NHS spending

[Rovinghawk]

968 said:

It has always been thus, politicians and accountants seem to know the solutions but seem to fail every time.

IYO what's the solution?

[sidicks]

pavarotti1980 said:

Cuts have never been a part because allegedly the NHS has not suffered cuts. I have direct experience of it both from the commissioner and provider perspective. A little fact for you. At the end of 2017/18 financial year every single NHS Trust will be in deficit or be using their capital reserves to keep their heads above water. This includes trusts who historically were always in surplus due to very good governance. Now if there hasnt been a cut to funding in real terms why are all of these trusts suddenly scrabbling around for money?

Which numerous reorganisations do you make reference to? The one handled by Andrew Landsley which created an extra layer of beurocracy in April 2013? Because apart from that there hasnt been major reform across the whole NHS in the years previous or since
The general incompetence from a very high ministerial level is the main reason.

Because they’ve spent even more than their budgets increased by (in part due to excess demand)?

Edited by sidicks on Monday 11th December 17:48

[JagLover]

pavarotti1980 said:

Now if there hasnt been a cut to funding in real terms why are all of these trusts suddenly scrabbling around for money?

But there hasn't been, the figures are there for you to see.

As pointed out already health spending has grown by 1.3% per annum in real terms since 2009/10.

Hence why it has remained at roughly the same level as a share of GDP.

[jjlynn27]

It's weird to same people drumming the same idiocies every single time NHS thread comes about.
'Real term' is meaningless if it comes with hugely increased demand. It looks like a desperate attempt to perpetuate the usual whine.

As predictable as it is pathetic.

[TooMany2cvs]

jjlynn27 said:

It's weird to same people drumming the same idiocies every single time NHS thread comes about.
'Real term' is meaningless if it comes with hugely increased demand. It looks like a desperate attempt to perpetuate the usual whine.

It's far more meaningful than ignoring inflation.

[98elise]

TooMany2cvs said:

jjlynn27 said:

It's weird to same people drumming the same idiocies every single time NHS thread comes about.
'Real term' is meaningless if it comes with hugely increased demand. It looks like a desperate attempt to perpetuate the usual whine.

It's far more meaningful than ignoring inflation.

Agreed. It at least tells you which way funding is going. It's it's going up 1.3% each year in real terms then their spending power is increasing. If demand is going up by more than 1.3% per year then we're not keeping up with demand.

[anonymous-user]

The NHS Federation publishes some interesting statistics. amongst them are are two that show that net expenditure has grown by 50% over the past decade, whilst in and outpatients, including A and E have grown by about 25%.

I guess some treatments are more expensive than they used to be but there should have been significant gains in efficiency too.

So why the struggle?

[Murph7355]

TooMany2cvs said:

Murph7355 said:

I'm not sure we want to be benchmarking ourselves agains the likes of Slovenia rather than Germany, do we?

Why on earth not?

Because it was only done in the article to demonstrate that we're not below average at all, but above it.

To be fair, I'm inclined to agree with the general position. But if that's the point to be made, why not simply do it against all 195 nations in the world. We're even more "above average" that way

I would imagine most (I do not include myself in this necessarily) want us to be the best in the world where healthcare is concerned. These are the types of people who will proclaim us below average. And will also simply dismiss comparisons against lesser economical powers.

[jjlynn27]

REALIST123 said:

The NHS Federation publishes some interesting statistics. amongst them are are two that show that net expenditure has grown by 50% over the past decade, whilst in and outpatients, including A and E have grown by about 25%.

I guess some treatments are more expensive than they used to be but there should have been significant gains in efficiency too.

So why the struggle?

Because the NHS is really really really wasteful. Everyone who works there is a raging leftie intent on spending as much money as possible.

[Murph7355]

jjlynn27 said:

Because the NHS is really really really wasteful. Everyone who works there is a raging leftie intent on spending as much money as possible.

I don't think it is, as a general view. But that isn't to say waste doesn't exist. In such a large organisation (5th largest in the world?) waste is inevitable, and even if the %age is small, the numbers involved will be eye watering.

It also doesn't take everyone in the organisation to be a "raging leftie". Only strategically placed, typically middle management types.

[Rovinghawk]

jjlynn27 said:

Because the NHS is really really really wasteful. Everyone who works there is a raging leftie intent on spending as much money as possible.

Or some of the staff want the NHS run for their best interests rather than those of the paients/taxpayers.

[oliverjthomas]

Having recently left a healthcare related business after twenty-five years of ownership, I won't even begin to comment in detail on the ineptitude and stupidity within the NHS witnessed on a daily basis. In respect of increases in costs and use of reserves though, I would wager that a huge proportion is as a direct result of the use of agency staff. Some of the figures quoted to me by staffing agencies were, quite frankly, mind boggling; a regular supply of staff to one particular general ward at £65 per hour for example and that is something repeated elsewhere. I think the description is thoroughly unsustainable

[968]

Rovinghawk said:

Or some of the staff want the NHS run for their best interests rather than those of the paients/taxpayers.

Total nonsense.

[Rovinghawk]

968 said:

Rovinghawk said:

Or some of the staff want the NHS run for their best interests rather than those of the paients/taxpayers.

Total nonsense.

So not one single person in the entire NHS puts their self-interest first? Are you absolutely sure of that?

[Crackie]

968 said:

Rovinghawk said:

Or some of the staff want the NHS run for their best interests rather than those of the paients/taxpayers.

Total nonsense.

Total nonsense ?? The Katrina Percy debacle from earlier this year is indefensible imho http://www.bbc.co.uk/news/uk-england-37288843 + http://www.bbc.co.uk/news/uk-england-36922039 . The subsequent use of tax payers money to use Portland Communications ( Alistair Campbell ) to try and spin / hide / disguise Southern healthcare's own incompetence, blatant cronyism and some might say corruption, was an example of the NHS at its very worst. This level of gross incompetence and imho disgusting self interest, damages public confidence in NHS management.

[Du1point8]

I wonder if big data analytics can be used to solve this issue of waste, etc?

We could even use it to crunch figures to predict and prevent health issues.

I guess the only main issue would be how long would it take the NHS to get the data into a structured format that could be useful and ready for batch or real-time feeds.

It could be used to manage all aspects of the trust from an overall level to the smallest stock room, from working out the health trends of a region/hospital to globally.

Hmmm I see an opportunity.

[200Plus Club]

Du1point8 said:

I wonder if big data analytics can be used to solve this issue of waste, etc?

We could even use it to crunch figures to predict and prevent health issues.

I guess the only main issue would be how long would it take the NHS to get the data into a structured format that could be useful and ready for batch or real-time feeds.

It could be used to manage all aspects of the trust from an overall level to the smallest stock room, from working out the health trends of a region/hospital to globally.

Hmmm I see an opportunity.

Just remember one thing. The govt forced all trusts to compete against each other for many years. All went pretty much their own way. Separate supplier systems, seperateteams of managers, different software. It cost billions. It will cost the same again to unravel. Most trusts do not liaise or communicate with others outside their very local area or if not part of the same group. All broadly have the same management job roles and a lot of people in theory "could" be made redundant by cooperation. It won't happen quickly , you are talking 20yrs min before the regional group working takes any major effect.
Set it off in one direction and stop the govt interfering again in 5 yrs time is all it needs really. Competition and NHS trust status is what started a lot of duplication and waste.

[Crackie]

200Plus Club said:

Just remember one thing. The govt forced all trusts to compete against each other for many years. All went pretty much their own way. Separate supplier systems, seperateteams of managers, different software. It cost billions. It will cost the same again to unravel. Most trusts do not liaise or communicate with others outside their very local area or if not part of the same group. All broadly have the same management job roles and a lot of people in theory "could" be made redundant by cooperation. It won't happen quickly , you are talking 20yrs min before the regional group working takes any major effect.
Set it off in one direction and stop the govt interfering again in 5 yrs time is all it needs really. Competition and NHS trust status is what started a lot of duplication and waste.

The duplication of roles and lack of inter trust communication might take 20 years to improve; better start straight away then. It would not be expensive to set up a team to carry out a cost benchmarking exercise between trusts. This benchmarking would look at cost to equivalent services or procurement of equivalent materials; trusts

This data may already be available under freedom of information............if it isn't then it should be imho. Lets get it out in the open and scrutinised. If things are being done well everywhere than the critics will have to back off...........if there are improvements to be made then lets start ASAP. What should be done with the management teams who have been shown to have performed badly ( procurement in particular ) is open to debate.

Edited by Crackie on Thursday 4th January 17:46

[TooMany2cvs]

Murph7355 said:

TooMany2cvs said:

Murph7355 said:

I'm not sure we want to be benchmarking ourselves agains the likes of Slovenia rather than Germany, do we?

Why on earth not?

Because it was only done in the article to demonstrate that we're not below average at all, but above it.

To be fair, I'm inclined to agree with the general position. But if that's the point to be made, why not simply do it against all 195 nations in the world. We're even more "above average" that way

If we go cherry-picking to prove what we want to prove, is that in any way honest? Slovenia is a developed, prosperous, industrialised European country. Why shouldn't it be included as a relevant comparison?

[langtounlad]

Crackie said:

The duplication of roles and lack of inter trust communication might take 20 years to improve; better start straight away then. It would not be expensive to set up a small team to carry out a cost benchmarking exercise between trusts. This benchmarking would look at cost to equivalent services or procure of equivalent materials.

This data may already be available under freedom of information............if it isn't then it should be imho. Lets get it out in the open and scrutinised. If things are being done well everywhere than the critics will have to back off...........if there are improvements to be made then lets start ASAP.

This is in line with my earlier comment re. the role of the media. Nothing will happen just because it's discussed on Pistonheads.
If however the Daily Mail (other large circulation newspapers are available) ran an extended investigation into NHS spending mis-management instead of just acting as a voice for local vested interest budget holders, then the country as a whole might start to demand proper action.

As already mentioned I support the NHS and want it to succeed and not be privatised but I don't want it to be a bottomless money pit and am of the opinion, through personal experience, that vast efficiency improvements can be made.