NHS Reform

I obviously heven’t been paying enough attention. I hadn’t realised that the reforms had gone this far:

From 2008 people needing
an operation will be entitled to select any hospital – public or
private – that can work within NHS cost limits. The treatment will
remain free for the patient and the hospital will be reimbursed by the
taxpayer.

Absolutely bloody marvellous. It’s a voucher scheme in all but name. Exactly what has been needed.

As the rest of the article points out it’s also bringing private investment into the system as well….another thing to celebrate. And this part:

Patricia Hewitt, the
health secretary, told the Labour conference that the contracts she
intends to sign with independent treatment centres will bring them no
more than 10% of the market for elective surgery. But she could not
commit the government to making 10% a permanent ceiling for the private
sector because she did not know how patient choice would work after
2008. The size of the private sector will be determined by competition,
not Ms Hewitt.

As I said, I haven’t been paying enough attention. As long as they don’t interfere this has the makings of being exactly what the whole system needs. Specialisation, competition, additional providers and all still single payer funded via vouchers (which is a political necessity).

From the Guardian Leader:

Do not be beguiled by the
health secretary’s assertions that the second wave of treatment centres
currently under negotiation will restrict the private sector to a 10%
share of elective care or just 1% of NHS expenditure. It would be a
mistake to infer that this would be the limit of private sector
involvement.

As above, it will be the market that decides the portion of health care that is delivered by private providers.

Don’t these people read their own paper?

3 responses

  1. I’m an economic ignoramus and no fan of this idea of “competition” in the NHS. I need to study this more closely but a couple of things bother me. You’re probably the guy to answer this for me, Tim.
    What happens to the 80 year-old, with no transport, needing a hip replacement but not living near one of these shiny new uptopian hospitals? Do they hobble to the nearest train station?
    What happens to those of us financially unable to top up our vouchers and stuck on the doorstep of, for sake of argument, the rapidly crumbling Royal Sussex Hospital?
    Tim adds: How does the 80 year old get to the hospital now? I haven’t seen anything that might change that.
    Why would having new money come into health care mean that the NHS would be worse than it is at present?

  2. Justin,
    The point isn’t competition ‘within’ the NHS. This won’t work – NHS staff don’t depend on their performance for their salaries (they’re centrally funded). One of the reasons we’re now hearing about newly qualiied doctors not being able to find jobs is that salaries are centrally determined and have increased hugely in recent years (thanks to the unions) – hence there is no money left to employ new doctors.
    Competition works at the margins, applying pressures on providers only as long as they have control over what and how they offer and their costs. The NHS doesn’t allow this.
    Incidentally, the NHS is an arch-closer of hospitals. They have tendency to centralise in large centres for their own convenience – not that of patients. This is why we see so many local campaigns to keep hospitals open. Anything which works against this trend is welcome.

  3. Rob Read Avatar
    Rob Read

    Now can I opt out of paying for stalinist organised bEurocrat rationed treatment and have a lovely tax cut instead?

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