ALL POLITICAL PARTIES SAY THAT THE NHS IS COSTING TO MUCH! Listening to the pathetic debates surrounding the NHS on television that do not address the core problems amazes me. The simple fact is that the NHS cost what it cost at any point in time. So the first question must be How do we find the money to fund the NHS as it is NOW. Consider the billions of pounds that are being lost in tax revenue through the super rich and their international corporations not paying their fair share of taxes. Consider the billions of pounds that corrupt politicians are paying in Aid money to equally corrupt dictators in India, Africa, the middle and far east. Consider the tens of billions of pounds cost of entering into unlawful wars in Iraq, Lebanon, Libya, Syria and Afghanistan. Consider the millions of pounds a year wasted by MPs fiddling their expense accounts on a daily basis. Consider the millions of pounds spent each year by MPs travelling around the world on so called government work that can only be really described as holidays at the tax payers expense. Simply put, the aggregated sum of all of these unlawful waste of British tax payers money could fund the NHS for decades to come. Once you have solved these problems first there is more than enough money to more than fund and indeed expand our NHS. After solving these financing problems we need to look deeply at the financial management issues surrounding the NHS. Here, the biggest problem for the NHS is caused by party politicians. The five yearly seesaw effect. One party believes in centralisation (brings the NHS under public control) of all the services anther party comes into power and believes in decentralisation (creates quango and private company control of services). Each time they go through that process it cost the tax payers billions of pounds. What is needed is for a government to spend one term of office simply gathering the worlds leading experts and planners to look into the NHS initially from a totally holistic systemic perspective. Their fist task should be to define exactly what the NHS aims to achieve. This means, what is within the remit of the NHS and more importantly from a cost perspective what is outside of that remit. The next step would be to proceed down one sample of each branch of the NHS from the highest level down to the local level and produce a series of strategic plans designed to achieve the objectives above. Doing this would produce a highly sophisticated template model for each branch. Once you have this high level template e.g for a hospital, you simply replicate it time and time again until all hospitals in the system are run on an equally efficient and effective basis. Lets face it, hospitals and other branches of the NHS are no different to any other manufacturing environment. In the NHS environment the term goods is replaced by the word patients. You have goods inwards, a series of operations and procedures and finally goods outwards (patients who are cured). During production sequence you have both rework (patients having complications) and scrap (patients who die). The efficiency of the NHS just like in manufacturing should be based on throughput. That is how efficiently you pass goods or in this case patients along the production line and get them out the door at the other end of the process. Obviously, in the NHS just like in manufacturing you have bottlenecks that constrain the flow of goods (patients) from goods inwards to goods outwards. Its the job of the management team to identify these constraints and clear the way for doctors and nurses to do their jobs and increase throughput. The benefits of Centralisation is obvious, economies of scale especially in buying in goods and services significantly cut cost and provides flexibility throughout the system. Decentralisation always means duplication of effort especially for non-productive staff like management and administrators and competition for resources which become inflexible. An example of the problems associated with a centralised and decentralised system is, if you are a doctor or nurse working in a centralised NHS you can be transferred at short notice to any hospital in the country that needs your skills with minimal wasted time and paperwork or effort. If you have a decentralised NHS system run by trust you cannot do this. If you do need to transfer human resources or machinery between hospitals that belong to different trust, you have to cancel the contract with one trust and form a new contract with another. When it comes to non human recourses the process of buying and selling comes into play. This bureaucracy significantly waste time, paperwork and cost to the overall system. It’s the bureaucracy and outdated, outmoded thinking that is the major problem with the NHS that raises the cost of running the system. The fact is, self serving party political MPs are simply not qualified to do this sort of job as outlined above.
Posted on: Sun, 26 Oct 2014 19:46:03 +0000
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