On the NHS, I tried for years to push for improvements to switch to digital cancer screening invitations after they missed my mother (offering to build the software for free), which is now happening, but suggesting the NHS isn't perfect is against the religion here. My sister who works in NHS DEI hasn't spoken to me since publishing a book on it.
Every time someone with the finances, vision and ability leaves I think the situation gets a little bit worse, it increases the proportion of people remaining willing to put up with all of it. Anecdotally, many of my friends have already left, some of the older generation want to leave but feel tied in. My flight out is in 6 weeks. Good riddance, no doubt.
That I could have multiple negative NHS experiences relating to missed cancer diagnoses of friends in that relatively short span of time is suggestive of a real problem. The institution seemed to have less of an issue with elder care (in the US, the phantom menace posed by Obamacare or any governmental involvement in healthcare was meant to be "death panels" deciding the fate of grandparents) than with avoiding at all costs detecting potential long-term problems in the young. It's a 'rational' fear in the sense, as you note, that such cases put tremendous pressure on services, but there's no world where the best health outcome is refusing to screen your working age population.