Thursday, January 24, 2008


Dr Rant appears to be coming around to your humble Devil's way of thinking, at last! In fact Team Rant succinctly sum up the reasons why the European systems are better than ours, and the whole post is worth reading.
So in these reports [the TPA's Wasting Lives... and Nick Seddon's Like Heaven] we find several suggestions to get the UK away from its miserable dependence on the monolithic, hidebound and bureaucratic NHS.

Maybe in the end a combination of doctors and patients will finally put a rocket under current NHS management and both sides could free themselves to work well with each other. The expansion of NHS management, for no clear purpose, under current structures is picked up in both these reports. These reports certainly provide additional strength to our model of “The Management Spaceship”- the proposition that if we sent ALL the NHS managers and DH civil servants on a one way ticket to Mars, it would be so much the worse for the Martians. The rest of us would get on better, and would feel no need to send a rescue mission to bring any of them back.

And just as we have needed to get an Italian coach to run the England football team, we need to admit we can learn something from our European neighbours about how to run a health service.

And there's no choking on cornflakes at this end, Team Rant: merely unconfined joy over the sinner that repenteth!


Roger Thornhill said...

Hear Hear!

For all these years people have been brainwashed into thinking the NHS is the best that there ever could be. Not so.

The monopoly is the issue, both in provision and the 'third party payer', i.e. the Treasury.

It. Must. End.

the a&e charge nurse said...

Clearly moral with the NHS is so low (again, yawn) that anything seems better than NuLab's endless reform and private sector shenanigans ?

Curiously NHS doctors and nurses are the highest paid in Europe.
According to the CIVITAS average GP earnings went up from £56,510, in 2001/2 to £95,350 in 2005/6 - while average consultant pay went up from £86,746 to £109,974 for the same period.

OK, well bring on the insurers, which in France, Germany and Switzerland have long cost more than the NHS ever did.

But I'm curious, where are the margins for sustainable improvement ?
Take A&E, for example, attendences up by over 30% during the last decade (to the present 19million annual visits).
Despite this unprecedented increase waits have reduced significantly (notwithstanding one or two cheeky scams, of course).

To my mind abolishing the NHS would result in the following, at least to begin with;
Pay cuts for the majority of staff (good for the tax payer, of course).
Health costs will increase to meet quality issues (as evident in those European systems so admired by the Devil, and now the Capello loving Rants, it seems).
In time, access to certain treatments will become increasingly problematic (without deep pockets).
Danger that competing providers might result in a 'dentist' - see inquiry into dental rip-off, including allegations that £200mils worth of unecessary work has been carried out.,6903,664916,00.html

Still, we'll have something new to moan about, eh ?

the a&e charge nurse said...

Thinking about European, aherm/cough, 'methods', do you think they will be able to make any of the charges of tax evasion stick ?

Of course, Capello may be innocent........... just like Harry (brown envelope) Rednapp was ?

Budgie said...

A & E "charge" nurse said "But I'm curious, where are the margins for sustainable improvement?"

Using Pareto's rule I reckon that 80% of the NHS management can be given the push. Oh and also the "nurses" who were chatting about a party whilst my daughters heart stopped.

That should make the NHS much more cost effective.

John A said...

but, but, but... Here in the US we keep being told (well, by one of the two big parties and a few that don't have a hope of electing past town mayor) that the NHS should be our model!

Especially when it sends patients to private hospitals in France, I suppose.

Actually, one of my favorite anecdotes comes from Canada. Seems a fellow retired, losing his private health insurance and going onto the national system. Two months later, he was diagnosed with a disease which would deprive him of sight in another six months. The good news - if treated within two months he could retain eighty per cent sight in one eye and full sight in the other. The bad news - the first slot for treatment was eighteen months away.

Luckily, he had the resources to fly to the US and be treated - within a week.

Why was his case memorable? Well, remember I told he had just retired - from being Minister of Health.

Mark Wadsworth said...

A&E, I used to live in Germany (where the system is pretty much as Dr Rant describes) and NONE, NOT ONE of the problems that you envisage has arisen. Everybody gets good treatment.

Do you not think that perhaps, UK doctors are wildly overpaid? Are you putting this forward as A Good THing or a Bad Thing?

the a&e charge nurse said...

Are you sure Mark ?

If pay is not an issue why did 20,000 German doctors escalate industrial action by going on strike (while demanding a 30% pay rise)

The proportion of GDP spent on health through the insurance based systems in Germany, France and Switzerland has ALWAYS been significantly more than the NHS - the gap has just closed marginally over the last few years (but still hasn't caught up i'm afraid).
How do you expect UK medical staff to provide a superior service (to the big 3) without the same, or higher levels of funding ?

Rationing rows are escalating in Germany, one daft suggestion was to refuse hip replacement surgery to the over 85's

According to some authorities the German system is riven with "fraud, waste and corruption".
And a huge deficit has arisen between insurance contributions and health costs, some have blamed it on increased spending (on drugs and hospital treatment) while there are fewer people able to pay contributions (attributed to recession and job losses)

As I say if we replace the NHS with an insurance based system expect pay cuts, higher health costs and some degree of rationing with the possibilty of a second "dentist" fiasco.

Is Jurgen-the-Girmin really that fantastisch ?

Budgie said...

A & E charge nurse says "GDP spent on health through the insurance based systems in Germany, France and Switzerland has ALWAYS been significantly more than the NHS - the gap has just closed marginally over the last few years"

Times online says "The share of the GDP spent on the NHS by 2010 will be “well above” the European average and more than 50 per cent higher than in Scandinavia and New Zealand."

the a&e charge nurse said...

Budgie - according to the most recent OECD health data the main Scandinavian territories, Sweden, Norway, and Denmark ALL spent a higher proportion of GDP on health than the UK, so did New Zealand.

This despite the much vaunted 'record' funding given to the NHS (but only very recently) - go back less than 10yrs and we were literally spending half that of the USA, for example.

Of course, the Yanks have always spent more than anyone else on health (so much for market solutions, eh) while, historically, the Swiss are the big spenders in Europe.

I accept that we have finally caught up with some of our European neighbours but the fact remains we have ALWAYS spent less than Switzerland, France and Germany, and over time this CULMULATIVE difference has given these countries a distinct advantage over the NHS.

I think you're right about the NHS managers (Dr Rant puts the cull at 90%) and the nurses you mention should be dragged bare-arse over hot coals.