The OECD has published a report that shows that when it comes the money per head invested in health services the UK is one of the bigger spenders. Only 5 countries in the world spend more - US, Germany, France, japan and Austria.
However, when it comes to outcomes, despite this high expenditure we are way down in the rankings.
For example, on average OECD countries have 4.3 hospital beds for 1,000 people. The UK has 2.3., with only 5 below us. OECD has 38 members, so we are rank 33 out of 38. We have fewer MRI, CT and PET scanners and we also have some of the worst paid nurses.
www.oecd-ilibrary.org/social-issues-migration-health/health-at-a-glance-2023_7a7afb35-en
Surely the time has come for a major review of how the health service is run in this country and why we get such poor outcomes from the money invested and with those in politics and the health service claiming it is underfunded.
It clearly is not under funded, just badly organised and run.
My flatmate worked as a secretary on the NHS and sat filing her nails most of the day- her words. I worked as a secretary in private industry and it was hectic. She earned nearly double my salary and I had to have an evening bar job to get by
1970's my flatmate worked as a secr
The difficulties you experienced weren't to do with the NHS as a system but errors by individuals.
M0nica
growstuff Both superficial and merely moving the deckchairs on the Titanic
What is needed is a thorough study of how other health services are run, especially those that produce better results for the same or less money. An enquiry thaat brushes asidethe vested interests that managers, consultants and GPs each defend in their separate laagers. I think we should look at the balance between what is provided in-house and what is bought in. merely changing superficial structures and bringing in extra layers between GPs and referrals to consultants.
An enquiry that talks in detail to significant samples of managers, consultants, junior doctors, nurses, GPs and PATIENTS to find out the diffivulties they have accessing thw service.
So which health service produces better results for less money?
M0nica
growstuff Both superficial and merely moving the deckchairs on the Titanic
What is needed is a thorough study of how other health services are run, especially those that produce better results for the same or less money. An enquiry thaat brushes asidethe vested interests that managers, consultants and GPs each defend in their separate laagers. I think we should look at the balance between what is provided in-house and what is bought in. merely changing superficial structures and bringing in extra layers between GPs and referrals to consultants.
An enquiry that talks in detail to significant samples of managers, consultants, junior doctors, nurses, GPs and PATIENTS to find out the diffivulties they have accessing thw service.
The changes most certainly weren't superficial. Do you actually know what they entailed?
What is needed is a root and branch inquiry into how the NHS is structured and run
Exactly this. With all the advances in medicine over the last 70 years, the NHS needs a whole rethink.
What happens currently is that, every time there is a new initiative, a new manager is put in place rather than an existing one adapting.
growstuff Both superficial and merely moving the deckchairs on the Titanic
What is needed is a thorough study of how other health services are run, especially those that produce better results for the same or less money. An enquiry thaat brushes asidethe vested interests that managers, consultants and GPs each defend in their separate laagers. I think we should look at the balance between what is provided in-house and what is bought in. merely changing superficial structures and bringing in extra layers between GPs and referrals to consultants.
An enquiry that talks in detail to significant samples of managers, consultants, junior doctors, nurses, GPs and PATIENTS to find out the diffivulties they have accessing thw service.
What is needed is not more money but the existing money better used. It is all very well listing the problems facing the NHS, but health sustems in other developed countries must have faced similar problems but they have overcame them. They have better staffed and better equipped hospitals and health services than we do and manage it on less money
I was going to write exactly the same Monica but instead I'll just agree with you!
It is a root and branch across the board that is needed; looking at what DOES work and best practice and what doesnt work and why and then redesigning structures and systems accordingly.
Our short termist political systems where govts. inevitably have their eye on the next election doesnt help this when making changes in something like the NHS ofcourse! A cross party long term plan for change is required!
The nhs was making great progress under the last Labour government.
Er really?
How many nhs hearing aids have been issued and now sit in a drawer because they didn't help much.
And I used to see a lot of stock thrown away because it was now out of date that could have been used up earlier in A &E. Thinking of blood sample containers.
What is needed is a root and branch inquiry into how the NHS is structured and run.
There have been two major restructures since 2010. How many more do you want?
www.wbs.ac.uk/news/six-reasons-why-the-nhs-needs-more-managers/#:~:text=But%2C%20while%20management%20in%20the,job%20and%20turnover%20is%20high.
Fiddling around with managment structutres etc is no more useful than re-arranging deckchaors on the Titanic.
What is needed is a root and branch inquiry into how the NHS is structured and run.
Grantanow If you had read my OP ort even glanced at the poriginal report, you would know that whaat triggered thisnthreaad was that the UK is one of the best funded health systems in the OECD, but it is delivering substandard care.
What is needed is not more money but the existing money better used. It is all very well listing the problems facing the NHS, but health sustems in other developed countries must have faced similar problems but they have overcame them. They have better staffed and better equipped hospitals and health services than we do and manage it on less money.
I expect a manager (or several) did oversee it Primrose. My experience of working in the public sector (not the NHS) was that people didn’t care a bit about wasting public money. All clock watchers marking time until they retired and got a very nice pension. The way things are run in the private sector, where everyone is accountable, is so different. I have tried to describe on GN so many times the difference between public sector and private sector management. IMHO the NHS needs managers from the private sector.
I live between 2 hospitals. Sometimes I'm referred to one, sometimes to the other. Each hospital is under a different trust and can't access my medical notes from the other one. How ridiculous is that?? And one of the hospitals doesn't use email but only Royal Mail !!!! so they post results to my GP, even during the postal strikes. The whole system needs revising.
Whenever we have this type of thread I say 'too many managers' too and usually get shot down in flames.
But it is true!
A small cottage type hospital closed down near us a few years ago. All the beds went to the scrap yard man. Many were completely brand new and still in cellophane. They cost several thousands each but they were all scrapped. My husband saw them with his own eyes when he went to scrap a washing machine. What a dreadful waste of money.
Surely a Manager should be overseeing stuff like this.
I couldn’t agree more. Whoever authorised that expenditure should be sacked.
A NHS mental health trust in my area had been much criticised for the standards of their care. They have paid £800k to a PR company to improve their image
This shouldn't actually be allowed.
If they invested that money in the service they're supposed to be running, their image wouldn't need glossing over 😡
Too many managers! I worked in admin in the NHS 40 years ago and far too many managers then. Things haven’t improved, even more managers now,.
Simply improving the way the NHS is managed won't solve the problems. If you want more beds per head of population they have to be bought. Better management won't magic up doctors, nurses, paramedics, etc., to fill the shortfall created by underfunding and poor recruitment. Modern medicine is much more capable but more expensive than it was back in the day of Matron. Ambulance services are failing to meet targets but offer far more paramedic help than the old ambulances of yesteryear. And private sector contracting out costs more because there is a profit to be secured. A good deal of money is wasted in paying for PR image consultants and expensive lawyers to fight off corporate negligence cases and respond to official inquiries when disaster strikes as in the maternity scandal.
Bed nos were deliberately reduced as part of a vision that ‘care in the community’ would make so many beds unnecessary. Then community care funding was savagely slashed. How do other countries finance social care?
No hospital depts seem to communicate with others when you are in the system. They also waste a lot of money.
My husband has had many health issues the last year or so and we are always at the hospital. In fact we are off there this afternoon.
Sometimes we get 3 identical letters about the same appointment. What a waste of money. Other times they cancel at the last minute.
As for NICE guidelines - a couple of years ago I had treatment on a varicose vein. Before the op I had to go to hospital and get measured for surgical stockings. The nurse measuring me said “even if you don’t wear them we have to measure you and provide them according to NICE. Just bin them if you don’t want them.” I was horrified.
It appears that Starmer and the Labour Party agree with the OPs sentiments.
So hopefully this will be tackled if there is a change of government.
Scandal after scandal about treatment and how hospitals and health services are run go back to at least the turn of the century. I had a relative in hospital in East Kent in the early years of the century. His care was appalling and there was a report on clinical care in their hospitals, which was highly critical shortly afterwards. I cannot find a reference because there has since been a major maternity scandal there and that fills google with references.
SGboo The 38 members of OECD are mainly European and developed countries so the variability of drug prices will not be significant.
Ilovecheese No one is saying 'how hard can it be' nor advocating privitasation. My experience is that privatisation increases costs not cuts them.
What this report shows is that we are one of the highest spenders on health, yet have half the number of beds that is the average for the other 37 countries, we have less technology and our nurses are poorly paid and most of us who have had any contact with the health service will be tearing our hair out over delays, cancellations, problems not listened to, telephone interviews that mean patients aren't seen and diagnosis that are guesswork when a sight of the patient would immediately trigger investigations.
the worst thing is that so many are blinkered about looking at the NHS. There is a blind belief that the NHS is perfect and should not be criticised. It formation by a Labour government has meant that it has become a left-wing idol, and any criticism of it is seen as an attack on social welfare in this country. Like the assumption above that those say the NHS is desperately in need of root and branch reform are, automatically, wanting it privatised. Nothing could be further from the truth.
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