NHS in a capitalist economy...

lostinrates

grizzly1911 wrote: »

Thanks for the insight.



I do think we live in a society where all demands are expected to be delivered instantaneously - not just healthcare but many services and products. By actually handing over our own money we think this gives us the power to demand it even when it isn't actually possible to deliver on the demand.

This is true too.

However, its the case that somethings. do seem possible under other healthcare systems (inc private).

Generali

resilie wrote: »

Go with flat coke...
The NHS is a beast and there are huge opportunities to improve, streamline and make it more efficient..... completely agree with this.... but we must also recognise that it has done an enormous amount of good and private doesn't always mean better value or service (I'm thinking G4S during the olympics) running the whole health service privately (warts and all- by that I mean emergencies, acute medical admissions, not just cherry picked outpatient appointments and elective surgery) would almost certainly be more expensive than it is now or lead to worse service (case in point privately run out of hours GP services- massively expensive and really not working very well)

Here you hit the problem on the head. The NHS is far too big ever to work.

A large part of my job is to save money and hassle as well as improving the experience customers have with us. The only way to do that is to understand a process from end-to-end and understand what all of the outputs are used for. There is no way I could do that in the NHS.

Any rationalizations in the NHS would almost certainly cause unintended costs elsewhere with entirely unpredictable results.

ILW

If you think the vast majority of NHS workers primary motive for being there is "to give care" you are mistaken. For most it is a job and nothing more.

resilie

ILW wrote: »

If you think the vast majority of NHS workers primary motive for being there is "to give care" you are mistaken. For most it is a job and nothing more.

And what do you base this statement on?

wotsthat

grizzly1911 wrote: »

I do think we live in a society where all demands are expected to be delivered instantaneously - not just healthcare but many services and products. By actually handing over our own money we think this gives us the power to demand it even when it isn't actually possible to deliver on the demand.

Poor businesses always blame the customers.

People are more likely to die having an operation on a Friday - because the NHS either can't manage staff rotas, haven't realised that there are seven days in a week or maybe they're happy with the trade off.

The failings of the NHS, and there are plenty, aren't due to unrealistic demand or lack of technical expertise. They're just basic things that other businesses deal with everyday.

ILW

resilie wrote: »

And what do you base this statement on?

A number of people I know who work for the NHS.

grizzly1911

Generali wrote: »

A large part of my job is to save money and hassle as well as improving the experience customers have with us. The only way to do that is to understand a process from end-to-end and understand what all of the outputs are used for. .

You also need to understand the requirements and the demand.

In your business do you have a greater degree of control over both of those inputs? How broad are those requirements in range?

Whilst you say you improve customer experience is that strictly true or do you manage their expectations. Delivering change that is really a benefit for of the business but sold as an improvement for the customer, whether it is or isn't ? Do you "price" your customers into more successful outcomes for the business?

resilie

ILW wrote: »

A number of people I know who work for the NHS.

Hearsay then... to base a sweeping statement like that on a few ppl you know for an organisation that employs hundreds of thousands is nothing other than hearsay...... there will be all kinds working for such a big employer and maybean admin person will have a different attidude to a palliative care nurse butin general real frontline staff do not have this attitude

ILW

resilie wrote: »

Hearsay then... to base a sweeping statement like that on a few ppl you know for an organisation that employs hundreds of thousands is nothing other than hearsay...... there will be all kinds working for such a big employer and maybean admin person will have a different attidude to a palliative care nurse butin general real frontline staff do not have this attitude

I said the majority of people working for the NHS. The majority are not frontline clinical staff.

grizzly1911

wotsthat wrote: »

Poor businesses always blame the customers.

People are more likely to die having an operation on a Friday - because the NHS either can't manage staff rotas, haven't realised that there are seven days in a week or maybe they're happy with the trade off.

The failings of the NHS, and there are plenty, aren't due to unrealistic demand or lack of technical expertise. They're just basic things that other businesses deal with everyday.

We are not alone it appears.

Even successful health systems have similar issues.

Most previous work has focused on acute admissions. A study looking at Veteran Affairs’ hospitals in the United State found an increased 30 day mortality (deaths in hospital and after discharge) after non-emergency surgery on Fridays versus early weekdays in patients admitted to regular hospital wards (that is, excluding intensive care units).7 A recent Australian study reported that after hours and weekend admissions to intensive care units are associated with increased hospital mortality, with the results attributed mainly to patients with planned admissions after elective surgery.8

http://www.bmj.com/content/346/bmj.f2424

I agree that constant reorganisation and being used as apolitical pinball does lead to less efficiency.