Lord Carter argues the case for a truly National Health Service again….

Lord Carter’s independent report has been released. Review of Operational Productivity in NHS providers. Several of the themes have been covered before in NHSreality. The advantage of a large mutual and it’s purchasing power could reduce dramatically expenditure on drugs, probably with a reduction in choice. The use of cold orthopaedic centres as recommended originally in 1983 would reduce complications and ensure spread of best practice including hip replacements of the highest standard. Costs would reduce because of bulk purchase .. His report is, indirectly, a case for returning to one large mutualised National Health Service, and is a good case against devolution… Nursing beds in recovery need to be provided somehow, and the inefficiencies of the former state homes have gone, as they have all been closed. Arguing for a return to state provided recovery beds is interesting, but without co-payments and an incentive to leave bed blocking will still occur, but not so much in acute care, until once again THE SYSTEM REACHES FULL CAPACITY. The demographics are such that any system without a disincentive to make a claim will fail.. In the end rationing by one means or another.. He does not address understaffing, and chronic lack of training places for both doctors and nurses…

In The Times 21st October this is reported as: Inefficiencies cost hospitals £5bn a year by Chris Smyth

Hospitals are wasting billions of pounds through inefficient organisation of treatment, an official review has concluded.

Savings of £5 billion a year could be made by using medicines better, improving surgical techniques and bulk-buying supplies, Lord Carter of Coles told the government.

Most of the savings would come through improvements in the ten biggest and least efficient areas of care, with £381 million of savings to be found in general medicine and £361 million in obstetrics.

Jeremy Hunt, the health secretary, said: “We’re giving the service £10 billion extra during this parliament, and it is vital to use that money to secure the best outcomes. So I’m grateful to Lord Carter, his team and those trusts that have worked to identify ways in which hospitals can become more efficient precisely by doing the right thing by patients.”

Lord Carter, a Labour peer, will contact 137 general hospitals to come up with detailed savings plans. Many health service leaders are sceptical about whether the savings can be made after a series of previous reports also found similar room for improvement.

The NHS has been told to make £22 billion in savings by the end of the parliament to meet rising demand from an ageing population.

However, bosses are struggling to make difficult changes after exhausting simpler methods such as holding down staff pay. Hospitals overspent by almost £1 billion in the first three months of the financial year.

Nick Triggle reports for BBC news 11th June 2015: Simple steps ‘could save NHS £5bn’

Hugh Pym reports on the same day: Less NHS waste: Is Lord Carter’s report a case of deja vu?

Orthopaedic waiting lists: time for more, and equal access to, non-urgent centres

Rationing and Models


This entry was posted in A Personal View, Commissioning, Post Code Lottery, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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