Angus worries....Is the NHS heading for a Perfect Storm?

 Writing in the Daily Telegraph on the 24 January, Chris Skidmore, MP for Kingswood and a member of the House of Commons Health Select Committee, argues that we need to find a way to care for our ageing population immediately if the NHS is to avoid near-collapse within decades.

In his article, Mr Skidmore points out that rising levels of obesity, alcohol abuse, chronic disease, diabetes and an ageing demographic are shoring up a "perfect storm” for the NHS, for which it is currently not prepared.

He also argues that more money is not the answer, pointing out that healthcare spending rose from £38 billion in 1997 to £102 billion today. An extra £12.5 billion will have been poured in by 2015, and this is likely to continue to rise. Under current projections, the NHS is expected to require in real terms £230 billion in 2030, or twice its current budget.

The government has pledged to make £20bn of savings over this parliament, but let’s be realistic. Frankly, there is very little chance of any real savings to be realised while the NHS is so disparate and unplumbed and suffers from a chronic silo budget mentality to commissioning goods and services. Furthermore, at times is seems there is more co-operation between Israel and Palestine than between Primary Care Trusts and Social Services.

The good news is that the Health Select Committee and Health Ministers are slowly beginning to realise that for healthcare to become ‘efficient’ it needs to reduce unplanned admissions, place more focus on community care, health prevention measures and above all a closer working relationship between various departments and budget holders.

However, until there is a cultural change in public sector procurement, the road to recovery will be slower than it need be. Presently, public sector procurement strategy places far too much emphasis on "cost effective procurement of goods and services" when they should be looking at "cost effective delivery of goods and services." There is a small, but significant, difference between the two and if we focus on the latter, well we might just get a tad more healthcare for our taxes.

 

 

Phillip G Rice
I totally agree that health procurement is inwardly focussed. In homecare and housing adaptations, for example, I have noticed how many, large and unitary councils, are starting to abandon local contracts in favour of large regional ones.

They are doing this because they believe a single regional supplier will save them money in the administration of the contract. It’s debatable that there are financial gains to be made in the administration of a large singular contract over several smaller ones given that, on the whole, collectively several smaller more localised contracts will tend to be far quicker, more responsive and efficient overall at delivering the homecare and adaptations required than a lone supplier.

Furthermore, unless the councils concerned intend to make staff redundant, then those admin savings are going to be relatively miniscule, if at all.

The government has pledged £170 million pounds to help get patients out of hospital and care facilities and back into their own homes as they recognise it costs an earth to keep them languishing in district general hospitals at £1,000 a day. Therefore, I simply find it bewildering that the local authorities, charged with spending this money, don’t put speed and responsiveness at the top of their homecare procurement needs.
03 February 2012
mark.mcnulty@platinumstairlifts.com
There is much truth to this argument. If it costs the NHS a £1,000 a day to keep a person in hospital waiting for a home adaptation, then every day’s delay is a wasted opportunity.

What is the point in a good price if delivery or installation is slow?

At Platinum we have invested in a product and operational process that aims to ensure regional mobility outlets can be rapidly supplied in order to offer a significant edge over larger competitors for this very reason.

So, councils that ignore smaller companies, those that tend to compete with innovative ideas and delivery responsiveness, over larger, national suppliers, that tend to compete on discounted prices but are generally slower to deliver, need to rethink their procurement strategy. Otherwise the additional DFG funding recently announced will not free anywhere near the number of beds it’s intended to release.
Mark McNulty - Sales Director - Platinum Stairlifts
05 February 2012

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