Our National Debt

MyOnlyPost

steampowered wrote: »

I think you've fallen into the trap of believing that it is very easy to make big savings. It isn't. The easy savings have already been made. Saving meaningful amounts means a painful reduction in services.

I disagree Yes easy big savings have already been made but like british cycling small cumulative savings could lead to big results, you just have to find them.

Regarding non prescribing of Paracetamol my local HA claims to have saved £1m in 1 year. You may say that is a drop in the ocean but that could mean 40 fewer redundancies, saving benefits and no loss on tax revenues so savings can be compounded.

One of my personal bugbears is my local council spending money on non essentials such as flowers in barrels or Christmas lights. The neighbouring LA uses sponsorship from local firms to cover these costs.

A_Medium_Size_Jock

steampowered wrote: »

The NHS has been "reformed" several times in the past few decades. Each time a pointless waste of taxpayer money.

How much money are you really going to save by stopping prescriptions for paracetamol and gender reassignment surgery? Not enough to make a significant difference.

Let me run some figures for you. The NHS spent £87m on paracetamol prescriptions last year. The NHS budget last year was £116.4 billion. In other words, 0.07% of the budget.

I think you've fallen into the trap of believing that it is very easy to make big savings. It isn't. The easy savings have already been made. Saving meaningful amounts means a painful reduction in services.

It has not been "reformed" - it has been tinkered-with.
I said "radical reform".
Your apparently-blinkered perception disregards the magitude of savings possible; if you think that major savings are not possible you really are sorely mistaken.

I provided only two examples.
There are many.
Each of which may provide savings, ranging from small (like Paracetamol) to huge (like restructuring of what procedures are free).
There is a very old saying: "look after the pennies...." ; well the sad fact is that the NHS has been too lavish and too all-encompassing for far too long.

MyOnlyPost

I also think there needs to be a better public awareness of cost benefit anlysis to the taxpayer within the confines of NHS priorities. Is it worth paying £90k to giive someone 6 months extra at the end of life? Most would probably say no until it was a family member and then the emotional decision is "whatever it takes." Whereas weight loss surgery, help stopping smoking or drinking for someone under 60 (certainly if under 50) is likely to have a net benefit to the NHS by preventing future costs

steampowered

MyOnlyPost wrote: »

I disagree Yes easy big savings have already been made but like british cycling small cumulative savings could lead to big results, you just have to find them

I just think this is not realistic. British Cycling? These are all things which eat away at a tiny chunk of the budgets here.

A_Medium_Size_Jock wrote: »

It has not been "reformed" - it has been tinkered-with.
I said "radical reform".
Your apparently-blinkered perception disregards the magitude of savings possible; if you think that major savings are not possible you really are sorely mistaken.

I provided only two examples.
There are many.
Each of which may provide savings, ranging from small (like Paracetamol) to huge (like restructuring of what procedures are free).
There is a very old saying: "look after the pennies...." ; well the sad fact is that the NHS has been too lavish and too all-encompassing for far too long.

Yes, you've provided two examples which between them would probably save the NHS perhaps 0.1% of its overall budget.

On what basis do you think a "fundamental restructuring" would achieve massive savings?

What would this "fundamental restructuring" involve and how would it save money?

I just don't understand why you (and others) think there are massive savings to be made in the NHS, given that the UK already spends significantly less than most other developed countries on healthcare. I'm happy to be proven wrong but this suggests to me that the NHS is relatively efficient.

Thrugelmir

steampowered wrote: »

Let me run some figures for you. The NHS spent £87m on paracetamol prescriptions last year. The NHS budget last year was £116.4 billion. In other words, 0.07% of the budget.

What's the profit margin for the drug companies?

Better to employ a few more front line medical staff in A&E departments than line their pockets.

MyOnlyPost

The NHS budget is so massive that anything you save from it is going to be a relatively small percentage. Look at the raw numbers, stopping prescribing 1 drug which can be bought for pennies saves £87m. If you can identify 11 savings @ 0.07% then you are close to £1bn saved. Do the same with education, pensions, benefits etc etc. and the actual money saved can be substantial.

You questioned British Cycling and I wasn't sure if that meant relevance? Or I don't understand? Apologies if that wasn't the case but:

British Cycling has dominated the last 3 Olympics and their philosophy is improvement by marginal gains. By improving everything by 1% Britain went from also rans to world beaters. The same can be said for finances but with such massive figures in play just making everything 0.1% better is a huge saving

http://www.bbc.co.uk/news/magazine-34247629

steampowered

MyOnlyPost wrote: »

The NHS budget is so massive that anything you save from it is going to be a relatively small percentage. Look at the raw numbers, stopping prescribing 1 drug which can be bought for pennies saves £87m. If you can identify 11 savings @ 0.07% then you are close to £1bn saved. Do the same with education, pensions, benefits etc etc. and the actual money saved can be substantial.

OK, let's assume you manage to save £1bn a year from health, education, pensions and transport.

You've now reduced the government's annual spending from £762bn to £757bn. And you've reduced the annual deficit from £70bn to £65bn.

Of course I agree with saving money. But I think it is misleading for people to start talking about "harmless" savings in the same sentence as deficit reduction. It fools people into thinking that the deficit can be eliminated, or NHS spending slashed, without making hard choices and without a significant reduction in services.

Thrugelmir

steampowered wrote: »

Of course I agree with saving money. But I think it is misleading for people to start talking about "harmless" savings in the same sentence as deficit reduction. It fools people into thinking that the deficit can be but, or NHS spending slashed, without making hard choices and without a significant reduction in services.

Maybe so. However to Corporate and Private entities the Public Sector is grossly inefficient and unproductive in the manner in which it manages it's finances. The drive to save money has to be undertaken concurrently on a number of fronts. Procurement being one aspect.

steampowered

Thrugelmir wrote: »

Maybe so. However to Corporate and Private entities the Public Sector is grossly inefficient and unproductive in the manner in which it manages it's finances. The drive to save money has to be undertaken concurrently on a number of fronts. Procurement being one aspect.

Is that actually true though?

I've been working with large private and public sector organisations on major projects for a number of years now, both on the procurement and provision side. The waste in large private sector organisations is unbelievable. Public sector organisations have it as well but not nearly as much (and the public sector certainly negotiates our fees harder than the private sector).

Of course that is purely anecdotal. In terms of hard evidence, the Commonwealth Fund found that the NHS was the most efficient health serviced out of the countries studied - which like most countries have a much greater proportion of their healthcare run by private providers than we do.

Similarly, you will get a much higher number of people on £100k+ salaries and highly paid managers in the private sector than you will in the public.

I do worry that we may, once again, be in a fantasy land of believing there are significant easy savings to be made by simply eliminating waste (which by the way most of the public sector has been trying extremely hard to do since the 2007 spending review - which at the time was perceived as being quite a tough settlement).

I'd be delighted if someone is able to correct me, but right now I see no evidence that there there are potential savings out there capable of making a meaningful dent in the deficit without a significant reduction in jobs and services.

Filo25

steampowered wrote: »

Is that actually true though?

I've been working with large private and public sector organisations on major projects for a number of years now, both on the procurement and provision side. The waste in large private sector organisations is unbelievable. Public sector organisations have it as well but not nearly as much (and the public sector certainly negotiates our fees harder than the private sector).

Of course that is purely anecdotal. In terms of hard evidence, the Commonwealth Fund found that the NHS was the most efficient health serviced out of the countries studied - which like most countries have a much greater proportion of their healthcare run by private providers than we do.

Similarly, you will get a much higher number of people on £100k+ salaries and highly paid managers in the private sector than you will in the public.

I do worry that we may, once again, be in a fantasy land of believing there are significant easy savings to be made by simply eliminating waste (which by the way most of the public sector has been trying extremely hard to do since the 2007 spending review - which at the time was perceived as being quite a tough settlement).

I'd be delighted if someone is able to correct me, but right now I see no evidence that there there are potential savings out there capable of making a meaningful dent in the deficit without a significant reduction in jobs and services.

I tend to agree, there are undoubtedly savings to be found, there always are, but I suspect looking for massive savings is likely to lead to disappointment all round, its a predictable mantra of those on the right politically that efficiency savings will be the answer to any awkward questions on public spending/services. In much the same way as the Left love to plug holes in public finances with questionable numbers for closing tax loopholes and tackling evasion and avoidance.

The underlying issue remains that with an aging population, the demands on the health service will continue to rise significantly, leading to significant further funding being required each year.

As you said, previously, we do not actually spend massive amounts on healthcare as a proportion of GDP compared to many other comparable economies.