British local councils have unusually broad responsibilities compared with those in other countries, covering social care, special-needs education (SEND) and temporary housing alongside standard functions like roads, bins and libraries. Social care alone accounts for two-thirds of local-government spending (excluding public health and education), up from half in 2010. The number of pupils with SEND plans has risen 140% since 2015. Councils have over 1,000 statutory duties. Spending on roads and transport has fallen by half per person in real terms since 2010; overall local-government spending excluding social care is down 36% on that basis. Utility companies that tear up roads without proper repaving face fines capped at £2,500 ($3,300), a figure that has been eroded by inflation.
Real-terms per-person spending on public order and safety fell by a quarter in the first half of the 2010s and remains 8% below pre-austerity levels. Around 20,000 police officers were cut, then 25,000 less-experienced replacements were hired a few years later. Trust in British police is the lowest in western Europe. Charge rates—the share of crimes resulting in a charge or summons—have fallen by more than half in a decade.
Shoplifting has risen to around 20m thefts a year, yet prosecutions are down by 60%. Shops report only about 2% of thefts, versus 10–15% in the 2010s. Since the pandemic, crown-court cases take over 40% longer on average. Britain is nearly out of prison spaces.
The NHS was founded after Labour's 1945 landslide election. Aneurin Bevan, the party's health secretary, predicted it would be the "envy" of the world. Brazil, Italy and Malta all copied the system.
Hospital waiting lists in England stood at 7.4m as of 2025—almost double the level in 2007. In emergency departments, 12-hour waits have become routine. Public satisfaction peaked at 70% in 2010 and slumped to just 21% in 2024. Among 17 rich countries, only Americans die more from preventable causes. Britons have the lowest life expectancy in western Europe.
Britain spends about 11% of GDP on health—less than France and Germany, more than Italy and Spain. The share of the NHS budget going to hospitals increased from 47% to 58% between 2006 and 2022, squeezing funding elsewhere. Britain has 16% fewer GPs per person than its rich-world peers; Britons visit emergency departments at twice the rate of the Dutch. In 2023-24 the health department set aside £58bn, almost a third of its annual budget, to cover the potential cost of past clinical negligence.
Productivity remains below pre-pandemic levels; during covid the NHS became a covid-only service, with other services all but shut down. Moving from analogue to digital in England alone is expected to cost £15bn over five years. Reforms to social care have been delayed until 2036 because they are deemed unaffordable. In Lincolnshire, linking NHS and social-care data helped cut emergency-department admissions by 58% in six months by flagging patients who needed social care.
A government scheme to outsource cataract operations to private providers drained the NHS of doctors and money by removing simple, high-volume procedures that help subsidise more complex eye care. The private cataract market has grown by 400% since 2019.
The Stafford Hospital scandal, in which the hospital prioritised rankings over care, led to hundreds of patients suffering neglect and unnecessary deaths.
Dysfunction in the NHS has made private medical insurance more popular. Retailers spend some £2bn a year on security, twice the 2022 level. Mitie, a security company, grew its retail client base from 3% in 2016 to 40% by 2025. My Local Bobby, a private policing firm, charges households £30–150 a month for a uniformed street presence. Some housing developments and commercial districts like King's Cross in London charge residents for cleaning, security and maintenance on top of council tax.
Support your local Search and Rescue unit -- get lost.