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Same side of the same coin

9 September 2016

A sad truth: The NHS is now failing in terms of performance and also failing on the money – both of which are the same side of the same coin.

With the news that the Provider sector bailouts were a shy away from an eye-watering £2 Billion for the financial year 15/16 and with no likely way for these loans to be repaid, it seems we have a Greece scenario.

As the system leaders continue their best efforts to drive transformation, I am struggling to understand how the system works, but far worse than that, I cannot see that any real thought has been given to how the system will work in the future – at least beyond the 5 year forward view (3 years remaining).

Tinkering at the edges is not the solution – the solution is most definitely political and it does not look like there will be any real decisions anytime soon – the main political parties have failed to agree upon the future vision of the NHS.  There is clearly polarisation in thought and when you have two distinct views with consensus building in the middle, it prevents collaboration and change.  Certainly the fact that the main opposition party is all-but leaderless doesn’t seem to be helping matters much.

The rapid deterioration in social care funding, which has placed enormous strain on NHS resources clearly means the boundaries between Local Government and the NHS need to grow – Manchester is leading on that and all eyes currently face North to observe this model with a keen interest; lets hope it works.

Some honest debate with the public in relation to the NHS would be no bad thing - the District General Hospital model is no longer fit for purpose.  What with rapid improvement in medicines and advancements in technology, a cash-poor NHS cannot sustain this model any longer and nor should the tax payer because it is an outdated one.  Obviously, there are further issues associated with this as transforming these organisations is expecting the organisational leaders to relinquish their posts – it is like asking turkeys to vote for Christmas.

I wait to see what announcements are made next week by NHS England regarding the plans for public engagement and the debate that will take place as a consequence once the sustainability and transformation plans have all been submitted (who knows where that will lead because without it, the general public will continue to remain largely unaware of the challenges and strain the system is facing).  Truthfully, I think it is about time too given the individuals driving these plans have all been politely discouraged from publishing any draft proposals.

Perhaps some learning from Iain Duncan Smith is required; he seemed to do this particularly well with the social reforms before he resigned citing his values – so, let’s see what November brings – what I can predict is cooler weather, a tough message for NHS finances in the Autumn Statement; there are most definitely choppy waters ahead.

Sarah Lovell, Partner

Sarah Lovell is a Partner in the Healthcare Practice, read Sarah's profile.

Categories: Healthcare


barry ryan at 17/10/2016 16:26 said:

The NHS if it were a business, would be bankrupt. Yet, it resists change/improvement, furiously. If I had the opportunity to work within it, I would begin its reformation by starting to regionalise and then centralise, its materials procurement. Why do hospitals pay different prices for the same thing, just because they are in different places? If I couldn't save the NHS £20 million in my first year...lock me up. Why this resistance to change..? Totally beyond me and those like me, who live in the real world, where savings have to be made and profits improved.