The NHS’ Wasted Billions – Where Does All Our Money Go?
Hardly a day goes by without one politician or another banging the NHS drum. The political ping-pong often revolves around the NHS wasted billions.
In July of this year the Jeremy Vine show on BBC Radio 2 covered the anniversary of the death of Aneurin Bevan, the founder of the National Health Service. I wonder what Mr Bevan would make of today’s NHS.
During the program Jeremy Vine interviewed Aneira Thomas, the first baby born in an NHS hospital. She was born on the 5th July 1948 at Amman Valley Hospital, Carmarthenshire.
She, her three sisters, and her daughter have all spent years working in the NHS in a variety of roles. As you can imagine she is a champion for the Health Service and is very proud of her connection to it.
However, when Jeremy Vine asked her what was the single biggest cause of waste in the NHS her answer was surprising. As I recall (and you can correct me if I’m wrong) she didn’t use the opportunity to knock the Tories or blame Conservative policies. Instead, she seemed to draw attention to the waste within middle management.
During the preceding weeks I had seen numerous stories in the press about the amount of waste in the NHS. It began to look as if the NHS is a huge bucket with so many holes in it that every time the budget is increased a lot of it escapes through the holes.
The NHS Wasted Billions
For 2015/16, the overall NHS budget was around £116.4 billion. It’s the second biggest slice of the tax payers’ pie after pensions. Defence spending for example is a third of health care.
If you work in the NHS you will probably have your own opinion so feel free to add your comments below this post. I’d be interested to know what truth there is for each of these examples of the holes in the bucket.
- Consultants paid thousands for weekend work (NHS paying locums up to £4,000 for a day’s work, The Times, February 2017)
- Agency nurses paid excessive daily rates
- The protectionism of middle managers who take a salary but contribute nothing
- Paying fortunes for drugs that should cost a fraction of the cost
- Outright and deliberate fraud (fraud costs the NHS £1.27 billion per year according to the NHSCFA’s own figures).
- Health tourism (accounts for £1.8 billion alone)
- Failed IT projects
- Hypochondriacs, malingerers, and attention-seekers. “Hospital wards are filling up again – with fakers“
- Over-treatment and over-diagnosis
- Contracting management consultants who give no value for money
- Perks, expenses, and bonuses paid to staff well in excess of their productivity
- Theft from hospitals and other medical centres
- Self-inflicted conditions and associated illnesses e.g. obesity and illnesses it causes like diabetes, drinking to oblivion (I’m not including alcoholism, just the binge drinkers who block up A&E) – (No excuse for eating junk food because healthy meals are cheaper, report finds)
- Six figure ‘golden handshakes’ for departing executives and consultants
- 1990 Courts And Legal Services Act (Section 58) which creates an annual legal bill of £1.5 billion
- Bills for private finance NHS hospitals under the Private Finance Initiative (PFI). All but one of these deals was signed for under the Labour government between 1997 and 2010.
- Loss of equipment lent to patients that is not collected or returned.
- Loss of supplies sent to patients that is not used after they recover or die.
- Money sent abroad to fund anti-smoking projects in other countries
- Missed appointments by time wasters. “Patients missing their appointments cost the NHS £1 billion last year” – The Guardian, 2nd January 2018.
- Failure of the NHS to claim reimbursements from the EU for EU citizens treated in the UK (while paying £670m for the treatment of UK citizens abroad).
- Questionable job roles that soak up annual salaries. What value does a Diversity Officer provide to an over-stretched NHS hospital trust? – NHS hospitals spending more on spin doctors despite record-high waiting lists – The Daily Telegraph, October 15 2022
- How NHS Test & Trace frittered away £37bn – article in The Daily Telegraph published 5 years to the day after starting this list in which it says, “NHS Test and Trace was given one fundamental task – to “help break chains of Covid-19 transmission and enable people to return towards a more normal way of life”. On this, the £37billion operation failed, says a highly critical report by the Public Accounts Committee (PAC).”
- Virtue signalling staff magazines, in print and online. “NHS spent over £700,000 in taxpayer cash on ‘virtue-signalling’ staff magazines” ~ The Daily Telegraph, September 2 2022
- Blunders in maternity units that may result in $90 billion in payouts – “NHS faces £90bn bill for ‘staggering’ maternity blunders” – The Daily Telegraph, October 18 2022
Are these all valid? Can you think of any others?
More on this (May/June 2018)
i. NHS guilty of ‘ridiculous waste of resources’ and could improve care without spending a penny more, top medic says – Daily Telegraph, 28th May 2018
ii. 70 ideas to save the NHS: part one – Daily Telegraph, 28th May 2018
iii. 70 ideas to save the NHS: part two – Daily Telegraph, 4th June 2018
iv. 70 ideas to save the NHS: part three – Daily Telegraph, 11th June 2018
Update: October 2021
It’s five years to the day since I first published this blog post and once again the NHS budget is making headlines. See Allison Pearson’s column in The Daily Telegraph.
As the exasperated Tory MP Mark Harper put it in the Commons: “The NHS is given billions more, and then sends out representatives who want to shut down our economy to manage their pressures.”
https://www.telegraph.co.uk/columnists/2021/10/26/nhs-extra-billions/
Hospital Parking Charges
Hospital parking charges are a contentious issue. Over £120,000,000 was collected in 2015/16 according to a report published by the Press Association.
On the one hand there are the hospitals justifying parking charges as an important revenue source that offset the budget cuts. While on the other the patients, their families, and their visitors are angry about paying for every visit.
If just some of the waste in the list above was addressed perhaps many hospitals could waive or at least reduce the parking charges.
Further Reading
Why can’t we admit to ourselves that the NHS is one of the most overrated, inefficient systems in the world? – The Independent, April 14th 2017
December 2019 Update
With the 2019 General Election this coming Thursday debates and arguments are raging in the media. This video was uploaded to Twitter by Rebecca Butler (@rebeccabutlerm2). Her Twitter bio reads, “All content is original. Grew up in India. Ex-NHS Nursing sister, Barrister and Mediator. All followers welcome.”
