The NHS: Where does all the money go?

Tales of the expected

This is the tale of a health service that gobbles up £170 billion a year of taxpayers’ money. It was born out of the suffering from two world wars and the “Land fit for Heroes” rhetoric.

There are several specific aspects to the tale.

Effective services usually have a clear mission, which is reflected in their structure.

Health services are about serving citizens, customers, and patients—call them what you want—and you expect excellent response times and accessibility. If you cannot access it, what use is it?

The service needs to have a flexible, agile structure to face the unexpected, which has a habit of constantly recurring when and what you least expect.

Because of the vast sums involved, politicians and independent auditors need to exercise strict oversight and understand how the system works. If its structure is simple and transparent, that is not a problem.

The service must also be very efficient, as it's publicly funded. It needs personnel who enjoy working in it, as the happiness w…