I think this is such a useful exercise. Lot's of people shouting that too much money is spent on anything but patient care, and this exercise will hopefully help us understand the system.
It would be good to explore how much admin is actually needed for such an organisation. Are there business equivalents that can be used in terms of % of turnover used for admin and necessary support?
4.8 billion? Health education? Would this be pt education or staff education. In my 27 yrs as a pt, I never had “health” education. Today, we cannot even get an appt to see a gp. My “annual” visit to discuss my medications (for rheumatoid arthritis and hypertension) never take place in person, nor annually. This year I will have a five minute phone consultation….but not for at least another month. The nhs system is so broken, I honestly see no way back. How did it get this bad?
I suspect a number of projects, with only a vague relationship to "healthcare" are lumped into this budget so that they become more politically acceptable. Some programs encouraging sports and outside activity might be examples.
The problem seems gargantuan. About hospitals, there are aspects that seem to have something in common with, say, supermarkets, hotels, blah blah. Namely procurement, cleaning, fixing stuff, what have you. In the IT world the NHS is famous for being ripped off, on and sideways for ethernet cables, never mind other IR paraphernalia. Maybe, as others say, it's too many cooks egging up financial broth, over-management. Never mind looking after sick people.
My partner, an ex-nurse, has always said that the NHS is now over-managed - too many chiefs and too few people to do the caring. So, this would be a very useful exercise. I appreciate the following suggestion is probably beyond the scope of the present exercise but at some point it would be useful to know how much money is spent on endless testing (as in the pandemic!), and the amounts spent annually on treating those conditions which are the most resource intensive. I vaguely remember diabetes, obesity etc are near the top of the list. If the NHS is to be rebuilt/restructured, root and branch fashion, knowing exactly which branches are the heaviest before the whole tree collapses, I would have thought is essential - including those branches top heavy with management!
The major cost is probably the bureaucracy based on the socialist management system. The cost of the bureaucracy includes (1) direct costs (staffing, offices, technical infrastructure etc) and (2) funding misallocation driven by mistaken priorities, inefficient delivery systems, ideological agendas and conflicts of interest. Free markets are most efficient for health care (but not free markets dominated by large monopolistic corporates) as they reduce infrastructure and management costs, and introduce efficiencies based on customer priorities. Their main drawback is that governments cannot use them to buy votes.
A huge machine that does not run at all smoothly, and is a money pit into the bargain.....I have friends in nursing and management. Nurses say there are too many non clinical staff.....
I think this is such a useful exercise. Lot's of people shouting that too much money is spent on anything but patient care, and this exercise will hopefully help us understand the system.
It would be good to explore how much admin is actually needed for such an organisation. Are there business equivalents that can be used in terms of % of turnover used for admin and necessary support?
4.8 billion? Health education? Would this be pt education or staff education. In my 27 yrs as a pt, I never had “health” education. Today, we cannot even get an appt to see a gp. My “annual” visit to discuss my medications (for rheumatoid arthritis and hypertension) never take place in person, nor annually. This year I will have a five minute phone consultation….but not for at least another month. The nhs system is so broken, I honestly see no way back. How did it get this bad?
This is going to be good!
I suspect a number of projects, with only a vague relationship to "healthcare" are lumped into this budget so that they become more politically acceptable. Some programs encouraging sports and outside activity might be examples.
I'd be very interested in your posts.
It might be very difficult to disentangle.
good point - we'll add a breakdown of the staff costs where available
Will I be ostracised…looks like a terminal case of…...too many chefs not enough little waiters/ waitresses……
The problem seems gargantuan. About hospitals, there are aspects that seem to have something in common with, say, supermarkets, hotels, blah blah. Namely procurement, cleaning, fixing stuff, what have you. In the IT world the NHS is famous for being ripped off, on and sideways for ethernet cables, never mind other IR paraphernalia. Maybe, as others say, it's too many cooks egging up financial broth, over-management. Never mind looking after sick people.
More like too many Matrie Ds ,chefs would at least produce something.
My partner, an ex-nurse, has always said that the NHS is now over-managed - too many chiefs and too few people to do the caring. So, this would be a very useful exercise. I appreciate the following suggestion is probably beyond the scope of the present exercise but at some point it would be useful to know how much money is spent on endless testing (as in the pandemic!), and the amounts spent annually on treating those conditions which are the most resource intensive. I vaguely remember diabetes, obesity etc are near the top of the list. If the NHS is to be rebuilt/restructured, root and branch fashion, knowing exactly which branches are the heaviest before the whole tree collapses, I would have thought is essential - including those branches top heavy with management!
Very good
As a GP i would be interested to hear how you see this service should be restructured/improvex
If you’ve not already: have a read at John Seddon’s ‘The Whitehall Effect’
The Whitehall Effect: How Whitehall Became the Enemy of Great Public Services - and What We Can Do About it https://amzn.eu/d/3eA4ECg
The major cost is probably the bureaucracy based on the socialist management system. The cost of the bureaucracy includes (1) direct costs (staffing, offices, technical infrastructure etc) and (2) funding misallocation driven by mistaken priorities, inefficient delivery systems, ideological agendas and conflicts of interest. Free markets are most efficient for health care (but not free markets dominated by large monopolistic corporates) as they reduce infrastructure and management costs, and introduce efficiencies based on customer priorities. Their main drawback is that governments cannot use them to buy votes.
I think Alf Garnett could see them writing on the wall for OAPs…..
https://youtu.be/AmcodUy1_vc?feature=shared
A huge machine that does not run at all smoothly, and is a money pit into the bargain.....I have friends in nursing and management. Nurses say there are too many non clinical staff.....
Thank you 😊