Rescuing the NHS: Are Reforms or Funding Needed?
The NHS is Britain’s most cherished public institution — and it is also in serious trouble.
The NHS is Britain’s most cherished public institution — and it is also in serious trouble. Waiting lists remain stubbornly high, GP appointments are hard to secure, A&E departments are overwhelmed, and staff morale is fragile. Yet despite record levels of funding, outcomes are not improving at the pace patients deserve.
This uncomfortable truth needs to be faced: the NHS does not just have a funding problem — it has a structural problem.
Talking honestly about reform is not an attack on the NHS. It is the only way to save it.
The Crisis in Plain Sight
Public spending on the NHS has risen dramatically over the past two decades. Annual NHS expenditure now exceeds £180 billion, having grown faster than inflation and population growth. And yet:
waiting lists have reached millions
productivity has fallen since the pandemic
patient satisfaction has declined
access to primary care is increasingly difficult
If ever-increasing budgets were the answer, the NHS would already be thriving. The fact that it is not tells us something important: money alone is not enough.
Reform Is Not a Dirty Word
In Westminster, questioning the NHS model is often treated as taboo. Any suggestion of reform is met with cries of “privatisation” or “Americanisation”. That shuts down debate — and protects failure.
Reform UK rejects that false choice.
Reform UK — and Nigel Farage personally — have been absolutely clear:
We will never privatise the NHS
We will never charge people to use it
Healthcare must remain free at the point of delivery
That principle is non-negotiable.
But how care is organised, managed, and delivered can and must change if patients are to get better outcomes.
Why the Status Quo Is Failing Patients
The NHS suffers from:
excessive bureaucracy and management layers
poor incentives that reward process over outcomes
weak accountability when services fail
fragmented responsibility between national bodies, trusts, and local systems
Too often, frontline clinicians are buried under paperwork while patients wait. Money is absorbed by administration rather than reaching beds, staff, and treatment.
This is not the fault of doctors or nurses. It is the fault of a system that has become too centralised, too rigid, and too resistant to change.
What Reform Could Look Like
Reform UK believes the NHS must be reformed to deliver better outcomes for patients, not to satisfy ideology.
That could include:
Cutting bureaucracy and redirecting funds to frontline care
Reforming management structures so failing services face real consequences
Exploring alternative funding and delivery models, including learning from systems abroad that deliver better outcomes for less money — while keeping care free at the point of use
Using capacity more intelligently, including the independent sector where it helps reduce waiting times
Nigel Farage has been right to say that the NHS funding model itself should be re-examined — not to charge patients, but to ensure money actually translates into treatment.
Other countries with universal healthcare — free at the point of use — often achieve shorter waiting times and better outcomes because they are more flexible and less bureaucratic. Britain should be willing to learn from success rather than defend failure.
Patients Come First — Always
Any reform must be judged by one standard only: does it improve patient care?
That means:
faster diagnosis and treatment
easier access to GPs
safer hospitals
better outcomes for cancer, mental health, and chronic illness
Protecting a broken system for ideological reasons does not protect patients. It lets them down.
Saving the NHS Requires Courage
The NHS will not be saved by pretending everything is fine, or by throwing more money into a system that cannot use it effectively. It will be saved by honest debate, bold reform, and a relentless focus on outcomes.
Reform UK is willing to have that conversation — openly and responsibly — because preserving the NHS for future generations means being brave enough to change it.
Reform is not the enemy of the NHS.
Labour Stagnation is.