How would we reorganise the NHS?

June 12, 2008 12:52 PM

NhscorridorThe Telegraph ask an important question, how should the NHS be reorganised?


Government plans for new polyclinics are facing furious protests and, despite spending £1 billion, government initiatives have not offered significant increases in choice that might drive improvements in standards for patients.


The problem is that the Government are trying to force what should be a decentralising agenda, greater choice within the NHS, from the centre.  Programmes like the National Programme for IT are a huge imposition on the independence of local health providers who, with so many decisions made by central quangos, have little ability to form their own policies.


Instead, as we set out in the report Wasting Lives: a statistical analysis of NHS performance since 1981 in European context (PDF), the NHS needs to be freed from day to day political control.  The NHS needs more decentralisation, competition and an end to political management.  Other European countries, with more effective healthcare systems, decentralise provision to competing social health insurers who buy services from independent hospitals.  Our report concluded:

"Failing to reform the NHS comprehensively leaves British healthcare without the decentralisation, competition and professional management that it so urgently needs. Confused and unstable policy has managed to combine the worst of both worlds through constant transitions but little lasting reform.


The poor performance of British healthcare is not preordained. It is not a price we pay for ensuring that everyone gets the treatment they need, given that the other European countries this study has examined all look after the unfortunate. Equally, our healthcare system has proved unable to make effective use of large amounts of additional resources so this is not a problem that will go away with more money. Gordon Brown has proved that.


Politicians should stop trying to do the impossible and focus on their proper role of setting high-level policy. Professionals working in the health service can enjoy greater autonomy which will make for more satisfying and possibly even less stressful careers. Patients can live longer and healthier lives. All it requires is that we learn important lessons from how other countries organise the provision of healthcare."

NhscorridorThe Telegraph ask an important question, how should the NHS be reorganised?


Government plans for new polyclinics are facing furious protests and, despite spending £1 billion, government initiatives have not offered significant increases in choice that might drive improvements in standards for patients.


The problem is that the Government are trying to force what should be a decentralising agenda, greater choice within the NHS, from the centre.  Programmes like the National Programme for IT are a huge imposition on the independence of local health providers who, with so many decisions made by central quangos, have little ability to form their own policies.


Instead, as we set out in the report Wasting Lives: a statistical analysis of NHS performance since 1981 in European context (PDF), the NHS needs to be freed from day to day political control.  The NHS needs more decentralisation, competition and an end to political management.  Other European countries, with more effective healthcare systems, decentralise provision to competing social health insurers who buy services from independent hospitals.  Our report concluded:

"Failing to reform the NHS comprehensively leaves British healthcare without the decentralisation, competition and professional management that it so urgently needs. Confused and unstable policy has managed to combine the worst of both worlds through constant transitions but little lasting reform.


The poor performance of British healthcare is not preordained. It is not a price we pay for ensuring that everyone gets the treatment they need, given that the other European countries this study has examined all look after the unfortunate. Equally, our healthcare system has proved unable to make effective use of large amounts of additional resources so this is not a problem that will go away with more money. Gordon Brown has proved that.


Politicians should stop trying to do the impossible and focus on their proper role of setting high-level policy. Professionals working in the health service can enjoy greater autonomy which will make for more satisfying and possibly even less stressful careers. Patients can live longer and healthier lives. All it requires is that we learn important lessons from how other countries organise the provision of healthcare."

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