The “burning deck”…. A great opportunity for no-fault compensation. Paying for Grandpa – how to pay for it all

The Mirror and all the other newspapers, BBC and all TV/Radio reported this week the words of our Hospital Inspector (England): NHS ‘on a burning platform’ with patients at risk warns England’s top hospital inspector – Professor Sir Mike Richards warned thanks to rising demand and “economic pressures” safety remains a “real concern“. Damien Gayle in the Guardian reports: NHS ‘standing on burning platform’ of outdated acute care model – Campaigners say inspectors’ report highlights impact of cuts to urgent and emergency services with demand putting patients at risk

Image result for burning deck cartoon

Following the NHS comparison report 2015 – (The Economist Intelligence Unit) in 2015

and on Jan 13 2017: England’s National Health Service: No more money for the NHS

The Economist (apologies for reproducing the whole article) prints: Paying-for-grandpa (How to pay for it all in the on line edition ) which compares the virtues of three options, more money, new models of care (Sustainability Transformation Plans), and a German style social insurance scheme. The latter is the only real option, and the author advocates either hypothecated taxation from wages, or a tax on hereditary wealth. The problems are partly around self employed (and there are many more of them than there were), who will largely avoid the former, and the really wealthy who will evade the latter.

A hybrid might be possible, but unless and until we deal with a tax on real wealth (not waiting until death), like the French, we will not have a system which feels equitable to the majority. The problem with taxing wealth is that any announcement will mean it leaves and goes overseas.. So it needs a world solution to wealth tax, and that is a long way off.

NHSreality firmly believes there should be a national debate, but it looks as if this may be omitted, and an announcement will be made. One wonders if it will be honest enough to address rationing overtly.

But in the post truth world appearances matter more than debate about ideology. The Telegraph (Laura Donelly) reports 28th Feb 2017: Every hospital ordered to change its logo by NHS “identity managers” in move which prompts ridicule.

The issue of Medical Negligence claims arose this week, and with the intention of a quick fix and raising £250m the government announced a change to the discount rate ( Ogden actuarial tables) at which compensation is calculated – to a negative or minus 0.75%. (The Scotsman –Car insurance costs set to soar after ‘crazy’ compensation rule change) (The Guardian –NHS faces £1bn annual bill after ‘reckless’ change to injury payouts) They quickly seemed to change their minds when the longer implications on personal injuries to victims of the health services were factored in over time.  (Insurance CEOs to meet UK finance minister over discount rate cut – trade body)

The fact that younger drivers would be uninsurable and perversely tempted to drive without insurance added to their change of heart.. But No Fault Compensation would be so much better. When a doctor makes a mistake at present he is thinking of his insurance, the time taken in the complaint process, and his mental health. He should be thinking of the patient and their family, and apologising as soon as possible. This is a great opportunity to re-visit no-fault compensation, at the same time as we change the whole basis of health funding.

March 3rd edition of Economist: (How to pay for it all on the on line edition )

Rob Merrick in The Independent 28th Feb 2017 reports: GPs urgently examine 173 cases of patients who may have been harmed after massive NHS data loss – But Health Secretary Jeremy Hunt denies Labour claims of a ‘cover-up’ and insists no evidence has yet been found of patients being put at risk

Adam Brimelow reported in 2013 for BBC News reports: NHS spends £700 on negligence cover for every birth – one wonders what the figure is now some 4 years later? NHS negligence claims bill tops £1bn (BBC 17th Jan 2015). It is possibly £2 bn!

In the National Interest we need to establish financial control…

The rising costs of failure: Worst hospitals cost NHS £300m

Former Natural History Museum boss wins £500,000 payout after ambulance was 17 minutes late

Patient complaints hit a ‘wall of silence’ from NHS – No fault compensation would help change the culture…

BBC – 10 charts that show what’s gone wrong with social care –

Nick Triggle for the BBC 2nd March: NHS standing on burning platform, inspectors warn

Hypothecated Taxation for the UK Health Services – India Keable-Elliott (report)

Image result for burning deck cartoon





This entry was posted in A Personal View, Perverse Incentives, Political Representatives and activists, 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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