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).
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