Daily Mail

How to cut NHS waste: ban IVF and recycle crutches


at long last, bosses have decided to tackle the appalling waste that goes on in the NHS. As the Mail revealed this week, a raft of efficiency and cost-cutting measures will be put in place, such as stopping free prescripti­ons for painkiller­s and indigestio­n remedies available over the counter.

It’s about time. Despite doctors and patients raising concerns for years about money being frittered away, the powers that be are only now listening. What took them so long?

It’s awful for patients to learn of funds being squandered while vital services are cut and treatments rationed. It’s infuriatin­g for taxpayers. And for doctors like me, at the coalface, the profligacy we witness on a daily basis is heartbreak­ing.

this interventi­on can’t come soon enough: the NHS is at breaking point, its finances stretched gossamer thin.

one of the founding principles of the NHS is that it’s free at the point of access. this ensures that people receive help on the basis of need, rather than ability to pay. But that doesn’t mean that everything we want should be dished out gratis.

When the health service was founded in a simpler age, society’s expectatio­ns were very different. today, we have a strong sense of entitlemen­t, but with an ageing population and a proliferat­ion of new, expensive treatments, we have to realise that if we’re going to balance the books, we can’t have everything we want.

the NHS should be for the essentials: for matters of life or death, and to prevent and ease suffering and disability. It shouldn’t be used to make people’s lives a bit nicer.

My fear is that the new measures don’t go far enough.

one major source of waste is the result of the labour government’s move to encourage private companies and NHS trusts to compete to provide various services, from children’s mental health to laboratory testing. It’s quite clear that the more providers there are in a system, the less efficient it becomes.

EXTENSIVE work by Allyson Pollock, a professor of public health research and policy at Queen Mary University of london, has shown that this set- up increases bureaucrac­y and money flowing out in the form of corporate profits. It’s not cost-effective or good for patients. that doesn’t mean there shouldn’t be private involvemen­t, but only when the NHS is unable to deliver.

But, I’m sad to say, thoughtles­s patients are also to blame for NHS waste. It’s time for a national campaign to tell people precisely how much their drugs, services and treatments actually cost.

the biggest problem here is missed appointmen­ts, which have a hugely detrimenta­l impact on conscienti­ous patients, forcing them to wait longer than necessary because others have taken slots that they don’t use.

If someone misses an appointmen­t, they should receive a letter informing them how much money has been wasted and how it has affected waiting times.

Doctors and managers, as defenders of the public purse, should feel confident in chastising those who squander resources: some trusts already do this.

And what about the equipment handed out to patients, such as crutches? this is expensive stuff, but rarely retrieved when the patient no longer needs it. And when a patient offers to return it, too often this is declined!

not only is this wasteful, it sends entirely the wrong message, that the NHS is profligate. How can we be surprised if patients are, too?

We also need to look at the huge sums spent on management consultant­s. Just this month, it was revealed that health bosses drawing up plans to close hospitals to save money have already spent at least £17.7 million — equivalent to 530 nurses’ annual salaries — on consultant­s.

Managers employ consultant­s for advice, but if they aren’t able to address problems themselves, they aren’t doing their jobs.

We should also ask: what can the NHS really afford? that means a serious discussion about funding obesity surgery, a lifestyle-related procedure. And infertilit­y, while deeply upsetting, is not an illness. Having a child is not a right and the NHS should not be footing the bill to satisfy people’s desire to become parents.

So, while the new plans are welcome, they should be just the start. Before we consider giving the NHS more money, we must make sure we get the most out of the cash it already receives.

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