24 September 2009

Can the NHS Save Money Without Hurting Patients?

I was intrigued a while ago to hear about the success achieved by Essex police in funding an extra 239 jobs largely through cost-saving measures. The force apparently took simple steps like cutting out biscuits with their morning cuppa and stopping the purchase of designer sunglasses, channelling the money instead into front-line posts which make a real difference to the service they can provide to people in the county.

Apart from thinking that's an awful lot of snacks and fancy eyewear, I was cheered by the idea of a large public body taking the sort of homely steps that families all over the country have been pushed to, in our efforts to reduce debts and manage our finances better. My other half being a great advocate of costing things over the year, I have never been in any doubt about just how much can be wasted on a daily cappuccino, Mars bar, packet of fags, (fill in your own favourite treat) - but if you haven't ever tried it, doing the sums can be salutary.

And now politicians are eyeing up the NHS, and asserting that serious cuts are going to have to be made. We all know that this is the case, but how is it going to be achieved? I would love to think that some of that expensive management time is being dedicated right now to identifying commonsense, waste-cutting measures that would save money without harming patients, but I fear that it's not happening.

I have heard recently a couple of anecdotes about life in the NHS which underscore my scepticism. First, a tale of sterile supplies - gloves in this particular case - supplied to the hospital in question in packs of six, from which the staff were accustomed to take the single pair needed at the time, and throw away the other five, since they were no longer sterile. It did not apparently occur to anybody to question this practice: it was a fact of life that sterile gloves arrived in multipacks, and therefore most had to be discarded. I wonder how many similar rituals are being enacted up and down the country?

And earlier this week, an outpatient attending hospital for an MRI scan took refuge in a changing room, in a clearly distressed condition, because he was obliged to put on one of those humiliating back-opening gowns, and there were no dressing gowns available to preserve his modesty because "we're saving money". This must be a fairly widespread experience; I know people who have been through it over many years and in various hospitals, with differing degrees of upset according to personality and mental state at the time.

So it's probably safe to say that whatever steps are taken to save money, challenging the status quo and respecting the dignity of patients won't be at the top of the list.

It is always tempting when faced with the challenge of cutting costs to go for politically sensitive targets, in the hope that public outrage will be so great that the government will back down from their demands. If you say "cutting X pounds from our budget will mean sacking nurses, or closing intensive care beds", you are far more likely to marshal opinion behind you than if you admit that you could achieve the savings by buying the office supplies from Viking and reducing the proliferation of highly paid managers.

What will probably happen in reality is that cuts will be made in those areas that are least glamorous and most in need of support, such as mental health and geriatric care. But wouldn't it be wonderful to be proved wrong, and see the NHS following the lead of Essex police; saving money in ways that hurt no-one, and actually improving the service they can give to patients?

What do you think? Share your ideas on how money could be saved, or your opinions about the way the NHS uses the funds it has - just click the "comment" link at the top of this piece, and you're away!

4 comments:

  1. Cost cutting is a very important area to look at, and it is typical of organisations such as the NHS and particularly the Teaching profession to over-glamourise the top positions in these areas. I have worked in the Banking profession for many years and I have seen the problems of overpayment into so-called top jobs where those who in those jobs feel the need to prove their worth through constantly changing the methods of those beneath them, and security is gained for them in not having hands-on positions where they should remain in touch with the people who they are paid to serve. Those beneath them should remain on the same pay until savings can be made in eliminating top positions.

    This I feel is necessary now, as we continue to feel out of any ability to control the soaring costs of large Company and indeed National and
    Governmental positions.
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  2. The problem is that the government has neutered itself by giving so much to the financial industry, without thinking about the consequences for other areas - such as the health service - for which they also have responsibility.

    We should be having a serious debate about the sort of NHS we want, and how it should be organised and paid for, but the government doesn't seem able to communicate positively, and it is left to the media to orchestrate proceedings - so all we get is criticism, rather than constructive thinking.

    I'm not critical of the NHS itself: as taxpayers, we're carrying the can for a government that has not put good-quality people in charge.
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  3. You can be sure that any government initiatives that are aimed at the D.O.H or social services will be in order to save money, and I fear the results of these will mean cutting services.

    There is much talk about creating independence to save long-term health costs. This will not be achievable if the cost of equipment needed to empower independence at home is also cut, which I fear it will.

    Children's equipment needs are often complex and constantly changing. I have a real fear that this area may be targeted in some way. What is essential, in my opinion, to be able to provide the correct solution is the involvement of an experienced therapist that can prescribe what is needed rather than a choice of "standard" equipment from a catalogue?
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  4. This is so well written, commendations for this piece.

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    ReplyDelete

Share your opinion - whether you agree or disagree, I'd love to hear from you!