Yet today, the United Kingdom, particularly England, faces some of the most severe challenges to its healthcare infrastructure in living memory.
In the post, COVID healthcare landscape, NHS England reports that the volume of general practitioner appointments in 2025 has returned to levels comparable to those in 2020. However, face-to-face consultations remain critically low, hovering at just under 20% of their 2019 figures. Meanwhile, Accident and Emergency departments are under mounting strain: daily waits exceeding four hours have more than doubled, rising from approximately 2,000 patients to over 5,000. The number of individuals waiting more than 52 weeks for hospital treatment stands at 200,000, more than double the pre-pandemic figure of under 100,000 (Baker, 2024). All this while the NHS England budget has allocated only £151 billion in funding to local NHS systems in 2024/25 (NHS England, 2025), compared to £124 billion in 2019/20, which was used to commission healthcare services for the people of England (NHS England, 2021) a modest increase of just £27 billion, or 21.77%.
In comparison, countries such as France, Germany and Norway offer similar models of universal healthcare to their citizens, each with distinct approaches to funding and with varying, yet ultimately, more effective outcomes. Germany’s healthcare system ranks among the best in Europe, offering robust state, and employer-backed insurance (Gesetzliche Krankenversicherung) through private providers. Its universal framework ensures that unemployment or student status does not hinder access to medical care. The system’s strengths are reflected in survey data from 5,618 citizens, showing an average wait time of just four days to see a general practitioner under public coverage, and an even shorter 3.3 day wait for privately insured patients (Luque Ramos, Hoffmann, and Spreckelsen, 2018).
The success of universal healthcare is also evident in southern Europe, where access is traditionally more constrained. In Italy, only 1.8% of the population reported experiencing unmet medical needs, such as delays or extended waiting times (OECD, 2023). The prevailing model is one of supplementation: Italy’s healthcare system is fundamentally universal and publicly funded, with private spending serving a supplementary, not primary, role. This underscores the effectiveness of a well funded and well managed public health system.
NHS England and the wider NHS across the UK can be seen as a focal point for government spending and management challenges. It is also a historical amalgamation that may have outlived its original purpose, though not its usefulness.
When considering the question of relevance, it becomes clear that a publicly funded and publicly owned healthcare system remains essential to maintaining the quality of life that people in the United Kingdom have come to expect.
That being said, while the existence of a public healthcare system is essential, its operation should evolve from a 1940s post-war project into a functioning service fit for the twenty-first century. This would involve a shift towards a more corporatist and individually focused model, without moving towards privatisation. Such a shift would not directly increase profits for healthcare providers through increased claims.