A GP writes...

Barry, your blog on your skin cancer service says everything that is wrong with the NHS today. The government believes that because management consultants and accountancy firms have come up with schemes THEY SAY which cut the cost and increase profits for big companies, that these people can cut the cost of the NHS by making it more efficient.

Management consists of looking at any subject, breaking it down into component parts, then getting less able, and cheaper people , to do the component parts - thus saving money. It just doesn't work with the NHS though, unless you actually do want to give the whole thing to private companies to see what profit they can make of it. As I have said often before, just see what private companies do for health care in America. My sister there, now on medicare pays $2500 per year, and has to pay for her drugs. Because of the lack of regulation there she has to pay $200 for a Seretide 500 for example of drug company profits

How can a manager with a commercial interest see that the the NHS is about patient care. That is getting the best possible person to see the patient in the first place, get that person to see the patient as long as possible and do as much of the treatment as possible. Just ask any patient at all and they will tell you that this is what they want. So the more efficient the NHS gets in terms of accountancy, the less will patients like their treatment.

AND apart from having long waiting lists and poor equipment and no ancilliary staff, the NHS in 1970 compared almost as well as today with other advanced nations of the world at a third the cost of today. The extra money, as I have said elsewhere has gone on systems, useless political schemes and accountancy which has contributed nothing to patient care, yet cost tens of billions of pounds which could have been spent better on patient care.

The answer to a better non-profit making NHS is to give doctors what they want to do their work and let them do it. The more doctors are monitored, the more they tick the boxes required which is a considerably lower standard than they would do for their own professional satisfaction. Why the BMA has not been in the media shouting this out loud and clear for all this time astonishes me. Instead they merely try to be reasonable, desperately looking for something in all the changes which is not too terrible and saying that this is a step forward, thus giving credance to all the crap we now have.