The Market for health

In a letter to the Times 25th Feb 2019 a consultant exposes the weaknesses of the Internal Market:

Sir, The abolition of competition among NHS hospitals is long overdue (News, Feb 22). The “internal market” introduced within the NHS in 1991 was intended to drive down costs and increase choice, among other things. In fact it was inefficient, costly, resulted in a proliferation of managers and was potentially harmful to patients, as well as many other problems.

Smaller hospitals wanted to introduce money-raising procedures for which they had neither the staff nor equipment, procedures usually performed by larger, more experienced tertiary centres. This resulted in duplication of expensive equipment, inexperienced staff doing procedures for which they did not have enough training and ultimately a risk of patient harm. A few years ago I recall a local colleague telling me that his hospital needed to start a cardiology procedure “to balance the books”.

Fortunately, it has been realised that collaboration is highly preferable to competition. At last the damage started by the internal market is being undone. Patients can be directed to centres that are best at the task in hand, not the cheapest.
Dr David E Ward

Consultant cardiologist (ret’d)
London SE22

NHS plan ‘ends public right to choose hospital’ – A form of rationing well known to Wales

Image result for health market cartoon

This entry was posted in A Personal View, Guest, 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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