Unwieldy behemoth that MUST scrub up
After appearing to lurch from one crisis to another, the Government has adopted what seems a rather more sure-footed political strategy: It’s linking Brexit to the end of austerity for the NHS.
And that sends two clear and crucial messages. the first is that there are tangible benefits from Brexit. Until now it looked as if Mrs May believed that Brexit was economically a bad thing, but felt it was her duty to minimise the harm.
Now the Government is unashamedly proclaiming that there will be a Brexit windfall after all. Moreover, as if in homage to the Leave campaign’s infamous and controversial battle-bus slogan that Brexit would provide extra money for the health service, it will indeed be allocated to the NHS.
Second – and perhaps more crucially – the Government is dispelling any doubts that Britain will leave the eU. the flip side of the claim that this extra money for the NHS is possible because we are leaving europe is that it cannot be made available if we remain a member of the eU.
these messages could not be more important at a time when shameless and unprincipled members of the House of Lords are abusing their power by introducing endless amendments to thwart Brexit – contrary to our long-held tradition that the unelected House should never oppose the clearly expressed will of the people.
Sothe strategy is politically shrewd. But it is also, to my mind, morally right. the NHS needs more money. even at its current appalling level of inefficiency, an increase in funding is justified if we are to prevent it slipping into third World standards.
the fact is that it has been underfunded since 2010 and this has begun to hamper its ability to meet all the medical demands it faces.
our rising and ageing population has meant that the delays, the outright denials of treatment, and the dilution of care standards have all increased remorselessly. But – and it’s a very big but – this extra cash simply has to come with vital new efforts to reform our health services. It should only be allocated to the NHS on the understanding that it must be unrelenting in its efforts to reduce waste.
there are two immediate areas of inefficiency that have been crying out for change: the purchasing of medical supplies and the use of agency staff.
only in 2016, Labour peer Lord Carter produced a review of NHS productivity that was commissioned by Health Secretary Jeremy Hunt. It identified a staggering £5billion of potential savings. on purchasing of supplies alone, Lord Carter thought up to £1billion of savings could be possible.
the problem is, the behemoth that is the NHS has singularly failed to gain the advantages that such a huge customer in the private sector would expect from central purchasing, while at the same time retaining all the disadvantages of the inefficient public sector.
In one year, for example, a sample of NHS hospital trusts used 30,000 suppliers for 20,000 different product brands, with more than 7,000 people able to place orders. Vast differences have been discovered between the prices paid by the NHS for identical medical items in different parts of the country.
for replacement hips, for instance, Lord Carter found 20 different brands being used with average prices ranging from £788 to £1,590. of course, the products are not absolutely identical, but there was no clinical explanation for the price differences.
More recent investigations into the purchasing of drugs have found the NHS paying Boots £3,220 for a mouthwash used by cancer patients that can cost £93, and £1,579 for a pot of moisturiser that other pharmacies obtained for less than £2.
It’s estimated the service is over-paying £30million a year for medicines known as specials that are prescribed for nonstandard treatments.
ONeof the biggest scandals is NHS mismanagement of its own staff. there are very high rates of absence due to sickness. But much worse, in 2016-17 around £2.9billion was spent on agency doctors and nurses, instead of employing a stable workforce.
As I say, the NHS desperately needs money. But this huge injection of funds linked to Brexit is already being criticised by vested interests as too little.
Which prompts the question of whether or not the service is actually unmanageable in its current form.