And, that NHS services should only be let out to private providers where there was no cherrypicking of routine cases – leaving the NHS with the cost of emergencies, complexities and post-operative catastrophes as well as training and research.
Haven\’t you ever heard of the division of labour? Specialisation?
What we would actually like is to have a system where the routine stuff was done over here, in as organised, mechanised, industrlaised, manner as possible, and the difficult stuff done over there.
Just as we already do in fact: wart removal is done by the GP, leg removal in an operating theatre with an anaethestist (spolling?), surgeon and team of nurses.
If a team set up to do nothing but hip replacements can crack through 15 a day, then we\’d rather like to have a team specialising in hip replacements rather than a general surgical team turning their hands to it once in a while and getting through 5 when they do.
We actually want to see the whole provision thing more fine grained: people specialising in certain tasks, where the division of labour increases productivity.
Keeping the NHS doing the non-routine stuff, the difficult stuff, is exactly what we do want to happen: getting others to cherry pick the simple stuff is similarly what we actually want to happen.
Blimey, this is actually the way that the entire medical profession is organised anyway, we don\’t get the ENT bloke to do ingrown toenails, the heart surgeon to do the brain surgery nor the schools nurse the leukaemia treatments. What the hell is this \”everyone must do everything\” nonsense?