Proper competition would help here

Minimum waiting times?

Health service trusts are “imposing pain and inconvenience” by making patients wait longer than necessary, in some cases as long as four months, the study found.

Executives believe the delays mean some people will remove themselves from lists “either by dying or by paying for their own treatment” claims the report, by an independent watchdog that advises the NHS.

…..

Under government targets, patients should be treated within 18 weeks of referral by a GP. But even when surgeons could see them far sooner, the study found that some trusts made hospitals wait as long as 15 weeks before operating. The tactic forced private hospitals, which were more likely to be able to treat patients quickly, to operate as slowly as overcrowded NHS units in an “unfortunate levelling down”.

True competition among providers would of course solve this very problem.

If people are gagging for the revenue they can get from treating someone then that someone\’s going to get treated rather faster than if the organisation paying for it has an opportunity and desire to delay treatment.

You know, competition\’s good?

6 thoughts on “Proper competition would help here”

  1. But it’s simple

    NHS Minolith – Good
    Anything else – Evil baby eating capitalism.

    You can’t win an argument by deploying logic against one of the lefts faith based tenets.

  2. I don’t know that this follows. The issue here is the fact that each NHS patient has a single payer responsible for their treatment: the PCT. So if the PCT wants to save money, then they just delay everyone’s treatment a bit. Fewer operations per year works out as lower spending.

    Competition would increase capacity, which results in more operations being done. And if the competition does not include a price element, then the competition does not help the PCT’s cashflow problem. It may even make it worse.

    We don’t just need competition among providers but among funders, and not just on quality but also on price.

  3. @Philip Walker – The only problem with your proposal is that it’s contradicted by all the available evidence. Even the recent report cited approvingly by Mr Wortstall on 27 July notes that “research for the UK…shows that when competition was introduced in the 1990s in a regime which allowed hospitals to negotiate prices as well as quality there was a fall in clinical quality in the more competitive areas”.

    This is a pressing problem for the United States, which of course does allow full price competition between healthcare providers, but where the costs of prescription drugs and diagnostic imaging, for example, are the highest in the world and where the highest world spend on healthcare does not result in better outcomes on many important health measures.

  4. Churm: No, I know about the evidence. That wasn’t, though, what I was talking about. I was ignoring the question of quality, and was instead referring to the fact that PCTs are trying to save money by doing fewer operations. Tim wrote,

    “If people are gagging for the revenue they can get from treating someone then that someone’s going to get treated rather faster than if the organisation paying for it has an opportunity and desire to delay treatment.”

    This is fine if the PCT is willing to fund those operations. But we already know that PCTs aren’t always willing to do so, hence the slowdown.

    We therefore need to encourage PCTs to fund more operations. Assuming the continued existence of PCTs and in the absence of more resources, it is a simple point of arithmetic that the only way to do this is for the price per operation to come down.

  5. This is nothing to do with competition between potential health-care providers but entirely to the power of bureaucrats in an unanswerable bureaucracy. If the budget doesn’t balance do you (i) cut bonuses (ii) reduce unnecessary spending (iii) reduce staff pay and/or numbers or (iv) choose not to do the job you are supposed to do because there are non-staff costs involved. The NHS chooses (iv)!
    This example actually puts some investment bankers in a good light. If stockbrokers have a bad year they cut staff bonuses first, then staff numbers, then either pay staff in shares instead of cash or cut staff pay or raise more money (one small broker raised a significant amount of additional capital to ensure that it met the FSA’s capital adequacy requirement from its employees), but none of them stopped providing the service to their customers to save money.
    Meanwhile the public sector (not just the NHS) is paying obscene salaries to its CEOs while cutting back on services and needed front-line staff (although I have told of one case where the local authority is recruiting additional staff for a team that is already marginally overstaffed).

  6. “If people are gagging for the revenue they can get from treating someone then that someone’s going to get treated rather faster than if the organisation paying for it has an opportunity and desire to delay treatment”

    Och, come on Tim!

    How will be they in the position to be gagging for resources? By being starved of them from the public purse? This is primitively Benthamite, a return to the thinking that gave us the Poor Law (Amendment) Act 1834. It’s the 21st Century, for goodness’ sake.

Leave a Reply

Your email address will not be published. Required fields are marked *