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Paddy Taylor's avatar

"With all these resources, it beggars belief that NHS productivity is currently 11% lower than it was in 2019."

Perhaps a comparison between 2 equally vast, but vastly different, organisations would be illustrative of the problem - and might lead Politicians towards the solutions that every one of them can see, but vanishingly few dare mention.

The overriding rationale behind our national response to Covid was to protect the NHS from being overwhelmed. The economy was broadly shut down to allow the NHS to cope, with most other NHS services curtailed to meet Covid-related demands. The butcher’s bill for this single-minded focus on Covid, to the exclusion of almost any other medical condition, is yet to be fully tallied, and will affect this country for years to come.

The initial spike in demand due to Covid amounted to between 2 and 2.5% of the NHS’s annual provision of service. To allow the NHS to achieve that we crippled the national economy and trashed many thousands of businesses and livelihoods.

The Supermarket industry had to meet a spike of over 30%. They managed to achieve that thanks to their ability, as businesses, to change working practices, supply chain demands, deliveries etc in a matter of days.

If we had an NFS (National Food Service) that reacted with all the inefficiency of an organisation like the NHS, we might have starved. We almost certainly would have faced severe rationing.

We need to look at the Private Sector and Public Sector business models of each and note the difference in reaction time and capacity to adapt to a crisis situation. The structural inefficiencies of the NHS, with its top-down, lumberingly bureaucratic nature, means it struggles to provide better outcomes.

Supermarkets were able to meet the demand by being more agile, less bureaucratic and far, FAR more efficient. Supermarket chains have spent years competing with each other and so have ruthlessly cut down on waste. If a process can be streamlined it will be, almost immediately, and across all stores in the chain. If an innovation is identified that brings even the slightest improvement or saves the smallest amount, it will be adopted and rolled-out as fast as possible.

No one, not even the biggest cheerleader of the NHS model, could pretend our health service does that. At all.

That, I would suggest, is the principal differentiator in their relative abilities to react well, and quickly, to a crisis and - in 'peacetime' - to deliver service fit for a C21st developed nation.

One of the big issues is that a Govt’s health policy is only measured by what monies they make available, rather than the outcomes the NHS delivers. Thus insane levels of waste are excused, reforms are scoffed at, whilst the gaping maw of the NHS requires ever more billions to be shovelled into it, for ever-dwindling returns. Post-Covid the public are finally being slightly more clear-eyed about this problem.

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Ian Watkins's avatar

One of the issues the Tories have with any reform to the NHS is that as soon as they try anything the commentariat and the more brain dead on the left start screaming about not wanting health provision like the USA. Nobody wants that, but it kills any discussion stone dead.

The other thing that occurs to me is whether there are any stats showing where this huge workforce actually works. How many are frontline medical staff and how has the proportion changed over the years?

Brown has a lot to answer for. We got one of the shiny new hospitals here in Peterborough. With a growing population (as everywhere) it has less beds than the two hospitals it replaced. Who was the brainless twerp who signed that off?

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