Walking the walk

May 24, 2010 4:49 PM

Today we heard about the £6billion cuts in spending - and that the Department of Health was spared. Any savings that the department makes can be reinvested. With so much extra money ploughed into such a large organisation over the last few years - £650billion since 2003 - lots has been wasted. Poor productivity in the NHS costs over £20billion according to the King's Fund. The debate about the health budget can be hindered by emotive subject matter; the budget shouldn't be protected from consideration for cuts when there is so much waste.

New Health Secretary Andrew Lansley has also said that he wants an end to
top-down decision making in the NHS. Genuine decentralisation would be welcome but proposals are still light on detail. Top-down bureaucracy means money is wasted, and centralised bargaining means that the biggest item of expenditure - pay - cannot be controlled locally. Any reform must include an end to centralised bargaining; decentralised, clinician led improvement would be so much more effective if this obstacle could be removed. Reform in the long-term needs to be substantial if the NHS is to close its productivity gap and, just like the spending cuts announced earlier, encouraging noises need to be followed up with substantive action.

Today we heard about the £6billion cuts in spending - and that the Department of Health was spared. Any savings that the department makes can be reinvested. With so much extra money ploughed into such a large organisation over the last few years - £650billion since 2003 - lots has been wasted. Poor productivity in the NHS costs over £20billion according to the King's Fund. The debate about the health budget can be hindered by emotive subject matter; the budget shouldn't be protected from consideration for cuts when there is so much waste.

New Health Secretary Andrew Lansley has also said that he wants an end to
top-down decision making in the NHS. Genuine decentralisation would be welcome but proposals are still light on detail. Top-down bureaucracy means money is wasted, and centralised bargaining means that the biggest item of expenditure - pay - cannot be controlled locally. Any reform must include an end to centralised bargaining; decentralised, clinician led improvement would be so much more effective if this obstacle could be removed. Reform in the long-term needs to be substantial if the NHS is to close its productivity gap and, just like the spending cuts announced earlier, encouraging noises need to be followed up with substantive action.

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