NHS all UK or smaller pieces

[saaby93]

An article here about whether health services in one part of the UK are better than the rest

http://www.bbc.co.uk/news/uk-wales-35549761

It it an advantage to have separate services, where if you live over the border from your hospital the accountants have to make sure the money follows, or better to have one NHS for the whole of the UK?
If smaller pieces are better should it be down to regional level or smalller

[speedy_thrills]

We have a health service based on district health boards but it doesn't really work. Districts with less funding or more elderly people end up outsourcing to larger health boards creating inefficiencies. I'd also suggest this is likely a key reason why privatised health services don't appear to deliver better outcomes per dollar spent according to most studies.

[saaby93]

I think I meant district health boards by towns
Regional means like London Scotland wales the midlands or south west
Should I edit the poll questions? How?

[DukeDickson]

One of several, but perhaps one of the top 1 - 3 reasons (and prime) why, the fabled NHS IT project failed is as a result of regionalistic attitudes of Trusts. Lots & lots of money down the pan!


Add in the influence of Central Gov = serious cess pool!

[Zedboy1200]

Interesting topic, not often discussed.

1: 1 UK, 1 NHS... Good idea in principle, especially for monstering procurement (which is currently woeful VFM). In practice it would be administerily horrific. A beast.

2: 4 Home Nations, 4 NHS. Maintain the status quo. No change for sure, but no money wasted on ineffective change.

3: Go regional. My fave option, but post code prescribing and regional variances in depravation and mortality would create conflict, particularly with the Celts.

4: Privitisation: Hasn't happened, won't happen....missed opportunity. All government will resist this as they will be unelectable irrespective of the successes gained.

The problems aren't structural, they're cultural. Big time!

[saaby93]

Most support for having one NHS for the whole UK rather than it being a devolved matter with a significant chunk thinking it should be privatised

[PRTVR]

I think there should be one NHS, covering things like drugs and equipment purchase, it makes sense to utilise the massive buying power, then smaller regional units, with 3 or more hospitals under their control, this would allow each hospital to specialise, the only problem is with areas like the lake district, small population spread over a large area, I would standardise hospital construction, it makes no sense to keep reinventing the wheel.

[dandarez]

I honestly thought I'd be the only one to go for 'why did I look here?' 10%!

Anyway, the NHS is fked. I most certainly don't want it privatised, but a lot of it already is, much back door.

The hospital car parking charging pisses many off. A young woman was on Radio Oxford yesterday, the birth of her baby had severe complications meaning she has spent lots of time over the last year or so making numerous visits back. She's spent nearly £2k on parking charges and can get no help, she's tried. Free at the point of entry is a joke.

Here's a nice insight to Romania and the UK regards health. Nice to see the great old EU is fking it up for Romania, needing a 83 year old Neurosurgeon to continue working, while we get their (and our) docs on the cheap.

Worth a watch, from 12 mins in if you are in a hurry.

http://www.bbc.co.uk/iplayer/episode/b0721ct6/insi...

[FredClogs]

The main political thesis at work since the 80s (yes it was thatchers fault) is that competition breads success. To create competition you have to have comparison metrics, league tables and localised management with the emphasis on individual performance (in this case each hospital or trusts). The idea was/is that once you know whose the best at what you can target the money to those places, I.e driving up standards... Thatcher started this but til be fair every politician since has been unable to regress the tide, only this week we heard on the news about pregnant ladies being given vouchers for maternity services to spend in the nhs market place. Blair banged on about choice, choice, choice but it was the same thing, a belief that competition breeds success.

So the decentralisation is necessary to achieve the choice, competition or whatever, it's theory though, and one I'm not sure stands up to much critical analysis.

[Murph7355]

FredClogs said:

...but it was the same thing, a belief that competition breeds success....

I suggest they think it's what we want, and that's why they push it so hard. And the general public is gullible enough to keep lapping it up. "Choice" - has to be better. Surely?

For services provided out of central funds there should be no choice. There should be a standard suite of services provided equally everywhere, and they should be constrained to those that can be done well. I'm also not convinced "ring fencing" budgets is helpful.

We all need to realise the NHS is not free. Pretending there are limitless funds for limitless treatments is crippling the system, no matter how it's managed.