The NHS Sinkhole

Cash injections versus assessment of alternatives and planning

The font of all knowledge, the Times, announced that the UK Chancellor will pour another £29 billion into a service which is failing the public in a significant way. The billions involved in the latest attempt to plug the National Health Service sinkhole made the two old geezers giddy.

As 'Trust the Evidence,' we should provide evidence to support such drastic statements. For once, we can let the MSM do that; the problem is so crass that even the current crop of journalists can report it. From rock-bottom satisfaction to massive waiting lists, to dwindling beds and crumbling infrastructure, to the steady increase in “senior managers” and the projected spend, elevating the NHS to the status of a European economy bigger than Greece and soon to be bigger than Portugal.

If we consider our Greek friends, then we can assume that each one works for the NHS, given the size of their economy. No money left for government, no police, no armed forces, no workmen, no industry, no tour operators, no farmers, no teachers, no artists, no dockers or air traffic controllers - All work for the NHS. Would you like to go to the cinema in Mykonos and then have a meal? You can’t, as the staff all work for the NHS.

Another bizarre cold war-era fact: the NHS was bigger than the Red Army. Honest guv.

While all this is going on, some NHS bodies are worrying about non-existent problems, such as the Chikungunya vaccine and the avian influenza pandemic - buying dodgy vaccines and wasting mountains of cash on failed technologies. They either know they are failures and so carry on the charade for their flawed reasons, or, like Rhett Butler in Gone with the Wind, they frankly don't give a damn.

This is not what worries us most, though. The funding announcement was made before the unveiling of a ten-year plan by the Secretary of State (SoS) that is just weeks away from its launch. Another one of the many plans that have been rolled out over the years (SoS, plans and reorganisations) with their apparent emphasis on community and prevention.

Winter Plan - will it work this time?

What concerns us is the lack of in-depth, impartial analysis of the problems and the testing of various delivery models. In this vacuum, we retreat to what we have seen in the recent pandemic: 200 policies based on political expedience and devoid of any evidence-based foundation. Followed by “let’s move on it was too awful to talk about. More tea, vicar?”

In a functional world, before spending a penny more, you need an in-depth analysis of a complex phenomenon - the causes of failure of a behemoth. And for economies of scale, you should look at the other complex lighting conductor at the same time: the winter crisis.

From an accurate diagnosis, you can then formulate treatment plans (many, perhaps competing), and then test them against real outcomes, such as life expectancy, patients’ views, and expenditure per capita. Those that are tested and found to work are funded, the other should go in the bin together with the many useless quangos sucking cash from taxpayers.

The NHS is facing a critical challenge: it needs to establish a clear path towards achieving meaningful outcomes, yet it lacks direction. Continuous reorganisations are not supported by evidence and are underpinned by the latest ministerial foibles that require yet more funding to support the next iteration of the plan.

Two angry old geezers wrote this post who do give a damn.

Readings

https://www.wesstreeting.org/news/2024/10/23/launching-the-biggest-consultation-in-nhs-history/

https://www.gov.uk/government/speeches/our-vision-for-a-new-model-of-nhs-care