Improving The Health Services In UK By Indo British Collaboration
Rajiv Upadhyay
UK’s National Health Service (NHS) , once the pride of UK , has now become highly inadequate for the needs of its increased and aging population . It was already quite inadequate but Covid has made it worse . Today health services in UK are possibly worse than most of the major West European countries.
Presently there are about 4.2 million pending cases of which more than 600 thousand cases have waited for more than a year. 
The waiting time for even cancer treatment to start is very high and it is expected that it may take five years to wipe out the arrears .
Even cataract patients are waiting for years in some areas . Getting an appointment from a General Practioner could take weeks or even months . The average waiting time for ambulance for stroke or burn cases is often two hours . Even in trauma cases waiting period for getting a bed in hospital is some times taking four hours .
The NHS’ continued decline is very old . It improved marginally in 2008 but has been worsening since then .
In 2013 and 2015 per capita NHS expenditure was increased but afterwards increase was not substantial. 
It could have continued but rising costs made UK cut allocation for NHS as measured by percentage of GDP.
On the other hand UK’s population was living longer and cost of providing medical facilities in old age increases exponentially. It is hoped that average age may further increase thus putting 
strain on existing NHS.
UK’s population has increased substantially due to increased immigration .
But immigrants are generally young and do not load education or NHS as much except in child birth and child care . The old age support by social service is also declining .
While the population increased , the number of hospital beds available in UK declined from 297364 in 1988 to 130944 in 2015.
In Europe UK’s per capita expenditure is behind its equivalent countries like Germany , France , Netherland etc .
The new capital expenditure goes generally in introducing new medical technologies in USA . UK is likely to be similar . The conventional cataract or cancer treatment facilities are not likely to increase in 
coccominging years .
UK health services are bound to slide down in coming years irrespective of the government due to resource crunch and aging population .
NHS is such a sensitive issue that no government can privatize it . But in its present form it just cannot meet the needs of public .
The solution possibly is in an Indo – British collaboration in health sector . The road map can be as below .
- Due to its large population, India has a big private sector participation in health sector with 69000 private hospital and 1.8 million beds in private hospitals . There are big multi speciality hospital chains like Apolo , Fortis etc. India gets about 500000 foreign patients in its hospitals every year. To begin with UK could use Indian medical facilities for willing commonwealth patients thus reducing load on UK hospitals. In addition to the treatment cost , airfare will have to be borne by the British government but it will still be cheaper .
- The four major Indian Information Technology companies are now expanding in health sector too . Tata have have world class hospitals particularly its Mumbai cancer hospital is the best cancer hospital in India . Tata , HCL , Infosys and Wipro have considerable presence in UK .
- These companies or big Indian hospital chains could be given management contract for say ten University Teaching Hospitals . Their mandate could include reducing the waiting period for critical cases to half in the next seven years ( includes two year set up time ).
- The road map is to first reduce the cancer and cataract cases which reduce the quality of life .
- The main hospital infrastructure could be used only for serious cases by setting up temporary , shiftable new day care, multi purpose diagnostic and treatment centers as an intermediate level medical attention in non critical cases . Tele medicines and emergency and post treatment consultation by video links to be allowed .
- Surgery arrears could be the next in reduction list as aging population will increase their need .
- Companies could be asked to increase the hospital beds in these hospitals by fifty percent in say five years . Setting up of temporary facilities should be permitted . If successful more hospitals could be given to them .
- For financial viability , the government should give cheap loans and pay them at NHS rate for treatment but they should be allowed to charge thirty percent premium for better and faster services in the new sections . In addition fifty percent extra seats in medical colleges under them should be created for Indian students on post degree contract service basis . Hiring of Indian medical personnel and use of Indian medicines should be allowed but the medical equipment could be British / European make .
- At present it is reported that 14 tests are being conducted for every citizen every year in UK. It is too high and can be reduced by revising protocols if essential .
- Insurance companies should be allowed to use these facilities for premium paying patients .
It is not proposed to provide social care by this arrangement which can continue in the present mode due to cultural factors.
The health care cost has increased from 5.1 % of GDP in 1990 TO 11.9 % of annual GDP . It is estimated that if unchecked , by 2040 , 16 % of UK GDP may be used for medical care . Indo – UK partnership may bring down the cost substantially and will be mutually beneficial.
