NHS Efficiency
Discussion
NHS spending has nearly doubled since 1997-a real terms increase (after adjusting for inflation) of 53.4% or 8.9% per annum-but Hospital activity has only gone up by 9.9% over the same period or 1.9% per annum.
These simple statistics explain why despite the large increases in our tax bills the NHS remains as bad as it does.
These simple statistics explain why despite the large increases in our tax bills the NHS remains as bad as it does.
I believe the problem is the structure of the NHS.
Labour has tried to solve the problems in the NHS by pumping in vast sums of money and increasing central control.
One result of this policy is that some of the extra cash is swallowed up by extra admin costs-Since Labour came to power an extra 80,000 managers and admin staff have been employed.
We used to be able to delude ourselves that the reason that other european countries like France had far superior health care systems to our own was because of the difference in money spent.
Under Labour the amount of spending is fast approaching the European average but without much improvement.
The reason for the difference therefore is becoming clearer and clearer-the way the NHS is organised the centralised beuracracy.
The way forward is clear- a move towards greater independence for hospitals, greater choice for patients and the ability to take state funding for operations into the private sector.
Labour has tried to solve the problems in the NHS by pumping in vast sums of money and increasing central control.
One result of this policy is that some of the extra cash is swallowed up by extra admin costs-Since Labour came to power an extra 80,000 managers and admin staff have been employed.
We used to be able to delude ourselves that the reason that other european countries like France had far superior health care systems to our own was because of the difference in money spent.
Under Labour the amount of spending is fast approaching the European average but without much improvement.
The reason for the difference therefore is becoming clearer and clearer-the way the NHS is organised the centralised beuracracy.
The way forward is clear- a move towards greater independence for hospitals, greater choice for patients and the ability to take state funding for operations into the private sector.
JagLover said:
...greater choice for patients...
And how are patients qualified to make such a choice? Patients don't want choice, they just want service. If you need an op, you want to go to a (reasonably) local hospital and get the op. You don't want to go and look through fifteen brochures telling you why getting your appendix out will be better and cheaper at XYZ hospital.
JagLover said:
...and the ability to take state funding for operations into the private sector.
That I would agree with - and the same for education, and 'National Insurance'.
Size Nine Elm said:
...greater choice for patients...
And how are patients qualified to make such a choice? Patients don't want choice, they just want service. If you need an op, you want to go to a (reasonably) local hospital and get the op. You don't want to go and look through fifteen brochures telling you why getting your appendix out will be better and cheaper at XYZ hospital.
JagLover said:
...and the ability to take state funding for operations into the private sector.
That I would agree with - and the same for education, and 'National Insurance'.
It perhaps might be the case that people are not set up to make an informed choice betweeen Hospitals-but they could ask their GP who will be far more knowlegable-If you make Hospitals independent then there needs to be a choice between them.
And yes I would also support the same principles in Education.
and as for National Insurance I already pay for private income protection insurance.
The whole system is up the creek. One of my kids broke his hip last year and (for reasons too complicated to explain) it wasn't covered by our private healthcare insurance. (I've since made the appropriate changes in the policy).
Anyway, the A&E sorted him, gave him crutches and stuff, and say "come back in a week to see a specialist". The appointment was set for 11am - but they're kept them waiting for 3 hours! The wife's now beginning to get worried about not making the school run. Eventually, the Doctor sees them and and he's "incredibly rude" - saying "I'm too busy to answers such stupid questions" and walks out saying he's "got a schedule to keep". My missus burst into tears and the nurses did what they could to console her.
When I heard about it, I was incensed and thought that I'd pay personally for private treatment - even if my insurance policy didn't cover me. I call the local private hospital, explain the situation and then a rather embarrassed PA explained that it would be the very same Doctor, but he'd give more time and would be "less curt". Needless-to-say, I didn't bother.
Anyway, the A&E sorted him, gave him crutches and stuff, and say "come back in a week to see a specialist". The appointment was set for 11am - but they're kept them waiting for 3 hours! The wife's now beginning to get worried about not making the school run. Eventually, the Doctor sees them and and he's "incredibly rude" - saying "I'm too busy to answers such stupid questions" and walks out saying he's "got a schedule to keep". My missus burst into tears and the nurses did what they could to console her.
When I heard about it, I was incensed and thought that I'd pay personally for private treatment - even if my insurance policy didn't cover me. I call the local private hospital, explain the situation and then a rather embarrassed PA explained that it would be the very same Doctor, but he'd give more time and would be "less curt". Needless-to-say, I didn't bother.
[quote=srebbe64]The whole system is up the creek. One of my kids broke his hip last year and (for reasons too complicated to explain) it wasn't covered by our private healthcare insurance. (I've since made the appropriate changes in the policy).
Anyway, the A&E sorted him, gave him crutches and stuff, and say "come back in a week to see a specialist". The appointment was set for 11am - but they're kept them waiting for 3 hours! The wife's now beginning to get worried about not making the school run. Eventually, the Doctor sees them and and he's "incredibly rude" - saying "I'm too busy to answers such stupid questions" and walks out saying he's "got a schedule to keep". My missus burst into tears and the nurses did what they could to console her.
When I heard about it, I was incensed and thought that I'd pay personally for private treatment - even if my insurance policy didn't cover me. I call the local private hospital, explain the situation and then a rather embarrassed PA explained that it would be the very same Doctor, but he'd give more time and would be "less curt". Needless-to-say, I didn't bother.[/quote
It is very often the same people you will be seeing if you go private. I was suffering from severe pain caused by nerve problems after an operation. I required an injection into the affected area-that would target that nerve.
I saw a specialist about the problem when it occured, they told me the treatment required but it would be a long wait to have this done.
My parents had to pay for it to be done privately-by the same doctor.
Anyway, the A&E sorted him, gave him crutches and stuff, and say "come back in a week to see a specialist". The appointment was set for 11am - but they're kept them waiting for 3 hours! The wife's now beginning to get worried about not making the school run. Eventually, the Doctor sees them and and he's "incredibly rude" - saying "I'm too busy to answers such stupid questions" and walks out saying he's "got a schedule to keep". My missus burst into tears and the nurses did what they could to console her.
When I heard about it, I was incensed and thought that I'd pay personally for private treatment - even if my insurance policy didn't cover me. I call the local private hospital, explain the situation and then a rather embarrassed PA explained that it would be the very same Doctor, but he'd give more time and would be "less curt". Needless-to-say, I didn't bother.[/quote
It is very often the same people you will be seeing if you go private. I was suffering from severe pain caused by nerve problems after an operation. I required an injection into the affected area-that would target that nerve.
I saw a specialist about the problem when it occured, they told me the treatment required but it would be a long wait to have this done.
My parents had to pay for it to be done privately-by the same doctor.
My mother has been waiting over a year for a cataract operation. She had one eye done about 3 years ago, but the other eye is now virtually blind. She keeps waiting for the NHS to tell her when she will be scheduled.
If we go private (which she doesn't want to do for percieved idealogical reasons) it could be done inside a week.
When you're over 70, you haven't necessarily got that long, and spending over a year half blind is a huge impact on quality of life.
NHS improving? Only if you're a middle manager HR organisational consultant on a £50k salary.
Christopher Brookmyre's 'Quite Ugly One Morning' is not far from the truth...
If we go private (which she doesn't want to do for percieved idealogical reasons) it could be done inside a week.
When you're over 70, you haven't necessarily got that long, and spending over a year half blind is a huge impact on quality of life.
NHS improving? Only if you're a middle manager HR organisational consultant on a £50k salary.
Christopher Brookmyre's 'Quite Ugly One Morning' is not far from the truth...
I know there are an awful lot of problems regarding the NHS but on the flip side of the coin, they couldn't have done any more or tried any harder to save my dad when he was in at the start of the year. Unfortunately they couldn't save him but the quality of care was second to none. Maybe thats because he was in intensive care but still... there is some good being done.
Mrs Fish said:
I know there are an awful lot of problems regarding the NHS but on the flip side of the coin, they couldn't have done any more or tried any harder to save my dad when he was in at the start of the year. Unfortunately they couldn't save him but the quality of care was second to none. Maybe thats because he was in intensive care but still... there is some good being done.
What I am saying is that there is a problem with the way the NHS is organised.
The NHS employs many dedicated Doctors and Nurses who I am sure do the best they can.
>> Edited by JagLover on Friday 4th March 13:38
Size Nine Elm said:
My mother has been waiting over a year for a cataract operation. She had one eye done about 3 years ago, but the other eye is now virtually blind. She keeps waiting for the NHS to tell her when she will be scheduled.
If we go private (which she doesn't want to do for percieved idealogical reasons) it could be done inside a week.
When you're over 70, you haven't necessarily got that long, and spending over a year half blind is a huge impact on quality of life.
NHS improving? Only if you're a middle manager HR organisational consultant on a £50k salary.
Christopher Brookmyre's 'Quite Ugly One Morning' is not far from the truth...
It is unusual for people to be waiting more than 6 months for a cataract operation, indeed in London, the wait is not more than 3 months. This is because the government have poured money into the cataract service, at the expense of other areas of ophthalmology.
The premise of this thread is justified in one sense, which is politicising the NHS has made it the football of successive governments who aren't really interested in patient care, but in installing targets, and then employing poorly qualified and frankly rather dim managers to ensure these targets are met, no matter what the cost to patient care.
What needs to be done is that the NHS needs to first be taken out of government control and put into the control of cross party organisations, then the funding system needs to be radicalised, with the private sector and co-payment taking a greater role. Doctors and nurses need to be freed from restrictive work practices to restructure the service they can offer, and how best to organise their time.
You should read the writings and seminars of ppl like John Seddon re targets. Targets are widely criticised in academia and management academia. There are lots of systems out there but the NHS never implements them right and picks and choses parts which they think will work. The new fad, may have passed now, is TQM.
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