A lot remains to be done to cut waste in the NHS

Further spending reduction plans in the NHS have been reported today as NHS England, which needs to find £22bn in efficiency savings by 2020-21, said reorganising local services is essential to improve patient care.

The draft sustainability and transformation plans (STPs) include proposals for ward closures, cuts in bed numbers and changes to A&E and GP care in 44 areas. While the effects of the proposed changes remain to be seen, there is little doubt that the NHS is in serious need of substantial reform to make it affordable in the long-term.

Aside from these, the TPA’s 2015 Spending Plan suggested several measures to cut wasteful spending without jeopardising the general quality of care for patients:

  • Stop the prescription of branded medicines where cheaper generics are suitable, and ensure that prescribers have to actively choose a more expensive alternative and that the practice, not the NHS, pays the premium when there is no medical reason for it.
  • Increase the extent of charges to discourage unnecessary use, including:
    • £10 prescription charge
    • £20 flat-rate GP consultation charge
    • £20 daily “hotel charge for overnight hospital stays
    • £25 fine for missed outpatient hospital appointments
    • Low income groups and those on benefits could be exempt from these charges or be given the right to claim a refund.
    • Raise the efficiency of NHS estates to match the top 25 per cent, and reducing the amount of unused floor space, which is currently equivalent to the space used by nearly 14 trusts.
    • Renegotiate contracts to cut excessive pay for GPs. The general practitioners in the UK are paid 3.4 times the average wage, which is relatively high. For comparison it could be brought down to the Belgian level, which is just 2.3 times the average earnings.

Our research shows that these measures combined would be able to save over £14bn by 2020/21, based on the economic forecasts in 2015.

What this demonstrates is that the funding model for the NHS cannot last in its current form. Higher taxation and more relentless spending will not deliver a better result.

Cutting out wasteful expenditure will be useful in the coming years, but in the long term it would be inevitable for us to adopt a European insurance-based model, if we want a better healthcare system without levying excessive burden on taxpayers.

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