Throughout the day, programmes across BBC radio and television explored issues ranging from smoking to sexual health.

Healthworkers and patients who took part in the original special two years ago were also given the chance to review whether conditions have improved since that time.

Has the NHS got better? How can we help the system work more smoothly?

This debate is now closed. Read a selection of your comments below.

Your reaction

The following comments reflect the balance of opinion we have received.

As a GP, having worked in primary care for 14 years and seen multiple "modernisations", I have to say no, the NHS is not improving. On funding - to reach the same level of investment as France, it would have to increase by �40 billion a year, we are not talking 1 or 2p in tax increases but 10-20p on the basic rate just to match the "first world", and that does not address the years of underfunding! Managers - the NHS has 4 times as many managers/administrators per hundred beds compared to the private sector. If we sacked half of all the management in the NHS, they would still have twice as many, perhaps this may go towards explaining where all the money goes.
Brian, York

Give in complaining. Of course there will be some people who get worse service than others. But what do you expect from a service free at the point of entry when you pay less than a 1/3 of the tax to run it than, for example, France?
Alex, London

I work for the local community health trust in the much maligned IT/admin sector. We have too many so-called managers on high salaries who are not qualified and too inexperienced for the positions they hold. Instead of complaining about admin and ancillary staff in general, which seems to be the new thing for politicians and press alike, it is this layer of people which should be investigated as well as the spate of advertisements for managerial posts with strange names.
Mary, Bury St Edmunds, Suffolk

I work for the NHS and have done so for 16 years. There has been a steady decline in the ability of ordinary staff to provide top level care, from choice of bandage to lack of beds. This has become more acute in the last 12 months. There is a staff shortage, the imported nurses do not fill the gap left by experienced nurses who have worked and trained in this country. Patients are being put at risk at the best hospitals because of these shortages and because of the bed closures. There are more managers doing apparently less work than ever before, it is time the public and the staff begin to see some benefit from the appointments.
DW, Gloucester, Gloucestershire

The demands of the public have increased over the years Anon, Stockport

I am a RGN working at the largest single-site hospital for cancer care in Europe. They have closed thirty four surgical beds and another ward works as a five day ward only. We have no on-call anaesthetist cover out of hours for a high dependency unit and physiotherapists do an on call service out of the goodness of their heart, they are not contracted to provide out of hours services. The demands of the public have increased over the years and so they should, why should they accept poor standards of care. But in our particular situation where the surgical wards have lost over thirteen staff in a few months and with their being a current recruitment freeze our ability to maintain standards are more and more difficult.
Anon, Stockport

I have used NHS and private hospitals this year. I was taken to an NHS hospital following an accident and was most impressed by the A&E operation. I paid to go to a private hospital for a routine operation and found it to be a first class service. These are perhaps their respective strengths but for me the real difference was that only the private hospital provided any customer care.
Anthony, Birmingham, UK

No, but the pen pushers have got better at cooking the books. How can it run more smoothly? Boot out the privateers and get rid of the wasteful distraction of monetarism within the welfare state
Staff Nurse Mark Rotherham, Colchester, UK

My most recent experience of hospital in January this year can be summed up as follows: A & E - just awful Consultant(s) - competent, very distant. Senior Registrars - almost incomprehensible because of language difficulties. Junior doctors - absolute dears, but resembling Road Runners. Staff nurses (grade E,F,G) on ward - first class, efficient, kind and excellent. Auxiliary nurses - poorly motivated and bone idle, seeming to get more nervous the further away from the nursing station they had to move. Ward orderlies/Housekeepers - friendly and kind.
The ward itself was pretty grimy. Little fresh air - windows glued down by varnish! Overheated. Generally better attitudes from most staff now compared to say 20 years ago - less paternalistic and patronising. On the other hand it all seems a bit mechanistic nowadays compared to the sixties and seventies.
Maggi, Lincs

I was referred by my GP to an orthopaedic specialist one month ago and still have not received an appointment. I am in unbearable agony with my hip and now have to spend thousands of pounds to have it done in Belgium next month. As far as I am concerned the NHS alternative just does not exist!
Robin Hassall, Aberlour

In my local hospital a �60kPA "Performance Manager" tells a �18kPA nurse how to perform. Also, how come Labour, with a bigger landslide now than 1945, when it implemented massive health facilities, cannot now find a bed for an old lady?
Brian Mitchell, Slough Berks UK

As a Brit overseas, I've seen two very distinct healthcare systems in operation. In the US everything costs, but treatment is near instantaneous when needed. Complaints arise from people who can't afford medical insurance to cover the huge medical costs. In the UK, the NHS should in theory be that, A National Health Service funded by and for the people. Unfortunately the facilities and services are abused by doctors and consultants spending a proportion of their time and the public resources (nurses, anaesthetists, beds etc), treating private patients. this causes delays to the NHS waiting lists and frustration amongst patients. We need to decide whether to have a fully funded NHS or a fully private system. The current in between status benefits no one in particular.
Andy, Houston,Texas

I work in genitourinary medicine. The amount of sexually transmitted infections is rising alarmingly but our waiting times get longer- not because we have a shortage of medical or nursing staff but because we have only two examination rooms for 3 doctors and 5 nursing staff to work from. Often staff are waiting around to see patients and patients are waiting to see a doctor or nurse but can't because of the lack of physical space. This has been a problem for 10 years and the problem is getting worse year by year.

The other problem we have is that there is not enough clerical and secretarial staff to cover the amount of paperwork that is generated by rising patient numbers. As usual because it's sexual health we are at the bottom of the heap when it comes to any improvements. The King's fund are deliberately kept away from our department when they visit the hospital! So I am not impressed by the King's fund findings. The trouble with the NHS is that there are too many managers in high paid positions.
Hilda, Kirkcaldy, Scotland

I work in Ophthalmology as a senior sister/nurse specialist. Yes the NHS is better for new patients, with the targets our managers have to meet, to keep government happy, we see the new patient sooner, we get their operations done quicker, BUT, Patients needing review suffer, they are not part of government targets and it is impossible to review them on time, sometimes at the cost of deteriorating vision. The majority of our patients are of the older generation and they sit at home waiting patiently for their appointment to come having faith that we will see them in time, they are the unheard. The majority do not complain. I say this knowing that my colleagues in Eye Units across the country are having the same problem.
Elizabet Lightowlers, Plymouth, England

I disapprove of programmes like 'your NHS' because of the "watchdog" tone that is used on the show. The NHS does have its faults but there are many good aspects. Shows like this fail to highlight all aspects of people's treatment. People are treated and looked after well in my experience. As a medical student I am on the front line and witness the way people are treated in terms of respect and dignity, and I observe the way patients are managed by both doctors and nurses. Ok, it isn't always perfect (some complaints are justifiable), there are staff shortages and too many patients but everyone tries to do their best. With respect to decreasing A and E waiting times, I think people should wait without complaining. A and E Doctors are working flat out, like all doctors really.
Russell Durkin, Oxford, Oxfordshire

Other people do actually work in hospitals M Crawford, Glasgow

Nurses and doctors do not run the NHS other people do actually work in hospitals! Medical Laboratory Technicians are amongst the highest qualified (up to MSc level )and the lowest paid. We are responsible for carrying out the thousands of test on blood samples, tissue samples, body fluids etc every week. Their are thousand of people who work for the NHS in a variety of roles and get no recognition for their efforts what so ever, just because they are not a nurse or a doctor.
M Crawford, Glasgow

Watching tonight's programme, I am outraged to hear Tim Yeo talk in such pompous and pious terms about the cleanliness of hospitals. He conveniently forgets that under the Conservative administration of the 1908's and 1990's, his party cut thousands of cleaning posts through 'competitive tendering'. Further, they reduced the monitoring of cleaning standards in order to minimise criticism.
John Toomey, Peterborough

All of you moaners should come and live in the good ole US of A and find out just what the private health sector is like. I know people who can't afford to live because of their high medical costs, and others working as many jobs as possible just to pay for dear ones who are seriously ill to provide for basic health care. I for one will be heading back to the UK when I retire - I can't afford to get old or sick in this country!
Jane Wilson, USA/British ex-pat

How can you say that pay in the NHS has improved when the lowest paid staff have been penalised in favour of the nurses, doctors, management and consultants. Housekeepers have only received a 3.6% pay rise in 2002. A 3,225% rise in 2003,will receive a 3.225% in 2004 and in 2005. The non medical staff in the south east have not been entitled to the cost of living supplement that nursing staff get. With most housekeepers receiving less than �5.00 per hour for a 39 hour week. But of course Housekeeping is not glamorous enough for the media to get hold of, but they soon complain about lack of cleanliness.
Robin Haydon-Brown, Eastbourne

It is unfortunate managers are given a bad name in the NHS. Little do the public know of the discussions, sometimes heated, we have with doctors to do the extra work needed to get all the patients seen. It is a constant struggle to keep within government guidelines and unfortunately a lot of doctors resist and resent having to do any extra work, yet they are always depicted as the "good guys" when often they are not. As a manager I genuinely think of the patients and how I would feel if a member of my family had to wait and inordinate length of time.
Sue, Kent

Improvements still need to be made to GP services. You need wait at least a week for an appointment. Maybe a clinic run on a weekend and one evening per week, would help clear the backlog and create some flexibility for working parents. Maternity services need investment, lots more midwives are needed to avoid taking unnecessary risks with mothers and their babies. There are far too many near misses.
Caroline Dixon, Sunderland

False economy. Why use bank & agency staff, to fill the gaps, jobs that are frozen to save money. Agency/bank nurses cost more fees/rates are more than employing the nurses permanently. False economy, complete madness, If I ran my household expenses like that I would soon be bankrupt!
A&E Sister, Shropshire

Health service workers want to give their best but are constantly thwarted Margaret, Manchester

I work as a radiographer in a recently formed super-trust. My colleagues and I can see no advantages to the merger of 4 hospitals except the introduction of more layers of management and the introduction of new uniforms for all clerical and nursing staff to promote a corporate image. Now we are being asked to lose the current vacancies we have and staff are being invited to drop from 5 days to 4 days as a cost-cutting measure. In a short staffed department the only result will be a reduced service to our patients. Health service workers want to give their best but are constantly thwarted.
Margaret, Manchester

As a trainee pharmacist about to qualify and begin work for the NHS I cannot believe how many people complain about this magnificent service. Yes it has problems, mainly due to understaffing and funds going to managers etc and not to where they are needed. However if you are ill the NHS will look after you - yes you may have to wait but where else in the world do you get free healthcare for so little input?
Ana, Stockport, England

As a nurse in the NHS I feel that the shift towards targets has meant a decline in patient care, and more time devoted to getting them through the system, so as to reduce waiting lists. Many nurses work past their contracted hours to try and finish over-long lists, and to try and do all the jobs they are required to. Coupled with the immense amount of paper work, this makes nursing very difficult.
Graham, Harlow, Essex

I work within the NHS as an RMN... I am sick of hearing about waiting times. These figures mean nothing as they can be manipulated. NHS standards should be measured by the care actually given. I feel that the government is pushing all the money in the way of reducing waiting lists and the money is required for quality care, not the cheapest option. Mental health is a massive area of the NHS but it is totally neglected and only given attention when a tragedy occurs.
Stanley, Stirling, Scotland

If you manage to get to the hospital there is a four hour wait most times to see a doctor in A & E Stephen Smith, Bury, UK

We had two hospitals, now we have one, and it's on the outskirts of the town with horrendous road access. If you manage to get to the hospital there is a four hour wait most times to see a doctor in A & E. The baby unit has closed down several times since Xmas and the NHS Trust is �20 million short this financial year. This is progress????
Stephen Smith, Bury, UK

I am an emergency medical technician for the London ambulance service. And whilst I believe services could be improved through all areas, I feel that the misuse of the ambulance service and A and E, results in increased pressure for staff and longer waiting times for patients. The public should be educated and understand the different options available to them before heading straight to A and E.
Nick, London

I keep getting letters postponing my repeat outpatient appointments. This never happened before the six month target to outpatient departments for first time visits was introduced.
Adrian Withers, Basingstoke, England

I recently gave birth in hospital. In the maternity ward I went to use the patient's toilet. The seat and the floor of the shower area were covered in blood. I reported it at 5pm but the blood was still there at 8am the next day when I went for my shower. It is disgusting to think that newly delivered mothers have to put up with this - particularly given how difficult it is to "hoover" when you have just given birth and have stitches!
Zoe, Reading

If the NHS is that hard up it has to suspend a top surgeon for allegedly taking an extra bowl of soup, it is reasonable to say it has got worse for both staff and patients. The surgeon who earns �80,000 is on full pay during his suspension over a bowl of soup that would have cost between �1 and �2. Can NHS managers not see where more money is being lost in this case?
Jennifer, Reading, UK

Well done the NHS! Andrew Thomas, Swansea

Both my Mum and Dad have needed the NHS recently and we have found the standard of care to be excellent. My Dad, who had a stroke last year, was treated by a most attentive doctor who was willing to spend time talking to me and my mother. My Mum needed a hernia operation (which she had yesterday) and she looked wonderful when I visited her last night. So well done the NHS!
Andrew Thomas, Swansea

NHS dentistry in North Wales is already non-existent unless you are on benefit. It can only be a matter of time before the rest of the NHS goes the same way. Let's face it, the dream of free first-class medical treatment for all has been destroyed by incompetent management and meddling politicians
Peter J. Tabord, Caernarfon, Gwynedd

Does everyone actually believe that focussing only on the problems is going to help? There are some major problems in the NHS, but what about the major achievements and the everyday commitment shown by staff who continue to save lives. I have had a number of minor conditions treated through the NHS over the past few years and continue to be impressed by the care I have been given by caring and skilled staff.
E. Richardson, Edinburgh, Scotland

I have been off work for 2 months due to ill health and have two children to care for. My excellent GP is trying to get me seen by an Endocrinologist and I also require a scan. He has had no success in speeding my appointment up (I have not even been given a date, just a letter confirming that I am on a 'long' list) and has asked if I can afford to go private as he is concerned about the amount of pain that I am in. It would seem that even our own doctors have little faith in the NHS.
Dee, Yeovil, Somerset

I'm appalled at the taxpayers' money that is wasted over continual restructure of the NHS for political gain Alan, UK

Being a relatively recent NHS employee with a solid background in the private sector I'm appalled at the taxpayers' money that is wasted over continual restructure of the NHS for political gain. How many times do politicians and bureaucrats, whose arrogance over the running of the NHS is only surpassed by their ignorance, have to pull apart then join together the NHS every 6-7 years for little more than political gain?
Alan, UK

John Reid said 98% of patients can see a GP within 48 hours. The remaining 2% must all live round here! It can be a week before an appointment in some areas. Our doctors' surgery has changed its hours so it is no longer possible to have an appointment or pick up a prescription without leaving work early.
Donna Irwin, Renfrewshire, Scotland

I waited a year to see a dermatologist and it was like going through a sheep dip. In and out so quickly, with no advice or time to discuss my case. Waiting lists may be going down but at the expense of customer satisfaction.
Thomas McCarthy, Cardiff, UK

The NHS plan has given staff and patients a greater say in what they want, and what we as health care professionals should be providing. However, the amount of nonclinical work has increased a huge amount which takes senior nurses like myself away from patient care.
Glenn, East London

I work within the NHS and constantly see staff overworked and stressed out. Staff shortages are horrendous and management useless. The NHS has become a total nightmare for both staff and patients
Mandy, Manchester

I find it incredible that such a large and complex organisation as the NHS can be so amateurish in its approach to management Chris Unsworth, Hampton Wick, UK

My wife is one of the thousands of nurses John Reid is gloating about having attracted back to the NHS. Having been away from the NHS for 20 years, she successfully completed a Return to Practice course in Jan.'04. Having applied to return to work for the PCT with whom she did her work placement during the course, she is still waiting to start work, despite the desperate shortage of nurses and health visitors actually working in the NHS. My wife has been amazed at the increase in the number of "managers" and administrators since she last worked in the NHS, seemingly to the detriment of the number of front-line health care staff. As someone used to industrial management discipline, I find it incredible that such a large and complex organisation as the NHS can be so amateurish in its approach to management.
Chris Unsworth, Hampton Wick, UK

The NHS is a fantastic concept. We have received exemplary service from the staff. Nothing is too much trouble.
Rob H, London, UK

Working in Medway Hospital A&E department, things have become better, patients are waiting for less time and the general care given to them has improved. Despite this because of government targets staff can feel very stressed as more strict waiting times are imposed and then when patients breach these the whole of the management descend and berate often a single person who possibly has no control over what has happened
Anthony, Medway, Kent

I have worked as a senior manager in a mental health NHS Trust in Suffolk for the past four years. During this period, I have witnessed no less than three changes in the trust board, resulting each time, in ever increasing levels of director appointments, all of whom require PAs, new offices and equipment. This has brought about the scrapping and rehashing of plans agreed through consultation, local voluntary and user groups, so as to allow an overspend of around �3 000 000 on decoration!!!! Patient care has changed little, if at all. The only way that I have managed to improve the service my departments provide is to become independent of the NHS. This has taken a considerable effort, but having nearly reached this goal, can evidence a massive improvement that service users can easily access and appear to benefit from.
Jeremy, Ipswich, Suffolk