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No. The health service is not on the point of collapse. No government would dare to allow it. More money will always be 'found'. Never enough because there just isn't enough money in our society to fulfill society's expectations. I strongly suspect that inefficient practices run away with much of the money which is available. It would be interesting to see a complete detailed accounts breakdown for the National Health Service, giving structure, salaries and functions at all levels. As far as I know this is not done - or at best is done but not published.
Pete Oliver, UK

I have personally felt that the NHS has been near collapse for a decade. The fact that anyone should need to wait at all for medical treatment is appalling. Our health is the most important thing we could possibly have, yet to get an appointment to see a doctor when I am ill takes a week!
Paul Charters, UK

Some of these comments seem to me to point to the case against socialised health care...there needs to be more education, there needs to be better prevention (more tax on cigarettes and alcohol, I suppose?) What about freedom? Let's scrap the NHS altogether, have a basic accident and emergency service, and privatise health care.
Alex Stanway, England

The NHS has been a victim of 20 years of underinvestment. Most staff, clinical and managerial, are working too hard. Some services, like inner city mental health services, are even more under-invested than acute medical services. Things should gradually get better with the increased investment and "modernisation" promised by the government but nobody should underestimate the problems caused by insufficient investment, especially in training adequate numbers of nurses and doctors which will take years to put right.
John Wattis, UK

Extra spending is obviously required, and this could be raised by charging patients for the full cost of drugs on prescription ambulance transfers, some medical procedures, and scrapping free prescriptions for over 65 / under 18's as is the case here in Canada. People could then have the option of taking out simple blue cross policies to cover these extra items, but this would not compromise the N.H.S.
A return to some smaller 'cottage' or community hospitals, covered by G.P's could lighten the load on General Hospitals, giving a more local degree of care to patients requiring hospital care, other than emergency or surgical help.
Rob Livingstone, Canada

Increase the morale of doctors by paying them more.
Jackel, UK

1997/98 was a mild winter. 1998/99 seems to be a normal winter in the NHS. The emergency service is under particular pressure because of the current emphasis on cutting waiting lists which is putting pressure on staff and resources. That said, the suggestion that the NHS is in crisis or terminal melt down is too ludicrous to be taken seriously.
The crisis is as much media generated and generated by well organised professional organisations looking to next month's pay settlement than it is real. Good luck to the staff on pay, but lets have some balanced and sensible reporting!
Paul Roberts, England

Teenagers are going to go out and have sex whether you like it or not and giving them access to condoms will reduce the rate of unwanted pregnancies.
Nichola, England

Whilst recently watching the NHS having to deal with the huge problems caused by the recent flu epidemic I tried to think about my own experiences with the NHS during my childhood. From these experiences I concluded that the present problems have not only been caused by nurses being poorly paid. In every major city there was a network of small hospitals which served the needs of local communities and nursing training was carried out in many locations. In the late sixties we started to see these huge monstrosities appear in our cities which were supposed to be hospitals, and as a result the many local hospitals started to disappear. Suddenly we had enormous buildings which were costing an absolute fortune to run.
Then in the eighties the nursing profession itself embarked on a disastrous but successful programme of re-organising itself out of existence by scrapping a whole layer of entry opportunities into the profession. The leaders of the RCN can be proud of their staggering!
incompetence. With a huge organisation such as the NHS the problems I know are varied and complex, but the combination of ill thought out politically motivated reforms together with the poor leadership from administration professionals coupled to the RCN backed disastrous re-organisation of nursing training has led to the present situation. I applaud the efforts of the many thousands of NHS staff who work in what I still believe to be a wonderful organisation, it is just a pity that they have had poor leadership across the whole organisation.
News Online User, England

Tom Conti said on 'Breakfast with Frost' on Sunday morning that the key to our NHS problems is around education, I couldn't agree with him more especially on diet and fitness, when to see a doctor, when to stay at home, and if more people did stay at home when infected instead of being heroic then infections wouldn't be as rampant in society.
Wild, UK

Reports of its death is greatly exaggerated!! The NHS is one of the best things about this country. As medical improvements are made, it puts further pressures on the NHS, but it has coped and will continue to do so. I refuse to pay into private medical schemes on the basis that it should not be a profit making business and I give my full support to our NHS, dedicated doctors, nurses and other staff. They perform magnificently under difficult pressures.
ANDREW LYE, England

I don't think the NHS will collapse. A collapse would indicate nobody gets any treatment at all. This will never be the case. What may happen is that more patients will be turned away and not receive the level of care they have in the past. The only way to sort the NHS out is more money. How many people are prepared to see their tax bills go up by 2% to pay for it? Not many I suspect.
Roy Matthews, England

Even without a flu "epidemic" the staff at the front line within the NHS cannot hope to care efficiently for patients, without there being a little slack in the system. Wards used to have 2 'acute' beds to take emergency patients; running at higher occupancy may seem more efficient on paper, but results in patients being 'lodged' on inappropriate wards where nursing staff may not have specific expertise, and doctors have to treck all over the hospital to see their patients.
Claire Marten, UK

Yes, and about time too! We've been conned into thinking we're getting something for nothing for far too long and it's about time we woke up and realised that if we want good healthcare then we have to pay for it. The best way to do that - just like with telephones, electricity and everything else that the government used to monopolise - is to privatise, privatise, privatise.
Alan Baldwin, United Kingdom

I am an NHS trained RN working in the US. I am shocked at how far the NHS has degenerated. The health service should be able to cope with the winter flu season. The incidence of flu in Britain is not particularly remarkable. It is the same as any other developed country yet no other country is buckling under the pressure. Clearly, the underfunding of the NHS, the low pay for RN's and lack of new initiatives by managers contributes a great deal to the crisis.
A well-developed primary health care system could have prevented this type of crisis. 24 hours community walk in clinics could improve access to health services and shift the burden from hospital services. However, this type of service requires money the government is not willing to spend. It's a case of being penny wise and pound foolish. The situation could also be alleviated by an adequate salary for nurses. In the US a registered nurse earns more than double average wage. In the UK nurses do not even get an average wage.
Katie Dawson, US

Welcome to Healthcare in the 90's. America is paying for all of the overspending, fraud, and high administrative costs that the 80's seemed to enjoy. Now with our Medicare program for the elderly in dire straits, every hospital in America in 1999 will receive approx 2 million less in Medicare reimbursements than last year. How do hospitals in America cope? Cut the number of beds, reduce direct patient care staff and hire more administrators to manage less money. I should know, I've been in the health care field for 20 years and have seen bureaucracy at work. Government supported Health Services are a wonderful concept, too bad it doesn't work. We all pay one way or another. Good Luck!!
Glenda, USA

The Labour Party, who have always set themselves up as the Party of the NHS, is now killing it - and many of its patients.
James Davenport, UK

Government controlled industries always fail in the long run. The NHS has had a long run, but it is feeling the strain of modern technology. The transfer of wealth from the middle class to the poor only ruins the entire economy.
Richard T. Ketchum, USA

I believe that too much time and effort is being put into producing statistics that prove nothing. Nurses are not being allowed to do the job they were trained for and spend too much time on unnecessary clerical duties. I have myself seen the results of the so called health policies that have not improved the medical/nursing care that is needed nor indeed that we once had. You cannot run hospitals purely by accountants views.
Barbara Hobbs, UK

Some evolution is plainly necessary. Something is also quite clearly wrong when the UK has the lowest doctor to patient ratio in Europe, Turkey excepted.
M Conyers, England

I don't know if the flu epidemic will bring the NHS to its knees. However, I do know that when I first came to Australia, the private health system here was excellent and premiums were low. Now we have universal health provision, the tax surcharge is higher than the old health benefit premiums and I had to wait nearly three years for gall bladder surgery. During those three years of waiting, I lost count of the number of times I was offered immediate treatment if I would pay privately.
Tom, Australia

I was a registered nurse with some 15 years experience and 8 of those years in trauma and cardiac intensive care. Nurses are their own worst enemy as they are unable to focus collectively toward a common cause. Combined with an overly romantic view by the public of the profession - "you're SO dedicated: what a wonderful vocation" - make any change very difficult to implement.
Everyone says that they couldn't do the job, but there is little evidence that they are prepared to support those who do. I for one will never go back to such a retrospective career.
Michael Williams, UK

If it is near collapse, it's more because of attitudes within the NHS than money problems. I've been a patient of the NHS for more than 50 years, and I've worked for them on occasion. We're told of great changes over that period, but I can assure readers that deep within the NHS, attitudes haven't changed in half a century. Money is wasted hand over fist through doubtful priorities, and far too many staff still regard patients as an irrelevant nuisance.
It's time to stop fiddling around the edges of the NHS, and get it sorted once and for all - top to bottom. When the rest of us don't make the grade at work, we get sacked - it's high time the same rules applied to doctors and hospital administrators.
Meanwhile - thank God for the nurses.
Jon, Scotland

The hysteria whipped up by the media, is quite disgraceful. SOME NHS staff are having to work harder than usual. There is no doubt a nursing shortage, and better pay is deserved and, more importantly, required, to boost recruitment and retention. It is, however, no coincidence that the nursing shortage has significantly worsened since academic nursing courses were introduced. Most nurses do not need a degree, and many potential recruits have been dissuaded from nurse training by this restriction. Fortunately, Frank Dobson is to review nurse training in the light of this.
The Independent reports today that nurses are to receive a 5% plus pay increase this year, no strings attached. Doctors, who have had a 50% pay increase in the last 8 years, against a 37% average in the private sector, and around 25% for nurses and teachers, are to receive a similar percentage increase again no strings attached.
Every year tens of thousands of highly achieving students apply to medical school. The places could be filled fifty times over. Any purported doctor shortage is due to the tightly controlled number of medical school places. Not because young people do not wish to become doctors. And which organisations have been most vigorous in keeping med. school places at a premium? The British Medical Association, The Medical Royal Colleges, both of which have the ear of Government ministers, and doctors themselves.
It would make a refreshing change to find journalists prepared to fight the vested interests of the nursing and medical unions as tenaciously as they have fought the teaching unions for the last 15 years.
Stephen Usherwood, England

Employ more nurses, and pay them more.
Ann, UK

Yes, the NHS is on the point of collapse because it can't compete in the modern world with a forties style of management structure and funding. All through the seventies we saw one nationalised industry after another collapse because we insisted on running them as subsidised havens, and refused to give proper incentives to those working in those industries. Then in the eighties and nineties we watched those industries recover as and when they were allowed to run as proper businesses. What makes us think that the NHS is a magic exception to this rule?
Jon Livesey, USA

I don't see how any health care agency could cope easily with the current flu crisis - your public service duties would be better concentrated on telling those who dial emergency services unnecessarily for flu symptoms to simply go to bed for a week.
David Sanderson, UK

We now have a NHS run on 9 to 5 office lines. It does not have the people and financial resources to operate 24 hours a day. It can't cope now with large work loads never mind epidemics. When you see health care professionals criticise a Labour government and talk of continuing demoralisation amongst staff you know that you have a serious problem on your hands.
Malcolm McCandless, Scotland

I find it hard to believe Ian Lowe's comments. The NHS relies on the good will of its staff to operate at all. That cannot be said of many institutions. It is the increasing preponderance of people that is wearing away at that philanthropy. Something must be done to make NHS staff feel valued.
Donald MacIntyre, Scotland

The hysterical stories about a NHS 'crisis' only serve to needlessly undermine public faith in the health service. The NHS sees more patients in the winter than the summer so resources are more stretched then. In the North West they currently have a larger than expected number of flu cases and there are instances of patients being seen in the back of ambulances by nurses. These examples show the NHS being very stretched, but coping thanks to extremely hard work by NHS staff. The NHS isn't on the point of collapse, but if the media keep saying it is people will believe it.
Edmund Lovell, UK

I think the NHS may well be at great risk of collapse. This so-called 'flu epidemic' is much smaller than that of 1989-1990, and yet I cannot remember there being such a sense of panic at that time!
I also do not remember seeing television pictures of people being treated in Ambulances, vehicles which should surely be in the front-line for emergency calls. The NHS seems to have its back to the wall.
Matthew Wilde, Britain

Having worked for the NHS for seven years in IT, I was in a position to see an overall view of life in a hospital. When NHS Trusts were formed, more and more accountants and managers appeared. I believe that this has had a detrimental affect on patient care, the primary job of the NHS. There is too much bureaucracy involved. A case was sited where it cost the NHS £30+ for a pencil sharpener. The sharpener cost approximately 50 pence, the rest went on administration. This is why the NHS is in the state it's in.
Simon Millard, United Kingdom

Yes, if The National Health System continues to be so charitable. Britain is a very caring society but now people should have to pay; in order to help future cases.
Patricia A. Humphrey, USA

The best asset any organisation has is its staff. If it does not pay them enough, no wonder there's a problem. If the Government cannot fund the nation's NHS then how about a Royal Commission to investigate a new way of funding? Germany seems to have "Health Insurance" without the insurance industry cherry picking the cases they wish to handle.
Andrew Walker, England

I fear the real problem is deep rooted. The NHS is regarded as a retreat for those who can't make it in "the real world" and I fear there are too many jobsworths and workshy slackers to ever make it work, no matter what money is poured into it.
Ian Lowe, Scotland, UK

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