Well, yes, except

I campaigned long and hard against the Coalition’s reform of the NHS. An academic study concluded I was the fourth most effective on line campaigner against those changes. And, I would stress, my efforts were not political, they were economically logical.

Great Ritchie. You were the fourth blogger on the subject I suppose.

In other words everything I predicted has come to pass.

That is, NHS England is not as efficient as we would wish. OK, go along with that.

That’s hardly surprising, and nor does it suggest enormous ability on my part. I only had to look at the disastrous economics of US healthcare to make such a prediction. There twice as much of GDP is spent on health than in the UK for arguably worse health outcomes and all because of the massive inefficiency of private sector involvement.

So what is the answer? Glaringly obviously all health and social care services, including GP services that need to be state run, need to be integrated in single health authorities in the future. These would be local but big, so in my patch Norfolk, Suffolk, Essex and Cambridgeshire are an obvious fit, and so on. And in these areas the absurdity of contracting has to be replaced with an emphasis on holistic care, supported by the monitoring of key clinical performance indicators.

Well, yes, except we know that NHS Wales and NHS Scotalnd are run along those lines. And we also know that they are less efficient than NHS England. Which is a bit of a problem for your desire for Stalinist management techniques….

13 thoughts on “Well, yes, except”

  1. As I recall his wife is a GP. She wants to change employers so as to be employed by the NHS or other state body?
    Funny really how few people complain about the privately employed GPs. They complain about not being able to get an appointment, thats a resource issue not a private/state issue however.

  2. Bloke in North Dorset

    I despair when it comes to health debates in this country. Any mention of the subject by anyone outside accredited lefty circles is immediately dismissed as wanting to introduce the US system. A visitor from mars wouldn’t think that other countries also had health care systems that managed to look after their populace.

  3. I despair when it comes to health debates in this country. Any mention of the subject by anyone outside accredited lefty circles is immediately dismissed as wanting to introduce the US system.

    I have noticed that too. It’s up there with house prices, the BBC, and the right to a “garden” which together act as an almighty millstone around the national neck but, like the possible demise of the Thai king, cannot be rationally discussed. Even otherwise normal, sensible people go off on a tizzy when you mention any one of them.

  4. “An academic study concluded I was the fourth most effective on line campaigner against those changes.”

    Which changes? The ones that the coalition have actually put in place?

    So he’s claiming to be the fourth most effective campaigner, in a campaign which did not succeed?

    As you like to say Ritchie, we’ll judge by results.

  5. “Any mention of the subject by anyone outside accredited lefty circles is immediately dismissed as wanting to introduce the US system”

    Because the true intentions of the Left regarding the NHS have nothing to do with obtaining the best outcomes for the healthcare consumer in the UK. They are primarily about defending the status quo of the 1.3m employees of the NHS, most of whom are trade unionised, and vote Left. Thus any suggestions that things may be arranged better in other countries must immediately be met with the counter that one is suggesting the worst possible alternative to State monopoly care, because they realise that reform of the NHS towards a Continental model would mean exposing those employees to more patient choice and the necessity to behave more like a private sector service provider than a State run ‘take it or leave it’ monopoly. And once State owned and run bodies are exposed to private sector forces, they tend to become less unionised, and the individual employees become less inclined to vote Left as they can see who pays their wages.

    It happened in all the former nationalised industries, and the Left can ill afford to lose another large chunk of its State funded electorate. It must therefore defend the NHS at all costs, regardless of the needs of the actual patients.

  6. Jim – Exactly.

    And more and more money will be poured in, and the NHS will continually get more inefficient, until we run out of money.

  7. @ Flubber
    “until we run out of money.”
    As you can see from Mr Tsipras’ demands for €279bn (yes, billion) from his biggest creditor, running out of money doesn’t stop the hard left from funding theirunion cronies and making outrageous demands to everyone else.

  8. If you read the report it has nothing to do with ownership or reorganisations:
    http://www.health.org.uk/public/cms/75/76/313/5625/HospitalFinancesAndProductivity.pdf?realName=45NRBM.pdf

    “The biggest driver of rising operating costs is staff costs, which account for around two-thirds of NHS providers’ operating costs. The number of permanent staff employed by the NHS rose by 2.3% in 2013/14, with the biggest increases in nursing staff, especially nurses in acute care settings and those working with older people. The rise in temporary staff was even greater (15.8%), resulting in spending on emporary staff growing by £1bn (27.4%) in 2013/14. Data for the third quarter of 2014/15 suggest that the pressure from spiralling temporary staff costs is continuing, with spending on agency staff alone rising by a further 30% for foundation trusts and 25% for NHS trusts.”

  9. Tim Newman,

    I think the attitude to the BBC is changing due to the fact that we’re getting so much more US TV and realising that their stuff is so much better. The BBC mostly excels at garbage like Bake Off and Strictly today.

  10. “nor does it suggest enormous ability on my part.”

    Well, it couldn’t really, could it? Not without giggling.

  11. Bloke in North Dorset

    A question for those wh have the stomach to visit his blog*, I don’t suppose he provides a link to that academic study? I’m guessing it’s one of those circular links that eventually leads back to something he has written.

    *I’m on a no alcohol day and I need a bottle of wine before I can stomach going there.

  12. “There twice as much of GDP is spent on health than in the UK for arguably worse health outcomes. . . “

    He likes to keep saying that our health outcomes are ‘arguably worse’. I’d like to know what he means by that.

    Because, from the numbers, our health outcomes are a fair sight *better* that NHS’. Maybe not on a per-dollar-spent measurement, but certainly on an overall measure.

    Especially when you take in to consideration that our base lifestyle is a fair bit more unhealthy than yours.

  13. Bloke in Costa RIca

    Anyone who holds up the US healthcare system as an example of private sector involvement has essentially ruled their contribution to the debate out of reasonable consideration. There’s no reforming it short of the “take off and nuke it from orbit” route and those that think the NHS is a victim of producer capture and thus hard to change should take a look at how completely the vested interests have carved up the US system. A necessary but not sufficient first step would be tort reform and while you have lawyers comprising 2/3 of Congress that is not going to happen.

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