Report on Britain's NHS finds flagship universal healthcare system in 'critical condition'

Sept. 12 (UPI) -- A damning report into the National Health Service released Thursday said Britain's free universal health system was in a "critical condition" struggling with the fallout from COVID-19 and failing to meet targets for cancer, emergency and hospital treatment, despite spending rising to more than $215 billion.

The 163-page independent investigation into the NHS in England said it was in "serious trouble" with the nation's survival rates in cancer and heart disease lagging behind other countries and public trust at an all-time low.

"From access to GPs and to community and mental health services, on to accident and emergency, and then to waits not just for more routine surgery and treatment but for cancer and cardiac services, waiting time targets are being missed," said the report by former Health Secretary and surgeon Lord Darzi.

The report said long delays for treatment had become "normalized" with 300,000 people waiting for non-emergency hospital treatment for more than a year and 1.75 million waiting for between 6 and 12 months -- in breach of the NHS Consitution that sets an 18-week limit between referral and the start of treatment.

Britain had "appreciably higher cancer mortality rates" than similar countries thanks to "no progress whatsoever made" in diagnosing cancer at stage I and II between 2013 and 2021.

The 62-day target for referral to first treatment had not been met for the past nine years with just under 66% of patients being seen within the time limit as of May.

Detection rates did improve in 2023, up from 54% to 58%, with notable improvements in the early detection of lung cancer due to the rollout of a targeted lung screening program.

Rapid access to heart treatment was also down with the rapid intervention time for the highest risk heart attack patients to unblock an artery up 28% from 114 minutes in 2013-2014 to 146 minutes in 2022-2023.

Suspected stroke patients were in a lottery on whether they would receive the necessary brain scan in the critical first 60 minutes with the target being delivered for 4 in 5 patients in Kent in the south of the country compared with only about 2 in 5 in Shropshire in the West Midlands.

GPs were seeing more patients than ever before but a shortage of doctors combined with a growing population had led to major disparities in the ratio of patients to GPs, particularly in deprived communities, with more than 1 million people on the waiting list for community services.

Another 1 million are in line for mental health services, 345,000 of whom have been waiting more than a year for first contact and 109,000 of those were for children and young people under the age of 18.

Accident and Emergency departments were in "an awful state" with most meeting the four-hour target only a little more than 60% of the time and 10% of all patients waiting 12 hours or longer for treatment.

Citing the Royal College of Emergency Medicine, the report said the long waits were likely responsible for an avoidable 14,000 additional deaths a year, more than double all British armed forces' combat deaths since the NHS was founded in 1948.

"How long people wait, and the quality of treatment, are at the heart of the social contract between the NHS and the people. The NHS has not been able to meet the most important promises made to the people since 2015," said Darzi.

The rot had not appeared overnight, Darzi said, but was the result of a decade of decline from falling productivity and underfunding in the face of rising demand for the service from a growing population that had become sicker and older.

However, Darzi insisted the "NHS' vital signs remain strong," praising what he said was an "extraordinary depth of clinical talent and skill" and staff across the service who were "bound by a deep and abiding belief in NHS values and shared passion and determination to make the NHS better for our patients."

"Despite the massive gap in capital investment, the NHS has more resources than ever before, even if productivity is far from where it should be," Darzi said.

He called for a major shift away from the majority of very costly healthcare provision by hospitals to care in community settings, more joined-up services and more prevention to keep people from getting sick in the first place.

The report was commissioned to provide the new Labor administration of Prime Minister Keir Starmer with a snapshot of the cradle-to-grave system to inform government plans for the service for the next decade.

Health Secretary Wes Streeting said the system could go bankrupt without reform to address the burgeoning cost which is expected to top $215 billion in England alone this year due to a rapidly aging society with more sick people and rising prices.

"Rather than a country with an NHS, we're going to have an NHS with a country attached to it if we're not careful, and more likely an NHS that goes bust," he told the BBC.

Prime Minister Starmer was expected to say in a speech later Thursday that there was no choice for the NHS but to "reform or die," pledging "the biggest reimagining of the NHS" in its 76-year history with a new 10-year plan to be announced within months.