The NHS – a Suitable Case for Treatment?
The fifth part of Policy Exchange's Policy Programme for Prosperity
July 14, 2025
‘The NHS – a Suitable Case for Treatment?’ makes the case that the NHS is not fit for purpose and is in urgent need of reform.The report finds that NHS performance ranks near the bottom of highly developed countries on key health outcomes including life expectancy, avoidable mortality, and waiting times.
The NHS consumes approximately 9% of GDP each year and the health budget is now approximately the same size as the GDP of Portugal – and is set to increase further. It is clear that simply spending even more money is not the solution and radical change is needed instead.
The report welcomes the Government’s 10 Year Plan for the NHS – which contains a number of policy proposals from Policy Exchange – but it does not go far enough.
The UK should follow the example of the Netherlands and gradually transition to a social insurance-based model of healthcare while maintaining universal coverage.
This system would introduce competition and increase patient choice. It would be similar to the models in place in countries with some of the best and most affordable healthcare systems in the world. These reforms would ensure that the NHS is sustainable now and in the future, reduce the burden placed on taxpayers, and – most importantly of all – improve patient outcomes.
In a foreword endorsing the paper, Sir Sajid Javid, former Health Secretary and Chancellor of the Exchequer said:
“We’ve come to a crossroads. A serious conversation with taxpayers about how we continue funding their favourite national institution is long overdue.
We have two options.
The first is to make an active choice to continue putting more and more money into healthcare, funded by yearly tax rises and by diverting essential investment into everything from education to defence towards the NHS. The second is reforming how we do healthcare.”
The launch of this report was covered by:
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