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  The NHS: Central government spending
Updated 20 February 2002, 12.59
Hospital staff

Citizenship 11-14/KS3/Levels E&F
Central government

The BBC's NHS day draws attention to the future of our health service.

Identify problems and solutions from a listening comprehension and select spending priorities.

Learning aims

  • Problems facing the NHS and some potential solutions
  • Health spending decisions are political with winners and losers
1) Icebreaker

A listening comprehension
Read students the description of an imaginary incident. Identify and write down seven problems the NHS faces, and suggest seven solutions.

For a structured answer sheet print the

Jamie's accident
[Scene setting] At about 7 o'clock on a weekday evening Jamie cycled to a nearby garage to get a carton of milk for his mother. On the way back he rode over a mini roundabout but couldn't signal properly as he was holding the milk in one hand and the handlebars with the other.

A motorist guessed Jamie wasn't turning. He did turn and was knocked off his bike. Straight away he felt that his leg was broken, when he looked down he saw that it was twisted round and looked wrong.

[A]The motorist rang 999 on his mobile, but he was put on hold for a couple of minutes. When the ambulance came the crew explained that accidental 999 calls from people who didn't lock their keypads had clogged up the system.

[B]At the hospital casualty department Jamie was seen straight away. This was because he was an emergency. However this meant that some people waiting with smaller injuries had to wait even longer. It took hours for many to be seen. Really the hospital needed to enlarge the accident and emergency department.

[C]Jamie was taken for an X-ray, there was a bit of a shortage of nurses because younger nurses couldn't afford to rent flats near the hospital. There were some cheap flats that the hospital owned, but not enough to meet the demand.

[D]There was also a shortage of beds. A lot of the beds were taken up by the many older people who lived in Jamie's area. They got ill more often than young people. It looked like they needed an area just to themselves.

[E]Like most people Jamie got a bed but had to share a ward with some older people. He would have felt happier on a special childrens' ward but that was full of younger children.

[F]When he had time to look around he noticed the building looked a bit tatty. It was over 100 years old and it could hardly house all the new machines the staff needed.

[G]The staff were very friendly but the doctor looked a bit stressed. The nurse explained that the health service needed more doctors as a lot left to get more money in private hospitals.

2) Main activity
Plan the hospital budget
Read some comments from

Working in small groups, the students imagine they are the hospital managers choosing which of these projects are to be funded.

They have 10 million. What is it most important to do?

Hospital manager's shopping list

  • Enlarge the casualty unit - 3 million
  • Build new cheap flats for nurses - 2.5 million
  • Build a new ward for children - 2 million
  • Build a new centre for old people - 3 million
  • Redecorate the hospita l- 1 million
  • Renovate the wards - 3 million
  • New machines to spot cancer earlier - 3 million
  • Extra incubators for sick babies - 1 million
  • 'Top up' the doctor's salaries so they stay in the NHS - 1.5 million

You can print this list as the worksheet:

When the list is finalised students should write a statement justifying their choices, or if there is time make a presentation to the class.

3) Extension activity
'Storyboard' an item to be shown on the local television news. The report will put the case for the project students feel really deserves funding.

4) Plenary
However public money is spent there will always be winners and losers. The Government would need to supply an extra 10 million for this hospital to buy everything on its list. Ask students to suggest where the government could get that money from?

Teachers' Background

  • Prime Minister Tony Blair has insisted the government is committed to increasing UK health spending to match the European Union average by 2005.

  • He said the European average had been roughly 8% of GDP, and that the government was on target to reach 7.7% by the end of 2003/ 4.

  • Some 11.5 million patients were treated in 1997/98 compared with 8.2 million in 1987/88.

  • A chronic shortage of nurses could undermine the government's attempts to modernise the NHS, the Royal College of Nursing has warned. The RCN says the only way to tackle the problem of under-staffing is for Chancellor Gordon Brown to commit 3bn over the next five years

  • In the 1960s, there were more than 3,000 hospitals with 550,000 beds between them. By 1995, there were only 250,000 beds and now there are some 194,000. New technology has meant 50% fewer overnight stays in hospital.

  • A 2.5bn PFI (private sector finance initiative) programme will build 30 new hospitals over the next few years, with the first PFI hospital expected to be finished by next year.

For all links and resources click at top right.

More InfoBORDER=0
TeachersWorksheet: Hospital manager's shopping list
TeachersWorksheet: Problems and solutions
PicturesIn pictures: the Cabinet
ChatYour comments on hospitals


BBC Links
BBC News Online: Health spending pledge


Web Links
Royal College of Nursing
Department of Health
Note: You will leave CBBC. We are not responsible for other websites.



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