NHS 101 please!

[art-of-the-table]

Very true, this cherry picking is taking place at many levels but we need to consider the following questions:

1 - If the easy cases can be done easily by lesser skilled people in the private sector, thus freeing up the really skilled people to deal with the more complex cases, is it such a bad thing?

2 - On the other hand, if we outsource simple cases, how can we make sure that we maintain quality, and particularly that, if one of these simple cases happens to be more complex than it looked originally, that it gets recognised early enough

3 - If management are misinterpreting the figures (which will inevitably look worse for the NHS if they only retain difficult cases), is it not more of a case of educating management and the public on all this rather than refusing the change?

[NorthernLight]

If management are misinterpreting the figures (which will inevitably look worse for the NHS if they only retain difficult cases), is it not more of a case of educating management and the public on all this rather than refusing the change?

Good luck with that. When there's a political imperative to do something (in this case, outsource easy NHS care to private companies) the evidence and the truth tend to get a little lost.

I seem to remember a recent issue with GP opening hours. The government did a survey to see how many people wanted weekend and extended opening, and the majority view came back as being not in favour of a change. (It would have been unfunded, so hours would have been lost elsewhere.) So the government decided to do it anyway, because people who don't use their GPs much but have a disproportionate amount of access to opinion forming media (the CBI for instance) decided they didn't like having to take time off work when they were ill. So they set the agenda for a service which they hardly use.
I'm not disillusioned, but only because I never had any illusions to start with.

[ben_]

Very true, this cherry picking is taking place at many levels but we need to consider the following questions:

1 - If the easy cases can be done easily by lesser skilled people in the private sector, thus freeing up the really skilled people to deal with the more complex cases, is it such a bad thing?

No, but only on the following conditions:
- laziness and fudging don't turn it into a directly comparative exercise, as happened in this case;
- it is subjected to proper public debate.

2 - On the other hand, if we outsource simple cases, how can we make sure that we maintain quality, and particularly that, if one of these simple cases happens to be more complex than it looked originally, that it gets recognised early enough

Agreed, it is hard to substitute like this.

3 - If management are misinterpreting the figures (which will inevitably look worse for the NHS if they only retain difficult cases), is it not more of a case of educating management and the public on all this rather than refusing the change?

I think NorthernLight has dealt with this but here goes anyway: this was not an issue of management being misinformed (or if it was then they were really not worthy of their positions), it was a cynical attempt to fudge the figures. But in any case it is hard to extrapolate from this one instance, I was just trying to provide an example of another potential problem.

[TLP]

This has been an interesting discussion so far, to be sure. For those with an interest in learning more about free market-based solutions, there is The Lucidicus Project The Lucidicus Project (of which I am the director). It's an independent educational initiative designed to help medical students understand the moral and economic case for capitalism in medicine.

We distribute books and lectures on these topics, supported by donations, and free to med students.

[Arch_Angel]

What's that sir? Bleeding to death? You were stabbed and someone stole all your money?....So you've got no money? Sorry.....can't help.

If you look at the GDP % spend on medical care in state-run systems it's much lower and more effective than insurance based systems. Mainly due to the fact that profit isn't an issue.

I'm not saying the NHS is the best way of running things, there are other European models that have their benefits, but a capitalist dominated system is something that leads to people either going without care or losing their house when they get older.

For each according to his needs and all that....

[Arch_Angel]

I challenge anyone to identify a problem with health care in America that is not caused or aggravated by federal, state and local governments.

If one person across the entire united states goes without a treatment that would have been covered by a state funded health service (any of them in the world), then the very fact that the government hasn't got involved is the cause of the problems.

And, I challenge anyone to show me people dying on the streets because they don't have health insurance.

Lack of insurance compromises the health of the uninsured because they receive less preventive care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates than insured individuals. - Institute of Medicine. Care Without Coverage - Too Little, Too Late. The National Academies Press, 2002.

Studies estimate that the number of excess deaths among uninsured adults age 25-64 is in the range of 18,000 a year. This mortality figure is more than the number of deaths from diabetes (17,500) within the same age group - Institute of Medicine. Insuring America’s Health - Principles and Recommendations. The National Academies Press, 2004.

The use of the phrase "Dying in the streets" is nothing by misleading demagoguery intended to show that the situation isn't so bad and that it hardly matters if people aren't insured. It purposefully ignores the fact that people go without healthcare because they cannot afford it and their condition gets worse as a result.

Questions quoted from: Dr. Williams - George Mason University as the John M. Olin Distinguished Professor of Economics

[Singh.Simran]

hear hear