Amount of private work NHS hospitals can take to rise from 2% to 49%

Graham_Devon

I'm not sure on the pro's or con's of a more privatised health service.

All I do know is that the current system cannot be provided by the funds we contribute. Therefore, something needs to be done. I think the first starting point would be to stop tinkering, as every bit of tinkering costs millions.

But as for changing it, privatised health care is looking an attractive option. It's either that, or whack up taxes. And whacking up taxes is a none starter. So the only option left is looking to make money from the system. To do that, you have to sell the services.....there is no other option. IMHO.

The only problem with these schemes is that any money we do make, will be eaten up mostly by beauracracy and yet more tinkering. It's a viscious cycle, and one which, I believe, will end up destroying the NHS. There is far too much oney being pumped to far too few people who ultimately walk away having done nothing but come up with ways of changing things which then get changed a year later. In all my time working for the NHS, there has never been a period where people just knew what was happening. Everything is always change.

The latest change, where PCT's are replaced has ended up in a complete shambles, costing a fortune, and still no one knows what they are doing. It's not so much the plans that are wrong. It's the political warfare which ultimately destroys everything and ends up costing all of us minions are small fortune in wasted taxes. The Andy Burnham malicious lies are a perfect example of this. PCT's are meant to be gone next year. No chance.

Cleaver

Graham_Devon wrote: »

All I do know is that the current system cannot be provided by the funds we contribute. Therefore, something needs to be done. I think the first starting point would be to stop tinkering, as every bit of tinkering costs millions.

I'm going to play devil's advocate here and ask whether this really is true?

If you look at health spend as a percentage of GDP you'll find that we spend around half of what the US does (and a quarter of their population don't even have access to it), and we still spend less than other European countries like Italy, Spain, France, Greece, Denmark, Germany, Switzerland, Sweden, Belguim, Portugal, Austria, Bosnia and Netherlands. Countries like Congo, Costa Rica, Canada and Jordan spend more than us.

I think there's a very relevant debate around efficiency and quality, as countries like Spain, Canada, Netherlands, USA and Sweden all have areas of healthcare that are light years ahead of ours and we should be learning a lot from them. But in pretty much any study you look at, our healthcare system is well rated. Not the best, but above what you'd expect for what we spend on when you look at all these complex studies. And even when you look at simple metrics around doctors, nurses and beds per x population we always have more than the US, France, Germany, Italy etc. despite spending less of GDP and per capita on healthcare. So again to play devil's advocate, what's so wrong with the overall current system and what we spend on it?

The rest of your post was around tinkering with the system, which I couldn't agree with more. The problem is that the government reforms but they almost don't go far enough. My view would be to either just leave it alone or, if you're going to change it, then make proper, wholesale changes. What we're getting is, as Graham described, 'tinkering'. It won't work but will create a lot of additional work for not a lot of benefit or change.

I think that if you want private companies involved give them a whole hospital to run, not bits of it. See if they can run the whole thing better (I think they could in many cases), not just the easy bits that anyone can run. But obviously this would be poilitical suicide, so instead they 'tinker' and have some absurd hybrid model.

vivatifosi

Interesting post Cleaver, thanks. Here's a question to those of you who work in, or know the NHS well. If you had a blank piece of paper what changes would you make and why?

Graham_Devon

vivatifosi wrote: »

Interesting post Cleaver, thanks. Here's a question to those of you who work in, or know the NHS well. If you had a blank piece of paper what changes would you make and why?

So difficult.

The first thing I would do is bring it right back to basics, and build up from there.

But that would need rather more than 1 piece of paper!

Just learnt this morning that a local hospital is hiring in services to run patient transport. Even a GP said it's crazy. It's one of the most simple things. Few minibuses, few drivers, few routes and a few schedules. Done.

But no. Must hire the services in, which has already caused controversy, as they are now paying the full going rate for transportation services with a company, BUT giving the company the transport, the servicing and the fuel.

Company must be wetting themselves. Don't have to use any of their own assets, but charge the going rate as if they are. Hospital has said "ahh yes, well we have a 5 year contract now".

Pennywise

Considering the amount of resources that aren't being fully used within our hospitals, it makes sense to look for any way of making far more use of them. That's why factories operate 24/7 by using shifts to run virtually non stop - the plant is so expensive, it can't be left idle every night and weekend. Yet, in hospitals, there are vast amounts of equipment, treatment rooms, theatres, etc., that only work 8-4 - that's only a third of the potential usage time! Our village GP surgery only opens five days a week, and even then, it's only half day sessions - there are three surgeries/treatment rooms, a waiting area, reception and office, left idle for 88% of the time! Go to any hospital after 5pm or anytime over the weekend and it's deserted except for the wards - whole areas and wings are completely shut down. For me, any ways of getting more use out of its existing resources must be a good thing. If that means sharing equipment and building space with the private sector, then that's the way forward. If that isn't how people want it to go, then the NHS must make better use of its resources and get away from the 8-4 mentality.

Pennywise

Graham_Devon wrote: »

But no. Must hire the services in, which has already caused controversy, as they are now paying the full going rate for transportation services with a company, BUT giving the company the transport, the servicing and the fuel.

That's the fault of the so-called highly qualified and experienced management who are responsibility for procurement. No real business is going to turn down work because the purchaser is paying over the odds for it. You can't blame the private sector because the public sector employ idiots!

Cleaver

Pennywise wrote: »

Considering the amount of resources that aren't being fully used within our hospitals, it makes sense to look for any way of making far more use of them. That's why factories operate 24/7 by using shifts to run virtually non stop - the plant is so expensive, it can't be left idle every night and weekend. Yet, in hospitals, there are vast amounts of equipment, treatment rooms, theatres, etc., that only work 8-4 - that's only a third of the potential usage time! Our village GP surgery only opens five days a week, and even then, it's only half day sessions - there are three surgeries/treatment rooms, a waiting area, reception and office, left idle for 88% of the time! Go to any hospital after 5pm or anytime over the weekend and it's deserted except for the wards - whole areas and wings are completely shut down. For me, any ways of getting more use out of its existing resources must be a good thing. If that means sharing equipment and building space with the private sector, then that's the way forward. If that isn't how people want it to go, then the NHS must make better use of its resources and get away from the 8-4 mentality.

How come no private hospitals do anything after 5pm either? I think I know the answer, but thought I'd get your view first.

Pennywise

Cleaver wrote: »

How come no private hospitals do anything after 5pm either? I think I know the answer, but thought I'd get your view first.

No idea.

Perhaps they already make enough money to cover the costs of their resources and still make a profit, because of their sky high charges. Perhaps there isn't the demand - they may be able to deal with all their customers within shorter time frames because they have fewer customers due to their prices.

Not sure why it matters though?

You could use the same argument to ask why a Ford factory works 24/7 yet the Bugatti factory works 9-5. Probably same reasons - i.e. Bugatti prices are so high they easily cover the cost of resources on fewer numbers, yet Ford are so cheap they have to use their resources 24/7 to turn a profit.

But whatever the reasons, I'd like to see some profits from those able to pay for private treatment to go into the NHS pot rather than shareholders of private funds to benefit from all the profits of the private patients.

I can't see any reason other than political dogma why the NHS can't benefit more from private patients and offering "add ons" to the NHS services. For example, when we had our DS, we had the option of "upgrading" to a single side room in the maternity ward rather than being in the main rooms - that cost us £10 per night and it was conditional on being moved to the main rooms if another patient needed a side room for medical reasons. To me, that's common sense - NHS got another £50 from me for our week long stay in hospital and we got a bit of peace and privacy - no-one else suffered - after five days, someone else needed the room so they moved us onto the main ward for our last two days. What on earth is the problem with this kind of thing? Why not take it further and offer evening or weekend appointments for a fee, i.e. for workers who would otherwise lose pay or holiday for a daytime appointment? You can take it as far as you want. I'd far rather pay a couple of hundred pounds to the NHS for a bit of flexibility and maybe a bit of extra comfort, than pay £500 to a private hospital.

silvercar

Cleaver wrote: »

How come no private hospitals do anything after 5pm either? I think I know the answer, but thought I'd get your view first.

My local private hospital has consultations every evening and weekends.

Road_Hog

Kennyboy66 wrote: »

Maybe it will work, maybe not, but it seems likely we are heading for an era of vastly increased private health provision or some kind of co- payment system. And to help all this along will be increased waiting times to 'encourage' those who can afford it to go private.

Yep, that's the top and bottom of it, free NHS care has numbered days.