The Inefficient English Health Service is compared with the German one. Hypothecated Taxation with choice of provider?

We all know it’s going to get worse pending honest politicians willing to debate ideology with Mr Stevens and the Media. Meanwhile suggestions for better systems are being discussed in closet situations.. This suggestion is most welcome, and particularly in Wales where choice has disappeared, or Northern Ireland where abortion is so hard to access. The NHS crisis is spiralling out of control.. (Chris Ham in The Times 12 months ago) and The NHS desperately needs cash or it won’t survive, says former GP and Tory Health Minister Dan Poulter (The Sun 2w ago).

In The Times letters 30th Jan 2017: NHS EFFICIENCY

Sir, With the NHS under intolerable pressure, and many independent commentators ranking our system well below many others, we should examine what makes other systems fairer with better outcomes.

Many European countries have systems that are funded through hypothecated mandatory health insurance, but people ask, how does this differ from our own national insurance? The answer is that health insurance allows the insured to choose a provider, and the system reimburses that provider. With 70 per cent of healthcare costs being attributable to staff, reducing costs depends on using staff more efficiently.

In the UK, we have created the world’s biggest monopoly employer to provide 95 per cent of healthcare, and we feed that monopoly by largely barring all others providers regardless of their efficiency. As a consequence, the German healthcare system, which allows plural provision, employs many fewer staff for 80 million people that the NHS employs for 60 million.

The future of our healthcare system depends upon better use of limited resources. Cutting the number of hip operations (report, Jan 27) may save on the metal hip, but if all the staff remain in the expensive PFI building, little will be achieved.

Adam P Fitzpatrick Consultant cardiologist and electrophysiologist, Mottram-St-Andrew, Cheshire

An epidemic of nationwide bullying. In most dictatorships this precedes dissolution or breakdown….

Political collusion to neglect…? If the Regional Health services were companies they would be bust and run by the reciever

The Health Services Procurement – inefficient and risky… Centralisation and management control is needed

This mismanagement of the NHS amounts to neglect

It’s nonsense. A £22Bn “black hole”! Management by incompetence.. Even a ghost could do it better.

Denial extends to the generic management solution – “Troubleshooters will be sent into struggling NHS regions”

Health services pay structures. Inequity and long-term mis management. Strikes and comparisons with politicians…

“Appalling care” in Gloucestershire hospitals due to mismanagement, warns whistleblower

Candour and Transparency? – what a farce

The NHS is being torn from those who have cherished it for decades

General Practice is “a house of cards….”

Changing the rules of the game

Trying to defuse some of the invective against NHS managers.



This entry was posted in A Personal View, NHS managers, 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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