Tuesday, October 11, 2016

The Inefficient NHS

We are told that the NHS is inefficient, and that the best way of improving efficiency is to break it up and privatise the profitable parts.
Let's think about that.

We have what is by some metrics the best health system in the world- debatable perhaps, but there can be no reasonable doubt that it is up there with the best. In terms of spending, both as a proportion of GDP and per capita cost it is one of the cheapest in the developed world.

Surely that makes it very efficient?

Of course it's not perfect, and of course there are inefficiencies. Nobody can reasonably claim otherwise. However, the idea that it can be made more efficient by selling parts of it to private corporations is ludicrous. That is the USAian model, which has created the most expensive and crassly exploitative system in the world, and which drives tens of thousands of families to bankruptcy each year. That is the model our political masters want to push on us. But of course, they have no real interest in efficiency- unless that is measured by the ability of corporations to make money from our illnesses.

Here's an idea: why not increase public spending on health to the same levels as France, Germany or the Nordic countries. After all, we are constantly being told how rich we are, and how our economy is the fifth biggest in the world. Use that extra money to improve and integrate health and social care, to support the training of medical professionals rather than relying on those trained elsewhere. Look at what we do well, and build on that rather than selling the best parts to the bidder with the closest ties to some cabinet minister.

I have had treatment recently at Queen’s Medical Centre in Nottingham. It is a large NHS hospital, one of the best in the country. I needed an MRI, which was carried out in an NHS facility - a scanner housed in what is little more than a portakabin tacked onto the main body of the hospital. Treatment was carried out in a very fancy, and to my architect’s eye clearly rather expensive private facility within the larger hospital complex.

The main difference between the NHS and the private facility is that the receptionists in the private facility wear more makeup, and that they are a bit less efficient in communicating with patients than the NHS.

What bugs me is that the money to build that fancy building comes from the NHS budget, and will in the long term be clawed back - no doubt under some preferential deal which gives it priority over other spending to make sure that the profits of the healthcare company are preserved.

That privatisation make things more efficient may be political dogma, but it is a myth. As numerous instances have shown us, in many cases it makes things more expensive and less efficient. Just look at our rail services.

It is a tactic employed by politicians and pushed on them by a handful of wealthy and greedy individuals to starve public institutions of funding so that they perform badly, then claim that the only solution to this inefficiency is to sell them off. History shows us that the level of public spending ends up being significantly higher than it was before privatisation. It makes the billionaires richer, but at the expense of the rest of us poor mortals who pay the taxes which support it.

 Given the shenanigans surrounding the appointment of Teresa May as prime minister - and I can only wonder who was pulling the strings behind that “efficient” change of leadership - and the attacks on civil society which are being promoted by her government I worry about the future of our county.

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