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There’s a man’s life at stake, Jim

 

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Friday, 18 February 2011

There’s a man’s life at stake, Jim

There was a collective sigh of relief in December when the government set the budget for GP commissioning. In the revised NHS operating framework, the so-called running cost allowance is provisionally given as £25 to £35 per head of population.

Two caveats: It’s a wide margin and for some odd reason the estimate is for 2014/15, year two, not year one of the new regime. 
 
Leaving that aside, the sigh of relief was because the rumour mill had been churning out much lower estimates – as low as £9.

The reason GPs are not turning cartwheels in the streets, apart from the obvious health risks, are that the figures are purely academic until the full extent of the legal obligations of consortia are known.

What we know for sure it that the government is not taking an enormous political gamble on the NHS for nothing. The QIPP programme, the sole survivor from the previous administration, remains high on the policy agenda. Curing the NHS of its profligacy, weaning it off a high fat financial diet and cutting the management flab are key objectives.

The NHS has spent most of its history improving. It has also spent most of its history becoming more expensive. The £20 billion question is whether these facts are inextricably linked or are just the result of lazy thinking and poor lifestyle choices.
The argument is unwinnable. There’s a man’s life at stake, Jim.
The moral argument trumps the business case every time.

There is another moral imperative, which is to make sure that spending on public services is proportionate. The NHS has consumed more than its fair share in the past decade and continued investment in health threatens investment in education, social care and other vital services.

The public finance options for the NHS are limited. QIPP may produce an economic miracle, but it is more likely to result in a more critical, self-regulating NHS that takes better care of its finances. 

Other money saving options will necessarily involve some form of private funding.
They include collaboration between the NHS and the commercial sector around specific conditions and disease areas. There are already rules governing such arrangements – the DH and the Association of British Pharmaceutical Industry have developed specific and well defined criteria for joint working. There is a comprehensive and useful toolkit available on the DH website.

Some people will always find the idea of collaboration between the public and private sectors objectionable in any form, but the unaffordable alternatives are surely worse. 

 
owenlloyd
owenlloyd says:
Apr 18, 2011 05:55 PM
I quote: The NHS has consumed more than its fair share in the past decade and continued investment in health threatens investment in education, social care and other vital services.

Who says?
jpatterson
jpatterson says:
Apr 18, 2011 05:55 PM
Growth in investment in the NHS over the past decade has been higher than investment in other services. That means the NHS is getting a bigger share of the public finances and with finite resources that means investment in other areas is declining by comparison.
owenlloyd
owenlloyd says:
Apr 18, 2011 05:55 PM
Editor - who are you? Are you paid by the NHS to write this
I can do the maths. JP explains that the NHS is getting a bigger share - this is a matter of public finance accounting:

The article said NHS has consumed more than its fair share. This is a matter of politics.

The implication from the editor of an NHS site that spending on the NHS has been unfair and threatens other areas is bunk. Whoever wrote that ought to be ashamed. Its a partisan viewpoint as is the assertion that
Other money-saving options will necessarily involve some form private finance. Politics again!
jpatterson
jpatterson says:
Apr 18, 2011 05:55 PM
Hi Owen
I wrote the piece. I think it's pretty hard to express an opinion about the NHS that isn't also political, but I reject the charge of partisanship. It's a point of view.
My point is not that spending on the NHS is inherently unfair but that it is unsustainable. Moreover, throwing money at the problem doesn't work so we need to try something else.
That's not an anti-NHS point but an anti waste, anti failure one.
"Insanity: Doing the same thing over and over again and expecting different results." Einstein
owenlloyd
owenlloyd says:
Apr 18, 2011 05:55 PM
You say "My point is not that spending on the NHS is inherently unfair but that it is unsustainable"

Then why did you say in your blog
"The NHS has consumed more than its fair share in the past decade" if it wasn't the point you awere trying to make
jpatterson
jpatterson says:
Apr 18, 2011 05:55 PM
I don't think the two statements are contradictory. You can always make a moral case for spending money on the NHS if your concept of morality is divorced from the real world. If the NHS gets a higher than inflation annual uplift when other services are being cut, then in a sense it is getting more than its fair share. That's not the same as saying that the sum received is not justified by some other measure, eg that patients benefit from the extra investment. Is that fair?
I don't want to be depicted as anti NHS. Nothing could be further from the truth.