Postcode lottery with the NHS is a massive problem .. in kent and east sussex you can't actually go to a hospital that's not in special measures .. the ccqc can't even rate one hospital in both counties as mediocre. In Kent it's hugely dis-organised and this has absolutely fuck all to do with money; it;s attitude, organisation and the dreaded C people hiring D people. My dad went for an outpatients op and they saw something they didn't like on the heart monitor. He only knew as my mum overhead a quack talking and pestered the staff for someone to talk to her and my dad. The letter they sent the GP didn;t arrive for 6 months. The GP had no blood pressure testing machine for 2 months, and couldn't provide a heart monitor requested by the consultant for over 6 months, then my dad was mi-advised by the nurse not record a diary to go with so the results weren;t very useful and then the wrong results were sent back to the GP. He's been on a cocktail of contra-indicated drugs on a trial and error basis but if he mentions that he thinks this one or that is making him worse, he's basically to told to shut the fuck up. 2 and half years later he still has no diagnosis..
The incompetance is so bad it almost has to be wilfull which wouldn't surprise me. East Kent has a lot of retired people and it often seems like the NHS is more than just willing them to hurry up and die.
Contrast to my business partner in Bucks. He had a teeny tiny micro stroke event, had all the investigations within 3 months and all round good efficient care...when he needed a procedure done the GP was pressuring him to take the private hospital (but paid for by nhs) option under choose and book.
HCPs refuse to except that any of this is down to them .. there is a pervasive, perverse "we can't do any better" attitude AND and obstreporous willfullness NOT to engage with IT... the number of people i talk in primarary care who are actually PROUD (their emphasis not mine) to be ignorant or anything IT is shocking hence the wannacry fiasco is most definitely not shocking. Am not talking about willingless to learn clinically ... but organisationally.
GPs are profit making businesses and hate pharmacies (unless, like an increasing number now do, they own one.) Many people can;t re-order prescriptions via their pharmacy now as GPs are convinced all pharmacies are crooks and making too much money (unless the GP owns a pharmacy which more and more now do) to the extent that they will even illegally pressure patients not use this pharmacy or that .. Why, cos the government contracted pharmacies to provide flu jabs as well as GPs and they do it cheaper.
We spend a fortune on GP training but lose thousands abroad each year. If you're trained by the state you should work for the NHS for a minimum period, like when the armed forces sponsor people thru uni. GP recruitment is suffering because partners keep way too much of the pie. In fact across the nhs training seems to be modelled after the worst of the public school fagging systems with the juniors and trainees forced to put up with so much shit til their 40s or 50s that, those who make it to consultant or GP Partner land take too big cut of the money for salaries and in turn put all their juniors thru the same shit they went through..
Meanwhile, Jeremy shit-for-brins Kunt is trying to close 3000 pharmacies even though we have a glut of pharmacists, pharmacists are under-used clinically trained healthcare professionals that could do a lot more primary care prescribing / referalls and they are very accessible to the public. Rumour has it, he's for the chop after the election hence the visits (interviews) to US health insurers.
I won't bang on about the criminal waste of money in PFI as plenty of other posters have done so already
Fundamentally, even with the best organisation, working practises staff, IT in the world etc, there's no way round the crux of the problem - when the nhs was setup the average life expectancy post retirement was 3-4 yrs .. now it's pushing towards longer spent in retirement than working. And we can cure or treat way more (much more expensively). I recall a panel of nhs docs, consultants etc on C4 prior to the 2015 election .. with completely straight faces they all agreed the public needed to be told what's what and that income tax had to be over 60% for everyone at least to even come close to the funding the nhs needs.
Seems to me the answer is less puritanism.. the gov should encourage to smoke, take drugs, get pissed and enjoy ourselves so we all we die young!