Can Britain fix its health service?
Britain’s National Health Service turns 75 this month. It is in the deepest crisis of its history: flooded by aging patients; starved of investment; and understaffed by doctors and nurses, many of whom are so burned out that they are either joining strikes or leaving for jobs abroad.
Doctors, nurses, patients, hospital administrators and medical analysts described a system so profoundly troubled that some experts warned that the N.H.S. was at risk of collapse. In 2022, the number of excess deaths rose to one of the highest levels in the past 50 years, and those numbers have kept rising, even as Covid has ebbed.
More than 7.4 million people in England are waiting for medical procedures, everything from hip replacements to cancer surgery. That is up from 4.1 million before the pandemic began in 2020.
Context: The pandemic exposed a legion of problems that had been incubating within the service since Conservative-led governments began curbing budget increases in 2010, the start of a decade of austerity. Health care spending rose by an average of less than 2 percent a year from 2010 to 2019, compared to 5.1 percent from 1998 to 2008.
By the numbers: During those years of belt-tightening, Britain spent less each year per person on health care than the wealthiest E.U. countries did. Its capital investment lagged the bloc’s average by $41 billion.
Shifts that could reshape the world
The world’s demographics are changing — but what we’ve seen so far is just the beginning. By 2050, people 65 and older will make up nearly 40 percent of the population in some parts of East Asia and Europe. Extraordinary numbers of retirees will be dependent on a shrinking number of working-age people to support them.
As a result, experts predict, things many wealthier countries such as the U.S. and those in the E.U. take for granted — pensions, retirement ages, strict immigration policies and more — will need overhauls to be sustainable. And today’s affluent countries will almost inevitably make up a smaller share of global G.D.P., economists say.
Soon, the best-balanced work forces will mostly be in South and Southeast Asia, Africa and the Middle East, according to U.N. projections, potentially reshaping economic growth and geopolitical power balances.
Opportunities for poorer nations: When birthrates fall, low-income countries can reap a “demographic dividend,” as a growing share of workers compared to dependents fuels economic growth. Adults with smaller families have more free time for education and investing in their children. More women tend to enter the work force, compounding the economic boost.
Land mines slow Ukraine’s counteroffensive
Five weeks into Ukraine’s counteroffensive, its forces are making slow progress as they try to cross fields littered with dozens of types of land mines — made of plastic and metal, shaped like tins of chewing tobacco or soda cans, and with colorful names like “the witch” and “the leaf.”
The Ukrainian military is also hindered by a lack of air support and by the deep network of defensive structures the Russians have built. But it is the vast array of mines, trip wires, booby traps and improvised explosive devices that has Ukrainian forces bogged down only a few miles from where they started.
Mines have long been a staple of Russian warfare, used extensively in Afghanistan and Chechnya. But the minefields in southern Ukraine are vast and complex, beyond what had been previously known, soldiers who have entered them say. Ukraine also plants expansive fields of antitank mines, to stop Russian advances.
Details: The demining teams work by clearing a path about two feet wide, allowing the infantry to walk forward. Then, the deminers work back along the path to expand it by another foot or more, to allow two soldiers to walk shoulder to shoulder while carrying a stretcher for those wounded in the fight.
THE LATEST NEWS
Around the World
On an unusually warm June day in London, three soldiers in full regalia fainted while practicing for a military parade. Why is it that, even as climate change upends our lives, we seem so set on doing things the way we’ve always done them?
Related: Europe faces a blisteringly hot week.
Lives Lived
Jane Birkin, the British-born actress who was a French fashion inspiration, died at 76.
SPORTS NEWS FROM THE ATHLETIC
The unseeded, unsponsored, undefeated new champion of Wimbledon: How Marketa Vondrousova did the “impossible.” And, from The Times, how Carlos Alcaraz won his first All England Club title.
Also at Wimbledon: The life of a ball kid. (Plus, see the best of the off-court fashion.)
Inside the Lionel Messi-to-Miami deal: A Paris hotel room, a passionate pitch — how the money worked and why Apple is so key.
From The Times: Why every Australian and New Zealand host city for the Women’s World Cup has two names.
ARTS AND IDEAS
Effects of the Hollywood strikes
The actors’ strike may reshape the Oscars season, as their union is preventing members from promoting any film while the strike is on. It has instituted an across-the-board ban on interviews and red-carpet appearances at film festivals in Venice and Toronto that can be crucial to Oscars buzz.
Post-pandemic, prestige films need all the help they can get at the box office. If they can’t be sustained by awards chatter and media-happy movie stars, studios could opt to move some more vulnerable year-end titles to 2024.
That could provide an awards-season advantage to streaming services like Netflix, which don’t have to factor the box office into decisions on what to debut or delay. And movies that have already had a big cultural moment — like “Past Lives,” from June, or “Killers of the Flower Moon,” which premiered at Cannes in May — will be better positioned to thrive.
Related: Why should you care about the strikes in Hollywood? Because background actors have more in common with us than with the megastars, our chief TV critic writes.
