngest. yeah. so it does, it's going to do on the positive good. but those, those are the countries we would respond to be towards the top of the task at all. and unfortunately, at best, we're in the middle accept some resources, but to be honest, which was the bottom of the table. dr. add a saw or it can. you give us as a practitioner, can you give us a just tell us stories of, of what it's like to provide care in this environment. and yeah, and i mean, it is the 1st thing i like to say is that what we say is the and it just best day. and there was also things to celebrate about the an h s. m. and i guess flu international view is that the main thing that i loved the most about was giving it to us is that it doesn't matter whether someone has, is a, you know, as a millionaire or has no money, a tool when they come in to see me in the clinic,

they get, they get treated equally and sadly say we don't help, you know, insurance based systems like i have another european countries where if you pay more, you get click lots as a bunch of cash. and everyone gets treated equally in the health care service to think of something. it's quite unique and very special to the an h s a which makes it very, you know, which is why i'm do loved working in the health of s. and, but i guess it was a caviar to that if i can jump in, which is more and more people are choosing to pay more to get better care and go private. is that fair? yeah. and, and that's what i was just about to say is that increasing me, particularly, i think in the past 2 years, i've noticed this of my clinic and i was, cannot stick in imply pool area of london. but i've seen people, i see people who don't really can't afford to, but having to say like, you know, they've been to the savings because, you know, i had, i had a, i had a case of a lovely gentleman who had a bad arthritis suit. so it was the insignificant pain in his head. it was an

imposing his ability to walk and the weights in time for the operation only in a chest was over yet. um, so this pull gentleman in existence so much pain and become increasingly debilitated. chose, you know, chose to go private, use his savings, try and get to get that surgery done quicker. i mean, increasingly seeing that so latest based that shows that up to, you know, go on and thoughts post for us. i can get both for a 2nd because this is such a vital part of the landscape today of the an h s and getting getting health care in the u. k. talk to us about that patient. what, what is the process of trying to get an appointment? and who tells you you're going to have to wait a year and how does that get decided? yeah, so the fast difficulties, the finding it difficult to get a g p appointment. and that's because dental dental practices becoming increasingly unsustainable, we have to be practiced as closing across the country is becoming more and more difficult for people to get g p appointment. so the delay that then that so you

come and see me as a g p, i think, but you need specialists, treatment, ill scans and the hospital. so all the 30 to the hospital to get that done. and the waiting times now in the hospital's up in increasing significantly over the past 2 years. and as he said of that stuff, the program we have, you know, 7000000 people waiting for routine. we quoted routine cab when we say routine care, this is often, you know, in very, very important because the people need to be some of the, of the disabilities of back pay, you know, to, to, to really, to believe them of their conditions and will be increasingly saying is that actually people walk away seem to get the treatment and sometimes that can be 6 months. so that can be a yeah. that between a 2 year, sometimes i'm seeing patients that conditions get with us the become a live living in pain and they'd be calling more debilitated as conditions get less . and so the thing is supposed to be private. so as a g p, then when you refer your patients to a specialist, you know, and you gave us the case of this patient we needed to, we had arthritis, you know,

that the patient may not get treatment for 6 months or a year. yeah, i know that with a lot a lot of conditions, the weights and times of that launch and even, you know, even with actually things that need to be treated as a nice so even with things like house that where we know that the treatment will improve political places and improve people's ability to survive, even then addressing delays and kathy, but not being seen within 2 weeks. and people are not getting the treatment within a timely manner. so we're seeing this throughout the, in a chest. and then also we have to talk about emergency kind of as well people, you know, when you go to the emergency department, you would expect, you should be seen very quickly. you should be treated quickly. and that's because assessment conditions where if you're not treated quickly, then it increases your risk of dying. and unfortunately, we saw this, particularly in the winter, and then it just stopped people not getting, getting treatment quickly enough people to come to a home visit result. you know, i have a, i have someone that is

a family friend of mine that sleep passed away because they didn't get the cancel that hoss stuck in time. now that's a massive problem. and we bought in a winters in ice and made people think when his baseball waiver, that's 6 months away. we need to be having now full that to make sure that people get the kid that they receive in a timely manner. cuz otherwise people will be, you know, it's, and this is what i mean my and it just work cuz it's getting angry because we, we want our patients to get the cabinet. they does. we don't want people to get home because they're not able to get to on time and i think is where i could do work. so that's how i see that my colleagues every day. okay, but as you did, we need the conditions to be able to deliver that to jamie, on this particular issue of waiting list. is that something either in a professional, a personal capacity that you have seen deteriorate over the last decade? plus i think i can safely say that in both capacities, i'd say that the terrier, right? of that from a passable prospective. i have been on the increasingly extended waiting lists. i

think it took about 18 months for one particular with arrow to go through to the consultant before testing could even be arranged. and this is certainly something that our members is struggling with as well. and why people have complex conditions and might be under both of those special isms if they are not, they will be under a single credits that can coordinate all of this. that many of our members see different specialists at different hospitals with different regularities. so then to compound the lights, for appointments, the lights are kind of glasses, the lights for tests and procedures that are there. so that's not necessarily looped in with what each other is doing, which could add increasing complexity in place and eyes. why we should have a system that is incredibly joined up and the interests that patients being seen across lots of sites. obviously, even the cut out the gift card they need,

which would save staff card and improve the experience for patients. because certainly things calling, keep going, the way that going from and that's one of the major concerns, particularly in winter, is just infections. many of us use forms of ventilation, either overnight or 24 hours a day, full of people who have, which is very true function like myself. and that means that even a simple chest infection could very quickly become life threatening. and it requires that somebody is seen in free to put pay and then i in the environment and the environment needs to have the stuff, time and capacity to weigh the address, the patient getting the call, the types of apple history and the practical risks balls at that and just having to speed for the patients as quickly as possible because certain things got best for patients with more, more complicated conditions. and i think as a community,

we are also grateful for the i'd 8 just for both it's doing for keeping us alive. i mean, facing the, for the community for funding drugs, the absolute game changes for people with conditions that are progressive and that would otherwise have continued to progress. so there is that why this, that there is progressively at night chess alongside the deterioration. but at this point, we are finding that people are increasingly going private, full time sensitive appointments, scans and treatments. because if your blood pressure has climbing and you're a high risk of heart failure, you don't want to wait 6 buttons to see a cardiologist. this is already said, i'm going to go back to you there. there are a lot of numbers that you can crunch to try and measure the performance of a, of a given health care system, especially when you're trying to compare between countries. i don't want to bury your viewers in numbers, but there's one that really stands out to me and it's in your report. it's about

avoidable mortality rates. do you want to talk to us about that a? yeah, and so if i was going to pick one area, i think i pick the same one but use it, which is a wait for more time to see i'm at 2 different bits of avoidable mortality. the 1st is preventable mortality on the 2nd is truthful mortality. and i'll say why both are important. truthful mortality because not swear with time getting affective health care treatments just could be devoid. yeah, so you've heard of hotspot, but you need quick can unfortunately ask me about it from sony. about doesn't always happen. but with rapid high quality care you can say someone's eyes on the u . k. forms very, very closely on this semester compared to appears on the other measure, which is predictable. mortality which is you know, try and prevent the person having a heart attack from the 1st prize or stroking the test case through interventions that help us need healthy. you guys maintain our health, and unfortunately the, the, you take those pulling again. so without trying to people is statistics. the unfortunate

reality is in this country, we are not very good at keeping people healthy or treating them when they get now, which is obviously the ultimate point and really should be the, the, the primary objective of any health care system. i want to put those there so telling i want to put those numbers up on the screen. so when it comes to avoidable mortality rates, the united states stands at the highest has the highest rate, which means the worst performance with 88 percent of avoidable mortality. rate just behind is the u. k. 69 percent avoidable mortality rate in canada is middle of the pack. i mean, you rate at your organization. the king's fund looked at about 20 plus countries. we're just going to show a few here candidates, middle of the pack, 56 percent. the lowest avoidable mortality rate is australia in your ranking, at 46 percent. so again, 46 percent for the best countries. 69 percent for the u. k. it's a massive gaps of a it says there's 2 spanish on these, but i says that's 800000 people. 11 thing psycho is that you can,

that can fuel and trying to book some fuel to be you can change your performance, you know, resort tasks from cancer and does from cardiovascular disease in this country. rob could we refuse when the serious investment was may 20 times 5 years ago? so it is a serious issue. we are not where we would want to be on to the table, but you can move out. you can improve your opponents. and in some cases like survival from breast cancer, it was a story of improvements. unfortunately, even the improvements and now storing. let's talk a little bit about how to improve this because it's not like successive british governments haven't been made aware of these issues and poll after poll reminds british leaders that this is something british voters care about so deeply what needs to be done, what say, maybe top to top 3 steps that need to be taken to improve the the state of the

image has dr. out of sar. i guess it was the best thing that's most important is stuffing that we because live a cat we weren't having and it has to be done and have enough stuff. that's doctors and nurses do. and, but also even in the cast that to coworkers, what we need to have and the stuff and, and in a vacancy rates me and it just them because that's what getting a getting was smoke getting back to. so we need to be thinking about how we train of colds. train will train the workers, but also how we retain workers. and this is a massive problem. a senior managers right now, we have doctors in the us is leaving the n h s and they are leaving. then it says, i've taken a gaze with training and use the divisions this up is because of the conditions and physical to, to reach what conditions or the cause of but out. so we can, we can put in the government, can do things like now to try and stop the out loud outflows nature as well, because in the, in the health 6 when the cast 6 of as well. and 2nd is what you know, i would, i would, you know,

prevention is such an important thing and we talked about an adult, but it might take you doing a practice most in the majority of the conditions. and we know things like heart disease and side the teeth. these are things the project will conditions and we could, if we invest now to try and prevent these conditions happening will be saving the unexpressed, a lot of money in the long term. so the investing down prevention would be, would be, is, is really very important noticed the patients, but also, but financially, to, to bring money back into the health service. silver. any thoughts on that? i think the numbers are pretty clear on that. it is cheaper for any government to prevent a disease rather than have to treat it. oh yeah, absolutely. yeah. and i, i would say, you know, when i look back at the end of my career, i do wonder if the single biggest thing that the u. k. would have done to improve the health and wellbeing of the population or something like smoking done. so yes, i see you need exactly sonya so to invest in all health care with for stuff whole

healthcare workforce. but another big positive level, mental health status best is reducing demand by helping people read healthy lives on some of that more investment. but some of it can be done through regulation, things like sugar types of salt, taxes, taking action on buy one, get one free or waste your time all tax for people who are not familiar with that concept is you're going to tax say. so does the suites that the kids will flock to buy, but they're actually terrible for their health. absolutely. so you even time prize policy on them to make it hard to, to buy them or even cars through that pricing, the manufacturers to reformulate the trains or the foods to make them healthy. yeah . or you, you do things like on the smoking, public prices that we've already done. so these are things where, you know, we haven't really seen to debate in this country of the 90 states and things like that. but when you have focus groups with the public, when you look at polling, i think the public option is to pay, you know, is a shared responsibility for individuals to maintain the house. i'm from the state

to pray that it's role in helping us need help. you with ours, jamie, your thoughts on priority measures. you would like to see a british government take to improve the interest to say that while complete the agreeing with that various because on and staffing being vital. i think the, the to the i would want to address joined up the cat and personalization, the bold people's carriage joined up across health and social cast services, including education. why that is relevant for children and young people. the board that we can reduce duplication of flight by the board that we could increase the ability to spot problems as they arise the back to that could be the cation back to the patient's experience. and the low of the bias that been destructive and stuffing demand. and then in terms of past lives, ation, one of the key costs with that and by see how to address that and to this i shall cast that stuff is out of the safe. okay. and health care packages for disabled

people living in often in the community. and why that is kind of packages done for the private care agencies. it becomes an increasing the expensive way of delivering cat in which he had a dress of local authorities, are beholden to the right set by private agencies to some extent. whereas other approaches, the 5 ball past lies. i'm the give people the control over that cat budgets to employ the facial kind of well, cuz they need to have independently improve outcomes of people while saving money. so i think boy invest been involved in out these increased aspects of past motivation that way the empower disabled people to take control over that house. and that size, they had a chest and the adult social cost extra money are very obvious. wife or what for me . mm. a look. thank you very much to all of you. that's where we're going to end this conversation. it's been really interesting to hear all your insights. sit on

on the see the chief panelist at the kings fund, dr. sonya, out of sar and a chest, dr. and campaign and jamie hale. c o. pathfinders and you were muscular alliance. i want to think all of you for joining us on the program today and thank you to for watching. you can see the program again any time by visiting our website alpha 0 dot com for further discussion on this to go to our facebook page at facebook dot com forward slash a inside story. you can also join the conversation on twitter or handle as a inside story from me. several then. yeah. and from the entire team here in don't by the the,

when a waterline is committed. is it kind of how does it or follows that goes in the human rights investigator on his unprecedented journey to the french high court, i visit every place to make sure that they are much off to practice taking on the arms trade. it is fine for justice, for innocent palestinians, and their families made in front. oh no, just once out loading cuba private businesses about since 2021. people have been able to incorporate small and medium sized businesses more than 7000 companies. i'm sorry for being incorporated how he pays for small businesses like this will boost productivity and get more food on people's flights. but in the nation with teachers and scientists and tiny salaries, the imagine private sector is already attracting highly qualified work is away from state jobs. the communist party of cuba is finally moving towards

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