Save the NHS!

I think the line that the NHS needs to make efficiency savings is a bit of a red herring. Yes, it's possible to find areas where money is wasted, but I could probably wander into any random office and discover things being done inefficiently and at a higher cost than they need to be.

The seemingly constant picture being painted of the NHS burning money in a giant hole needs to die, because it's preventing actual discussion about funding from taking place.

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

We point at other European countries and ask "why is their healthcare better?", well a large part of it is that they spend more.
 
tom_nieto said:
The NHS, GPs especially, rely on reaching performance targets to maintain their level of funding. The problem with healthcare as a business model is that it's not always clear what your outcome measure should be, as they're not always clear cut. I absolutely agree that the NHS should be making efficiency savings, but this should not coincide with a cut in funding.
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If the NHS needs to improve efficiency a few places for consideration.

The IT budget for the patient record IT system, which I believe was several years late and multiple billions over budget. I believe the deal/contract for this was made in Whitehall with Capitia and the outcome of being late and approximately twice the cost of the original quote had little to no negative impact on the private sector vendor.

Purchasing prices of drugs (from one of the worlds largest customers) from private sector providers, which similarly spiral out of budget with little to no come back on the suppliers.

It would be very interesting to impose KPIs and contract clauses on those responsible for the state of the running of the NHS in both Whitehall and the private Sector.
 
Freddie1980 said:
I believe in France you are charged to see a GP. I don't know about zee German's though.

'Humanitarian Crisis in the NHS' does make for a good headline.
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I'm not sure if it is a simple non refundable charge in France:
http://www.blog.parisunraveled.com/how-much-does-it-cost-to-go-to-the-doctor-in-france/

In germany it is also more complex than a simple flat fee:
https://www.internations.org/german...urance/going-to-see-a-doctor-in-germany-15995

I all three cases, France/Germany/Ireland do the citizens pay a NI equivalent tax in addition to fee's at the GP?
 
Caged said:
The seemingly constant picture being painted of the NHS burning money in a giant hole needs to die, because it's preventing actual discussion about funding from taking place.

https://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_per_capita

We point at other European countries and ask "why is their healthcare better?", well a large part of it is that they spend more.
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Well if you look at those stats:

UK has increased spending on NHS by 25.41% since 2012.
France has increased spending on healthcare by 8.47% since 2012.
Germany has increased spending on healthcare by 12.18%

Suggests we are pumping lots of money into the system in the last four years and if as suggested the NHS is in crisis then we need to look at other matters!
 
Shoza said:
Well if you look at those stats:

UK has increased spending on NHS by 25.41% since 2012.
France has increased spending on healthcare by 8.47% since 2012.
Germany has increased spending on healthcare by 12.18%

Suggests we are pumping lots of money into the system in the last four years and if as suggested the NHS is in crisis then we need to look at other matters!
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Interesting but only referencin 2012 isn't a full picture.
 
Shoza said:
And yet they are spending more money on it than 4 years ago?
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Shoza said:
My bad!
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Hardly means they aren't killing it, the we are spending more money argument cuts loads of ways, are they spending more money in real term or increasing Below inflation etc. The sell off of the easy most profitable work has already started with loads of nhs work being done privately which just diverts money and resources out of the system and into the pockets of the rich. Anyone who doesn't think the NHS is heading for privatisation if we keep a Tory government for a few terms is in my opinion extremely blinkered. The switch to academies has already effectively privatised vast numbers of schools by the back door and you can guarantee in the next 10 years we will see the stories of who got rich off the back of falling school standards.
 
Shoza said:
Well if you look at those stats:

UK has increased spending on NHS by 25.41% since 2012.
France has increased spending on healthcare by 8.47% since 2012.
Germany has increased spending on healthcare by 12.18%

Suggests we are pumping lots of money into the system in the last four years and if as suggested the NHS is in crisis then we need to look at other matters!
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Spending increase from a fixed point doesn't mean much, if you had a poorly funded service to begin with you can get a larger % increase. This is our healthcare spending as a percentage of GDP compared to other European countries.

https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/health-care-spending-compared

Not as surprising France and Germany have better systems now is it? The problem is that every winter there is a crisis. We then close beds, reduce social care funding and seem surprised when the year on year demand continues to rise, despite this being the obvious trend for years.

Shoza - can you show me where this 25% increase from 2012 data comes from? Most sources show a very low rise if anything from 2012 and certainly nothing close to a 25% increase in the last 4 years.

If you read https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-budget

There is a planned 35 bn increase from 2011, but after taking out interest this is actually 10 billion, which would be a inflation corrected increase of less than 10% by 2021, so I'm not sure how we can have a 25% increase already.
 
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Shoza said:
And yet they are spending more money on it than 4 years ago?
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By fragmenting the system the Govt. now have to spend more just to stand still and that is without taking into account the profiteering of some drug companies or inflation.
The efficiency saving argument is getting a bit stupid as a slogan after years of real cuts.
 
PikeyPriest said:
Spending increase from a fixed point doesn't mean much, if you had a poorly funded service to begin with you can get a larger % increase. This is our healthcare spending as a percentage of GDP compared to other European countries.

https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/health-care-spending-compared

Not as surprising France and Germany have better systems now is it? The problem is that every winter there is a crisis. We then close beds, reduce social care funding and seem surprised when the year on year demand continues to rise, despite this being the obvious trend for years.
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But we already know from Labour's hosing of money into the nhs during the 1997-2010 period that healthcare outcomes didn't improve in line with the funding increases.

http://www.nao.org.uk/report/management-of-nhs-hospital-productivity/

The problem is not one that can be solved by throwing money at it. Reform is needed.
 
a1ex2001 said:
Hardly means they aren't killing it, the we are spending more money argument cuts loads of ways, are they spending more money in real term or increasing Below inflation etc. The sell off of the easy most profitable work has already started with loads of nhs work being done privately which just diverts money and resources out of the system and into the pockets of the rich. Anyone who doesn't think the NHS is heading for privatisation if we keep a Tory government for a few terms is in my opinion extremely blinkered. The switch to academies has already effectively privatised vast numbers of schools by the back door and you can guarantee in the next 10 years we will see the stories of who got rich off the back of falling school standards.
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Apart from the recent cases of school company directors siphoning money to other parts of their organisations or giving jobs/contracts to family/friends.
 
Dolph said:
But we already know from Labour's hosing of money into the nhs during the 1997-2010 period that healthcare outcomes didn't improve in line with the funding increases.

http://www.nao.org.uk/report/management-of-nhs-hospital-productivity/

The problem is not one that can be solved by throwing money at it. Reform is needed.
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Get rid of the insane internal market and the inept PPI hospitals that do more damage to the NHS than good.
Stop the fragmentation of the NHS as it costs more. We will end up with the 'railways model' for the NHS with lots of money making private companies rich while providing a p*** poor service. It is a service not a profit making concern. They should make a central purchasing for drugs and things like IT systems so you can get bulk buying savings and IT systems that can be accessed over the whole country. We need to get away from the dogmatic approach.
 
do_ron_ron said:
Get rid of the insane internal market and the inept PPI hospitals that do more damage to the NHS than good.
Stop the fragmentation of the NHS as it costs more. We will end up with the 'railways model' for the NHS with lots of money making private companies rich while providing a p*** poor service. It is a service not a profit making concern. They should make a central purchasing for drugs and things like IT systems so you can get bulk buying savings and IT systems that can be accessed over the whole country. We need to get away from the dogmatic approach.
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I agree. The whole purchasing system makes no sense. For the amount of money wasted on ourschasing and IT in the last 10 years we could have had amazing system that was used in all hospitals allowing to share information easily.

The problem is that there is no long term thinking in government. Everyone focussed on their legacy or achievement to get their next job as there is very little accountability in the longer term. PPI was a horrible idea, but we'll be paying for it while those who agreed the terms are long gone in other roles.
 
do_ron_ron said:
Get rid of the insane internal market and the inept PPI hospitals that do more damage to the NHS than good.
Stop the fragmentation of the NHS as it costs more. We will end up with the 'railways model' for the NHS with lots of money making private companies rich while providing a p*** poor service. It is a service not a profit making concern. They should make a central purchasing for drugs and things like IT systems so you can get bulk buying savings and IT systems that can be accessed over the whole country. We need to get away from the dogmatic approach.
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Isn't your suggestion just as dogmatic? What evidence do you have that such an approach leads to better outcomes?

How about we look at what the best performing systems do and take it from there?
 
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