Over £650 billion has been spent on the NHS in the last 7 years. For that sort of money, we should have an unrivalled healthcare system. But we don't. A lot of the money is wasted, the result of which is poor productivity. This is expensive: the King's Fund estimate the productivity gap in the NHS amounts to £21 billion. Frivolous cases of waste contribute to this: the Is Hitler Cool? survey in the West Midlands and the Burger Boy
effigy in Barnsley spring to mind. Ridiculous, sure, but the skewed priorities that underpin these stories are deeply troubling.
Structural and procedural problems can slow things down too, costing money. In Nottingham, a manager at Queen's Medical Centre has been suspended on full pay for 5 years pending an investigation into a case of alleged gross misconduct. In this time the manager has managed to rake in £315,000 in salary. The manager is now retiring 'in the interests of efficiency', and Nottingham University Hospitals NHS Trust - who have taken over the running of QMC - will have to pay out even more more to end the contract.
These cases are all too common in the public sector; disciplinary procedures must be started as quickly as practically possible in the interests of the organisation, the people involved in the case and of course the taxpayer. In this particular case, there was a two year gap where no investigation was happening at all. And all the while money dripped out of the Trust's coffers. These cases show that simply upping investment or ring-fencing spending does not address the deep-rooted problems in the NHS.
The layers of bureaucracy in the NHS have clearly hindered quick and decisive decision making in this case, and do so in many, many others. The independence that local Trusts have is notional in reality: they still must adhere to centrally set targets, which clearly places a heavy burden on their day-to-day operation. Patients and taxpayers are the only losers as a result. Less monopolistic, decentralised, clinician-led healthcare will free Trusts from the bureaucracy that hinders them. Our paper Wasting Lives sets out a robust case for how vital this is.