‘Alarmist calls for centrally determined, across-the-board staffing cuts and slash-and-burn retrenchment of hard-won service improvements are well worth ignoring. But the message that the scale of challenge for the NHS (and all public services) is real and will need practical, cash-releasing solutions, needs to be heard by politicians of all stripes. With space and direction, doctors, nurses and managers in the NHS will have to work together with local politicians and communities to find ways to deliver improvements with frozen budgets and rising costs and demand. After 2011 we will enter uncharted territory, whoever is in power and we need to prepare for it now.’ – Joe Farrington-Douglas, senior policy manager at The NHS Confederation
‘The government was right to raise spending on the NHS and to reverse decades of under-investment. In the rush to deal with the deficit, we should not engage in short term salami slicing of health budgets. The real way to save money in the longer term in health is in the areas of prevention and behaviour change: it is far cheaper to help people quit smoking or lose weight than to deal with smoking or obesity related diseases later down the line.’ – Rick Muir, senior research fellow at ippr
‘I think it’s inevitable cuts will have to come in the NHS but they can’t be led by a management consultant’s report. Lord Darzi’s focus on quality and the efficiency that brings is the only agenda to follow. Quality will mean more staff in some areas and fewer in others as treatments and practices develop. Strong management and commissioning are key. If you get the commissioning right, layers of bureaucracy are no longer needed. We’ve got to get tighter; tough choices will have to be made, but they must be clinically-led and locally accountable. Labour started that revolution and we remain the best party to finish it.’ – Sharon Carr-Brown, Labour PPC for Bournemouth West and public governor at the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
‘There is a case for cutting costs, but cutting frontline staff is not a good idea. Over the last seven to eight years Labour’s impetus of cash into the NHS has increased frontline staff in terms of doctors and nurses, but disproportionately of managers. If cuts are necessary it should be in managers as they are the least productive in terms of output.’ – Suresh Pushpananthan, vice-chair of the Fabian Society
‘It’s been less than ten years since Labour took the historic decision to save an NHS that had been starved of funds for decades. The three-fold increase in investment that resulted, whilst generous and utterly transforming to the service, only brings Britain up to the EU average for healthcare spending, and well behind the USA as a percentage of GDP. As with all public services (and indeed business too), there’s never been a more pressing time to cut out inefficiencies (unnecessary operations or lengthy hospital stays). But it would be a fallacy to believe that efficiency savings could lead to drastic reductions in NHS costs. Britain needs and deserves world-class healthcare, something it won’t get on the cheap. Labour’s response to our indebted national finances should be to shelve unpopular projects (such as ID cards) and ask the rich to pay a little more in tax. We should then trust voters to make the right choice. – Neil Goulbourne, GP in Coventry and a vice-chair of the Socialist Health Association
Rick Muir, Senior Research Fellow at ippr is quite right in his piece above, but what he has left out is the wherewithall for bringing about behaviour change. This is a huge challenge but we cannot eskew what needs to be done to achieve this. Some of the greatest leaps forward in health haven’t been via the NHS at all but were via Public Health works i.e. supplying clean drinking water and an effective sewage system. The way to address this modern day equivalent public health problems is via far greater regulation of big business to help speed a reduced demand for the NHS. The NHS is in the same invidious position as the Prison Service in that it has no control over the number of people referred to it and this is the route for a Labour Government to be going down. It puts clear blue water between Labour and the Tories. For a start lay off all the alcohol related health costs to the Drinks industry to include the supermarkets. This would have a self correcting effect on the sale of alcolhol especially when also applied to all alcohol related crime and anti-social behaviour……….and please don’t tell me that binge drinking is down to peoples individual rights and responsibilities. We’re talking about people who binge drink, get violent when they drink, drive when they drink NOT all those who don’t do any of the above. To argue that it should be down to individual responsibility is the same argument I’ve heard over in the US defending the right to own a gun saying guns don’t kill, people do. What a load of codswhallop. Einstein said that you can’t solve a problem with the same kind of thinking that created it in the first place. He was of course right and we need to think much more radically about these issues otherwise we will not be in a position to implement anything after next May. On this basis, technically, Government doesn’t need to be saying how much a unit of alcolhol should cost, notwithstanding a loss of revenue but if we’re healthier we need health care less or if not tie costs to those industries that clearly generate avoidable need, so just as we might not need complex regulations relating to industrial effluent discharging into a river when we can merely insist that all outflows pipes be positioned upstream from intake pipes; job sorted but we’d need robust regulation in the first place to insist on where they’re positioned. We really do need to think and act outside the box; stop tweaking the system which is what the continual pursuit of ever greater efficiency savings amounts to. This is not a sustainable strategy. Sustainablity is not rocket science; its been going on for billions of years, well until we came along that is.
When I came to work from abroad, I have been told and I found so much of waste. The service provided varied from Hospital to hospital. Till 1997, NHS under the Tory was trying to improve the services without high investment. Creating more Managers (including me), taking the doctors and Nurses away from clinical area/direct patient care, to do administration with little benefit. In the past 12 years under Labour the investment, spending on NHS increased without control with some benefit to patient care. Not value for money.
Cut down massive administration cost. Let the Doctors and Nurses return to the direct patient care-what they know best. Stop outside Consultant advisers and Agency staff at massive cost. Give incentives for the hard working Clinicians and Administrators.