We are living fewer years in good health: Is the NHS part of the problem?

By Eleanor Lawrie Social affairs reporter Angie currently lives in the English Midlands but is preparing to move to Bulgaria. She has suffered for years from multiple chronic health issues including ME and an autoimmune thyroid condition. She says holidaying in Bulgaria has been transformative - enough that she has decided to leave the UK. A strong sense of community and the fresh air of the Bulgarian mountains are part of the pull. But she also feels the Bulgarian healthcare system is more responsive than the one she is leaving behind in the UK. "You have to pay a small fee to see a doctor, but then you see one quickly," Angie says, describing her experience in Bulgaria. While she is "very glad" the free at the point of use NHS exists,  she believes it is failing to deliver. "People aren't getting a service - particularly with chronic health issues - that actually makes a difference to their health outcomes or quality of life," she says. "Once you're diagnosed, that's it, you're left to your own devices. I've had to spend a fortune on private healthcare because I couldn't get any improvements [with]in the NHS." A 2025 study from National Voices charity found 37% of people with a long-term health condition did not feel supported by the NHS to manage their physical health, compared with 16% of those with no long-term conditions. Image source, NurPhoto via Getty Images Image caption, Angie is preparing to move to Bulgaria - partially because of her health Unlike the UK, Bulgaria's healthcare system is a mix between public and private. Employees, including foreign nationals, pay a compulsory 3.2% of their pre-tax salary into a healthcare insurance fund topped up by their employer. However, there are many extra costs for non-emergency medical treatment, such as doctor's appointments. Despite progress, Bulgaria's health outcomes are ranked relatively poorly by the OECD. But other countries without tax-funded systems do perform strongly. Angie has become one of a growing number of Britons living with ongoing poor health. More working‑age adults are reporting long‑term health conditions, with 36% saying they had at least one in early 2023, up from 31% in the same period of 2019. Healthy life expectancy - the years in which a person can expect to live in good health – has fallen in the UK in recent years, while it has increased in most other wealthy countries. While life expectancy has stagnated, in more than 90% of areas, healthy life expectancy has dropped below the state pension age, with Britons now living about a quarter of their lives in poor health. While life expectancy in the UK has recovered after the Covid-19 pandemic, healthy life expectancy has worsened, particularly in the most deprived areas. Across the country, healthy life expectancy in 2022-2024 was 60.7 years for men and 60.9 years for women, according to the Office for National Statistics (ONS).  This was a drop of 1.8 and 2.5 years respectively compared wi