Is the NHS improving?

The NHS has made tremendous advances in treating patients faster and informing them better, says the Commission for Health Improvement (CHI).

NHS staff are "almost universally" committed, caring people, who are striving, under great pressure to do their best for those who use the service, a report by the watchdog says.

But mental health and cancer are two particular areas which need more staff and improved standards of treatment, said the commission's chair Dame Deirdre Hine on Radio 4's Today programme.

This debate is now closed. Read a selection of your comments below.

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Your reaction

The NHS offers incredible value but clearly suffers from years of underinvestment in both professionals and the infrastructure upon which they depend, which will probably take years to put right.
Matt Prescott, Oxford, UK

All this talk of how the NHS is getting worse makes my blood boil. I am a staff nurse on an acute surgical ward and see how tired and demoralised the staff are. After finishing a shift we are considered lucky to have finished on time rather than the 30-45 minutes later that we usually finish a shift. And the more we give, the more we are expected to give.
Mike, UK

I have worked in the NHS as a Paramedic for 7 years now, and my opinion is the same as Baroness Thatcher, in that it's a wonderful organization that is plagued with far too many managers and that the NHS could swallow up as much money as you wish to give it, cut back on the bureaucracy and use the money for clinical excellence rather than target shooting.
John Morgan, United Kingdom

The fact is we still pay a smaller part of our national wealth on health car than the other major economies. For what we pay we get fantastic value for money.
David Rowe, England

Is the NHS getting better? I'm not sure. I've been diabetic for ten years and have never experienced any problems (other then some doctors' arrogance). I have always had treatment expediently and been dealt with in a friendly manner. The only crib is that hospitals are run for the staff, rather then the customers.
Richard Keville-Evans, England

Some bits are truly superb, others less so

Greg, UK

On Friday, I went to my GP's office, and asked to make an appointment; I was told I could do so at any time on Monday, morning, afternoon or evening. Last time I used it, two years ago, I was given an appointment similarly quickly, diagnosed, and able to make an appointment with the physiotherapist twice a week for two months, no waiting. Unfortunately, the last time I went to a hospital, the A&E department was crowded, dirty, and the professionals, although doubtless dedicated, were clearly overworked. Some bits are truly superb, others less so - as with everything in life, there is simply too much disparity to make a blanket statement.
Greg, UK

No, the NHS is not improving at all. A friend of mine is in the Hammersmith Hospital seriously ill and yet she has had to wait over two weeks to have a feeding tube refitted due to lack of staff! This is ridiculous. Another friend of mine collapsed with a faulty heart rhythm in USA and was given tests over the weekend which would have taken months to have in this country. Where are we going?
Trish Neeves, United Kingdom.

I am British but live in the US. One thing that I have learned from living here is that the UK should be very proud of the NHS. Although many people have health care insurance over here, there is often a sizable deductible associated with any treatment that you have. This, coupled with the meagre allowance for sick leave at work, often means that people walk around for years with ailments that should have been treated ages ago simply because they cannot afford the deductible or the time off work. I know where I would rather be if I had a serious illness.
Philip, USA

The NHS is brilliant and I am fed up with the ridiculous amounts of criticism directed at it.
James E Siddelley, United Kingdom

Keep the good work up

Graham Meadows, England

I'd like to say that I went to the hospital to get my ear checked out and I was dealt with very quickly and efficiently. Also we have just had our scan for our first child and again fantastic service and no hours of waiting. Keep the good work up.
Graham Meadows, England

The magic of the NHS is the chemistry between its wonderful staff and a public which put their trust in them. Every time its "modernised" by the bean counters it deteriorates a little. But it then levels back up as the chemistry takes over again.
Charles Moore, Scotland

Improving the NHS is a two-way thing. It's all very well investing more and more funds into the infrastructure, training more doctors, nurses and ancillary staff along with better equipment. But surely we, the public, should have a little bit more responsibility for our health and actions.
Russell O, England

I lived in Canada for many years, and while the Canadian health service is not perfect, it does seem to provide the kind of efficiency and personal service that you would expect at the private level with relatively low fees (costs are, for example, a small fraction of the equivalent US costs just across the border). The NHS could certainly learn some lessons from the Canadians.
John Frewen-Lord, UK

I have seen massive improvements

Zoe, Wales

Why would we want to say that the NHS has improved? The great British people would have nothing to whinge and moan about if we could say that it was getting better. But as an NHS worker (and a dreaded manager at that) I can categorically say that I have seen massive improvements brought about by the hard work and determination of NHS staff, doctors, nurses and clerical staff. We still have a long way to go, but we will get there. What will we all find to complain about then?
Zoe, Wales

For the past 14 years I have lived in the county that has been quoted as where you get looked after from cradle to the grave - Sweden. We pay the world's highest taxes, we have to pay about £20 to £30 to see a doctor each time and pay for each day you're in hospital as well as an entire fee. It takes at least 3 weeks to get to see a doctor, there are beds in the corridors at hospitals. Back in the UK, I was taken ill a year ago. I was rushed to hospital and how nice it was not to have someone standing there behind a cash register. Instead I got wonderful doctors and nurses caring about how I was and was even asked if I would like a cup of tea? NHS - the best in the world!
John, Sweden

If you want a good NHS you are going to have to pay for it. As an NHS medic who has worked in the US and Australia, if we put in the money and facilities that they have then we would have no problems. Unfortunately the Great British taxpayer still clings to the great Thatcherite notion that we don't need to pay that much for the NHS. Also I agree that we are top heavy with managers. At my trust, there are almost as many managers as doctors and nurses! And they certainly get paid more!
Andrew, UK

Is this in the patients' best interest?

NK, UK

I work in Accident & Emergency, where government standards say that a patient will spend only 4 hours in the department, before either going home or being admitted. In theory this is brilliant for the patient; in practice what happens frequently, usually there is still only one doctor working on the admitting team which leads to delays quite often longer than the 4 hours laid down by SITREP. If we breach, then the hospital is penalised. If we succeed in seeing over 90% of patients within the time consistently, we are rewarded with more money to fund more doctors and nurses. The pressure on all staff to get the patient through the department in the given time is immense. Is this in the patients' best interest? I think not.
NK, UK

I am from UK and living in the USA. The medical scene is here is private, very complicated and very expensive. A serious illness here could well bankrupt you. 25% of the folk do not have medical cover. UK citizens should bless the day that the NHS was set up in the late 40's.
Ron Willams, USA

Having worked in the NHS for over 12 years I can see huge improvements but don't deny there is room for improvement. However one factor that I feel influences the way in which health professionals work is this new climate of litigation. Something doesn't quite go to plan and families are looking either to the courts for compensation or at least to complain until someone loses their head. Some of these complaints and legal cases are legitimate but many are not and only add to the existing levels of stress in the health care environment.
Andrew, UK

I might get a five minute consultation if I'm lucky

Oliver White, UK

If I want to see my GP I must wait a week and then I might get a five minute consultation if I'm lucky. My cat, on the other hand, can be seen at any time by the vet and is granted as much time as she needs. The reason for this difference? At the vet I am a customer, whereas at my GP I am a number and it makes no odds to him whether I choose to use his services or not. We only need to look across the Channel to France to see how a health service can work brilliantly if it is based on a system of direct payment by the patient backed up by social insurance.
Oliver White, UK

I treat quite a few NHS workers for stress. Yes, they are all willing to give 100% to patient care and all have the same story of management decisions totally out of touch with the requirements "on the sharp end" of the health system. The result of this, plus the rapid changes being implemented mean that they are already "punch drunk". I think that considering the above, the service they provide is extraordinary - and if they were less stressed by the system they work in, it could be a lot better still.
AC, UK

I am a GP of 20 year's experience. The NHS will always be struggling as long at it is provided free at the point of use. Such a service will always be misused and abused.
Jules Caithness, UK

The problem with the NHS is that funding is aimed at disease once it has started since that's where the bean counters in the Treasury can see it being spent. If they spent more on preventative healthcare they'd save more money in the long run - the obvious example being to eradicate cigarettes once and for all.
John, UK

All this lost valuable time

Sue Hudson, London, UK

Hardly improving - in fact, it's getting worse. My father recently had treatment for prostate cancer. However, they lost his notes, someone hadn't put his details on the computer - all this lost valuable time, and it was all inexcusable! A friend of mine, living in Italy, was recently in a road accident and, having been in a similar accident in the UK, now declares that the Italian NHS is FAR better!
Sue Hudson, London, UK

My husband, myself, and two friends have all received good care from the NHS, including complex and life-saving operations. OK, it's not always perfect, but it's a lot better than the private systems in certain other countries, where a great many people have no access to even basic health care, let alone expensive operations!
M. Perkin, UK

Both hospitals are now modern clean and more efficient

Norman Courtnell, UK

The NHS has improved. As a father and grandfather and in the normal course of events have visited the A&E and outpatients departments of both my local hospital, Watford and Barnet, recently with children. Both hospitals are now modern clean and more efficient. The waiting time was not unreasonable for the minor injuries but on the occasion of a serious problem help was prompt and effective. The improved facilities have improved the staff morale and on several outpatients visits we were seen on time with the system working well. I hope it continues to improve.
Norman Courtnell, UK

The NHS employees 1.3 million people and has more administrators than hospital beds. It's a dinosaur that has outlived its usefulness. We must learn from other countries with far better health services, dismantle the NHS and replace it with something far better
Adrian, UK

I have to say that irrespective of all the complaints from other people, I've only ever had a good experience with the NHS as far as treatment goes. But the cleanliness of the wards is horrendous and the lax security especially on children's wards is incredibly worrying.
Helen Thear, London, UK

No one in our family has ever had to wait for care

Fatimah Begum, UK

Medically the NHS is top-rated and world class. The administrative side is top-heavy (as are many corporations) and inefficient (as are many corporations). However, corporations can hide their inefficiencies until bankruptcy. The care in London is as good as ever, given how overstressed the system is. No one in our family has ever had to wait for care (unlike when we were in the US) and the care has been excellent. Streamline the bureaucracy in the NHS (avoiding corporate models) and the NHS will continue to be the envy of the world.
Fatimah Begum, UK

From a "grass roots" perspective, the answer is definitely no, the NHS is not improving. My grandmother is currently in hospital, in a ward with over 24 elderly patients, staffed by two qualified nurses, and some minimum wage ancillary workers. At each visit I find it necessary to point out deterioration in my grandmother's condition that nursing staff are too busy to notice. The fault does not lie primarily with the Nurses, but rather with cut-throat staffing levels imposed by Administrators in pursuit of greater "efficiency". Administrators are primarily concerned with getting good values for their published "Performance Indicators". Patient care and the provision of a good service take second place.
David Smith, Scunthorpe, UK

I'm prejudiced because I work in the NHS, but not only is it getting better, but compared to the US it always far better for more people. The respondent who complained about not getting a home visit should wake up. In the US, no amount of money could get you a house call!
Nick Grealy, USA in UK

Moan, moan, moan - is that all people in this country do? The NHS used to be the envy of the world, because we paid for it. Since successive right wing governments have reduced upper rates of tax, the money going to the NHS has gone down. You get what you pay for and unfortunately we are getting the NHS this country has asked for. This whole "I want an NHS that will give me excellent service but I don't want my taxes to go up" is killing the whole service. What we have to realise is that it MUST be free for everyone, for ALL services and we MUST pay for it, otherwise we get to the US model where 40% cant afford primary health care and everyone else is ripped off by the insurance companies who refuse to pay out if you ever get ill.
Vish, UK

The problem with the health service is not government funding, the staff who work in it or its managers, it's the people who use it. For two decades we had a government saying "there is no such thing as society" and people no longer think of the NHS as something to which everyone contributes and shares. Millions of pounds get wasted every year on people demanding compensation for things which, on the whole, are for genuine human errors while the rest of us get away with errors and mistakes all the time (just check the complaints departments of any organisation sending bills out by computer).
My mother's GP surgery has a notice which states that "Last week x people did not turn up for their appointments and gave us no notification" and every week the x is in double figures. Hospitals do not have out patient clinics the week before Christmas holidays because people just don't bother to turn up - and then complain at the length of waiting lists. Perhaps if we had to pay in full for medical services we might abuse them less and appreciate them more.
C G, UK

The NHS is basically a socialist nationalised industry and the biggest employer in Europe and it will never be able to responded to the 21st century in its current format. Bold changes must and will be made for the system to work to the standard of a first world country. This is no time for dogmatic sentimentality.
John K, Liverpool, UK

I believe that the failures within the NHS are due to several badly thought out ideas - far too many administrative departments, far too many reorganisations and hospital closures, and far too many non-health threatening services that could be paid for in other ways. The NHS needs policing firmly both in a practical sense with security on the doors of all out patient and emergency departments and financially not by the hospital staff as such but by a MacGregor (he of the coal mines) person to deal with waste, poor performance and bungling and incompetent staff.
Dave, Kent UK

I only have the utmost admiration for the doctors and nurses

Graham, UK

Last year my elderly father passed away in hospital from heart failure. My mother's health has also decline over the passed couple of months resulting in her having to be admitted to the same hospital. To my surprise the hospital still had my dad as her next of kin on their computer system! From my exposure to the NHS I only have the utmost admiration for the doctors and nurses. The overall management of information, lasing with relatives, and interhospital communications is however dreadful. I would tell Mr Blair more than money and spin is needed here to convince me things are really getting better.
Graham, UK

The NHS is desperately inefficient although the services it does deliver are usually very good - if you have the need or the patience! Over the last two years Manchester eye hospital has restored my sight and by doing so restored my self confidence and quality of life. I do however think that there should be a "contribution" if not an outright cost to all NHS services.
T W, England

There is unfortunately a culture of bullying in the NHS which starts from the top and permeates down hospital structures. I recently left a senior level administrative position at one NHS Trust Hospital. I was signed off sick for depression for a month; a result of bullying that had gone on for the entire time I was employed there. Bullying is occurring at the highest level of NHS hospitals. My manager was the Surgical Division's Senior Nurse, but I was also bullied by the whole tier of management under her i.e. all the General Managers of each directorate in the Surgical Division.
Katherine Oliver, England

It is getting much much worse

Carol, UK

Take it from me, as someone who works in a hospital as a medical secretary that it is getting much much worse. There are more managers and less of the people we actually need. Waiting lists maybe coming down and the A+E wait is now down to 4 hours, but staff morale is at an all time low. Due to financial restraints we are not even allowed to order the basics of stationary items and I am now seeking employment elsewhere.
Carol, UK

I don't entirely agree with this bullish statement. In January of this year my father collapsed and was rushed into hospital. The nursing staff on his ward were brilliant - but clearly very overworked and overstressed. The doctors treating my father were a different story - ill-mannered, arrogant and clearly unable to tell my father or my family what the problems were in plain English. I would say that the NHS is still suffering from over-worked nursing and ancillary staff and doctors with poor communication skills.
Lisa, UK

Coming from Southern Africa I am appalled at your NHS System. In darkest Africa I can visit a Doctor within hours and they still do house visits. But in Chelmsford I have been told that the lists are full and I can not even get an appointment. I hope that I don't fall ill as I don't have faith in the NHS if they can¿t even get the basics right.
Roger Bolton, UK

I feel that we should be thankful for the benefits that the system does provide

Stephen, UK

The NHS may or may not be improving, but all anyone talks about is the GP service and hospital operations. They ignore those of us who need to consult doctors at the hospital as an outpatient for conditions that, whilst not immediately life threatening, need continuous treatment as there is no cure - which means they are not covered by private health insurance either. I only have to pay £90.40 per year for my monthly 4 item prescriptions, a considerable reduction over the full retail cost. I had to wait 5 1/2 months to see a dermatologist and 3 1/2 months for the lipids specialist but at least, now I'm in the system, I'll receive treatment for as long as it's necessary. There is certainly still a lot of room for improvement; but sometimes I feel that we should be thankful for the benefits that the system does provide.
Stephen, UK

Britain's National Health Service is supposed to be the envy of the world, but its record in treating patients with cancer and diseases of the circulatory system (the two main causes of death) is extremely poor. Survival rates for sufferers are almost the worst in the developed world. If it is the envy of the world why has no other country copied it
Mark, UK

I smashed my Knee on Easter Monday and within one hour the hospital had seen me, done the X-rays and treated me - which was to a very high standard. This was at Halifax Royal infirmary. Unfortunately when I need to seen my local GP for a check up it took 3 days before i could get an appointment because no prior books were taken. There have been some improvements but there is still a huge mountain to climb.
Jon, England

In my experience outpatients appointments are regularly 2 hours behind schedule. That means a half day off work to attend rather than just an hour. I pay national insurance contributions and then pay to use the hospital car park as well as pay for prescriptions. NHS staff may well be committed - health ministers and hospital management certainly should be.
Barry N, North Herts