The public want NHS reform, not more wasted spending4

Throwing money into the NHS is synonymous with the phrase, “throwing another log on the fire”. Yet what would you expect to pay for top class or quality services, in a fast paced moving environment, where breakthrough drugs and treatments, are not optional, but a requirement, and where high grade, high tech equipment, and the expertise to operate them is at a premium?
Everyone and every party rants and screams about quality of care, yet all still stop to bicker about the cost of such care – sure efficiency can be honed and tweaked here and there, but quality of care and modern drugs and equipment are costly, and ever more expensive.
The NHS should be based on the ability to pay, the ideal – hence, those who cannot afford to pay a premium should still be provided with the same quality of care and same drugs, as those who are “able” to pay a premium. This is where the private sector, company health subsidies and benefits, charitable donations, and private sector investments, can be encouraged to help pay to improve services, and provide essential drugs and equipment. This, coupled with a “high quality” administrative strategy from the dept. of Health, should be the way forward. Instead of the dept. of Health and it’s administration “eating” into the NHS budget.
1. Decentralisation. Why wouldn’t this work? – Because local bodies have neither the expertise, nor the experience to spend monies wisely. This is a fact. If we trusted local health authorities or even local government authorities to manage NHS spending, then all will be lost – literally.
Local bodies do not employ the required quality of managerial and administrative staff to cope with, or have the experience in dealing with, high quality NHS provisioning, employment, and modernisation.
Hospitals are not schools! Where you can manage how many exercise books, how many teachers, and how many pupils you can teach within your budget – it is quite the opposite in fact, no-limitation on patient numbers treated, increasing drugs costs per annum, and ever increasing modernisation costs.
Which is precisely why – all spending should be capped and controlled by a central body, and extravagant building, maintenance, staff, consultation, and equipment purchases should be overseen, and brought in line with a national expenditure that would ensure the equitable and efficient use of funds.
2. Encouraging competition. Why is this not the answer? Because all you do is encourage the degradation of quality of care, in place of pricing and costs. If you want to treat patients with quality drugs and staff – then you have to pay the going rate, not second rate. Running hospitals with accountants, “who know the price of everything and the value of nothing”, is exactly how the NHS has ended up in years of under-spending, (under the tories), and over-spending, (under Labour).
Sure you can open up competition in areas such as modernisation, or even the purchase of goods and services, but you cannot cut corners with patient care, medical staffing or drugs.
Do you want your hospitals clean and free from bugs?…….then you cannot cost cut on cleaning, a proven fact! Which is precisely where local bodies have failed in the past, in utilising second rate cleaning services to cut costs.
3. Getting politicians out of management. Yes, let’s get the hooray Henry’s, and the bickering boneheads out of the way, and that includes all the party leaders for starters. Let’s get the spin doctors out of the way, and let the real doctors get on wiv it!
Yet to provide a national standard quality of care throughout the UK, requires central administration, which is a requirement of the dept. of Health – who need to do their job just that little more efficiently, and a little more proficiently, and stop the wastage of funds before they even get to our hospitals.
Footnote:
The NHS Litigation Authority, a Special Health Authority responsible for handling both clinical and non-clinical negligence cases on behalf of the NHS in England. The NHSLA handles negligence claims on behalf of the NHS under a number of different schemes. In 2006/2007, the NHSLA made payments totalling £613.27 million in respect of all five schemes.
As at 31 March 2007, the NHSLA estimates that it has potential liabilities of £9.23 billion, of which £9.1 billion relate to clinical negligence claims (the remainder being liabilities under PES and LTPS). This figure represents the estimated value of all known claims, together with an actuarial estimate of those incurred but not yet reported (IBNR), which may settle or be withdrawn over future years. These estimates are strongly affected by the “discount rate” set by Government, which was changed on 1 April 2003 from 6% to 3.5% and was changed again on 1 April 2005 from 3.5% to 2.2%.
http://www.nhsla.com/NR/rdonlyres/465D7ABD-239F-4273-A01E-C0CED557453D/0/NHSLAFactsheet2August2007.doc.

I agree that the NHS is a sorry example of something that is long overdue in terms of modernisation. Johnbluk’s response is interesting at best and somewhat naive at worst. He asks why can’t decentralisation work? Well just take a look at the last decade or so, surely there’s the answer. Would the great supremos of the supermarket world work efficiently and deliver effective results if they were run centrally? I think not, so why is the NHS exempt, this I remind you is real people’s lives. In fact I agree on one point dismiss the politcians who have held the NHS to ransom and seem to use and abuse it at will.
Another convenient omission is that of the trade unions strangle hold over the NHS forcing it work as an out dated public sector entity rather than a 21st century service provider. Remember the primary objective is healthcare not political orientation. I doubt the same unions are receptive to anything that requires a hint of change and thus without it things will remain at the same status quo.
If we can’t do something then perhaps we can go abroad and witness how others do it. I find the lack or in cases somplete absence of progress very worrying making the NHS more suspectible to political and greater union influence by the day.
I’m sure you all recall with some warm comfort the backdrop to the carry on doctor films, where things appeared to be in order…. A matron in charge of both herself, her team and the ward. That was evident in their conduct, demeanour, compassion, pride and professionalism. Couple those mannerisms with not a politcian in sight nor union reps and you had a hospital that was operating itself and most importantly within it’s limits. I agree that’s a simple almost romantic interpretation of events but you can surely see where I’m coming from.
Change is never easy and the later you leave the precarious things seem and appear but we have to go through with it. Not to do so what spell disaster as people despair over the lack of medical service provided they most ceratinly won’t be in the mood to hear accusations from politcal parties as to who’s fault it was.