GREAT BRITAIN: NHS IS PUTTING THE PATIENT LAST
August 14, 2009
While British health ministers have been quick to applaud the advantages of a "national" health system to fight the swine flu outbreak, the very centralized nature of the service cuts two ways, say researchers from Civitas, a British think tank.
They argue that the "customer" of the National Health Service (NHS) -- Great Britain's government-run health care model -- is the health secretary rather than the patient. The report sees much in favor of attempting to introduce private provision within the state system and competition between NHS trusts to attract patients.
But this has been stymied by incessant interference from the Department of Health, says researchers:
- According to health service managers, a staggering total of 69 public bodies -- excluding the Department of Health and 10 regional strategic authorities -- currently regulate, inspect or demand information from NHS organizations.
- Questions posed by bodies such as the Care Quality Commission and the Environment Agency are frequently duplicated or irrelevant, imposing a huge unnecessary burden.
- The nature of Great Britain's centrally funded system inevitably means that ministers are constantly intervening and setting targets because they see themselves as the taxpayers' guardian; thus, undermining the market mechanism.
Researchers conclude that the NHS has put into practice the 10 Commandments of Business Failure as drawn up by Donald Keough, past president and former CEO of Coca-Cola:
- Among these commandments are "assume infallibility;" however its outcomes are worse than other universal health care systems and the NHS ranks low in international surveys.
- Another commandment is "isolate yourself" -- healthcare is conducted in separate "silos," particularly regarding communication between GPs and hospitals.
- A further commandment, "be inflexible," is met by hamstringing units with state control: staff pay is set centrally, capital expenditure is constrained, IT is a top-down program and availability of drugs, such as expensive cancer treatments, is centrally determined.
Source: Peter Pallot, "NHS 'is putting the patient last'," Telegraph, August 11, 2009; based upon: Peter Davies, James Gubb, and Donald R. Keough, "Putting Patients Last: How the NHS Keeps the Ten Commandments of Business Failure," Civitas: Institute for the Study of Civil Society, August 10, 2009.
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