Wednesday, March 08, 2006
NHS Questions of Value for Money set to Increase
When Labour acceded to power in 1997 spending on the NHS was £34bn- by 2007-08 it will have trebled to £90bn. Huge numbers of new staff have been taken on: 23,000 more doctors, 67,000 more nurses, 26,000 more therapists and technical staff and 72,000 clinical support workers. It's a huge input of cash and new resources even before the £6.2bn in IT schemes is added together with the scores of new building projects mostly funded by PFI arrangements. Today Blair boasted how waiting times for operations had plummeted. Of course it's better he claimed: when we inherited it in 97, the question was not 'can we improve it?' but 'can we save it?'
But has the spending led to the huge improvements Blair claims? Everyone seems to have a different tale to tell. MPs complain about constituents waiting for operations; there were the dirty hospitals which surfaced at the last election; and we have our own experiences to inform us. Personally, I recall how my mother's terminal illness was not diagnosed at all in 1989 when the Tories were in power- my sister moved her to where she lived in Germany and the diagnosis was near instant and subsequent care excellent. When I incurred a stroke while out jogging in 1992 I slept all night on a trolley in a corridor, during the time when close medical attention is crucial. Looking back I realise I was very lucky to escape with only minor permanent effects. More recently I have had two smaller operations: both were conducted with great despatch and efficiency and I was out in a matter of hours. Other people of my age tend to report similar experiences, but this is all subjective.
Objectively, we learn that the NHS is heading for a deficit approaching a billion pounds and staff are allegedly being laid off in some health authorities. We hear staff costs have sucked away most of the extra cash with only a quarter going on real front-line improvements. We hear some hospital trusts can hardly pay the outgoings on the PFI schemes which created them; a kind of generous rent payable to the sponsoring companies over a 30 year period. The Economist ran a piece this week on productivity in the health service based on the work of Sir Tony Atkinson of Oxford University.The journal concludes that it is impossible reach any conclusions based on this work as it has produced six alternative measures of productivity, all of them different. But even the mot favourable only shows about a 10% increase since 1997 compared with the more than doubling of funding over the same period. So, we tend to fall back on subjective impressions instead. Stand by for much more of this- or a new magic way of measuring- as Gordon's big election approaches.
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