From the famous referendum vote in 2017, we can infer very little, other than the British people want less immigration from Europe and more money for the NHS. Some were convinced that leaving the EEC would free up money to be spent on the NHS – if a slogan on the side of a bus is a promise.

The NHS has become one of the largest employers in Europe, a huge organisation and expensive. The question has to be asked, are there any other ways the NHS could raise money, other than indirectly by Brexit?

One obvious way would be to claim back money from Europeans given medical treatment in the UK. At present the NHS spends about 600 million pounds on such treatment to European visitors and yet recovers a mere tenth of that. Remove the ‘European’ element of such costs and there is left the ‘medical tourists’ from all over the world, coming to the UK and suddenly discovering they need expensive treatment. Should the tax payer be paying for this? Simple laws, like a requirement to take out private medical insurance when you enter the country as a temporary or permanent resident, has to be a good solution. After they have contributed in taxes for a calculated number of years, they are eligible for free treatment. Not in the arrivals lounge at Heathrow.

Governments have been very keen to take up public / private contracts in the construction industry, known as PPI’s. Such partnerships could also be made in the health service. One obvious place where there would be immediate benefit is the A and E Departments. I can imagine a private A and E department built within hospital grounds, say a storey above a new multi level car park. The parking can be allocated to staff as part of their contract employment, thus improving staff retention. The private A and E will offer treatment within thirty minutes for a set fee. This amount would be in the region of eighty to one hundred pounds. Many a person seeking stitches or an X-ray – would be grateful for the option to pay and eliminate long waiting times. The NHS would start to meet it’s waiting time targets as a result.

The NHS spends a lot of money each year on compensation for mistreatment. This has no doubt resulted from the growth of the ‘compensation culture’ in British society and the proliferation of ‘ambulance chasing’ lawyers. Lawyers often obtain more in their fees than the litigants!

And yet these are the people who want more money for the NHS, the referendum voters and believers in the ‘battle bus’ promise of 350 million pounds a week for the NHS. But one would like to think that there is an alternative to seeking monetary compensation. Sometimes an apology is all that is morally needed. If there are no lifetime costs as a result of mistreatment, then morally, I would ask for no compensation. I prefer NHS money to be spent on healing people, not paying off my mortgage.

The bottom line is that the NHS is a potential ‘black hole’ for money. These are just a few suggestions for saving money and there are no doubt many more. Ultimately though, the expectations of UK and foreign people have to be educated to expect less and pay more. The models of other European countries might give the NHS a few ideas, but then, we don’t like Europe or its standards do we?