Posts Tagged NHS
Probophilia
Posted by James Gubb in Education, Health, Politics on 18/08/2010
In this article, written for Civitas, Dr Peter Davies and Dr Adrian Kenny, two GPs from Yorkshire, draw on an amusing medical analogy – probophilia – to describe a painful affliction across UK public services today – not least the NHS. ’The probophile’, Davies and Kenny write, ‘ places false confidence in numbers , and uses these as his focus for justification of activity, whilst losing sight of what the organisation is actually set up to deliver. The sufferer is either oblivious to his affliction, or if aware falls into learned helplessness and just does what the organisation demands (and sometimes cynically pockets the cash). Fundamentally it is based on the ability of spreadsheets to analyse data without any matching ability going into primary thought about what data is being measured or why it counts for anything’. Have a read: it is unnervingly widespread and surely represents one of the biggest challenges the Coalition Government faces.
The NHS: going Dutch?
Posted by James Gubb in Health on 16/08/2010
Good article in the FT today by Nick Timmins on possible future direction of NHS… competing health insurers (or GP consortia) along the lines of the acclaimed Dutch health system. For a bit more flesh on the bones as to how such a transformation could be achieved have a read of this book and article published by Civitas 3 years ago. This article by Gwyn Bevan of the LSE is also worth a scan.
Narayana Hrudayalaya: a lesson for the NHS
Posted by James Gubb in Health on 11/08/2010
Long has this blog argued the benefits of increased specialism in the way health care is delivered; that is, for example, for focused centres for operating on particular conditions and disease-specific networks that treat and help people manage chronic diseases. Evidence, contained particularly in Clayton Christensen’s brilliant book The Innovator’s Prescription, has long suggested such centres offer better and cheaper health care than the 19th century district general hospital model of every hospital trying to do everything. Senior clinicians also appear to agree.
A dog’s breakfast or radical reform?
Posted by James Gubb in Health on 13/07/2010
Yesterday, Civitas released a brief commentary on the NHS White Paper published by the Coalition government. I’m happy to repeat congratulations to the Coalition government on moves to introduce greater competition in the NHS by expanding choice and supporting a genuine ’social market’ through the introduction of meaningful competition law.
Recent evidence on the impact of the competition that already exists in the NHS suggests this is the right course of action to drive value in tight financial times.
However, I want to devote the time and space of this blog to analysis of the more fundamental proposals on the purchasing side of things. That is, moves to transfer responsibility for commissioning from PCTs to GPs. A number of concerns:
Lansley’s plans could set the NHS back by up to 3 years
Posted by James Gubb in Health on 10/07/2010
Moves to transfer commissioning responsibility to GPs could cost the NHS its £20 billion efficiency savings target, and worse
The coalition government’s White Paper on the NHS is due to be published next week. It is widely expected to outline plans to hand control of as much as £80 billion of resources in the NHS from Primary Care Trusts (PCTs) to consortia of GPs.
Analysis released today by Civitas suggests such moves are likely to:
- Lead to at least a one year dip in performance in the NHS in absolute terms.
- Set the NHS back at least three years relative to what could be achieved without any structural change.
Read the full report and press release, here and here. For ideas for what the government should be doing, return to the blog tomorrow. Also, have a listen to R4 World Tonight (10 mins 55 secs in).
Freedom. Fairness. Responsibility. And the NHS.
Posted by James Gubb in Health on 20/05/2010
Freedom. Fairness. Responsibility. The sounding words of the coalition document, released today. But do these words (most particularly the last one) not, then, require at least a mention in the section on the NHS of the scale of the productivity challenge facing the health service… and perhaps a few ideas of what to do about it?