The NHS is in the headlines once again for all the wrong reasons. Here is a personal anecdote. My uncle has been in hospital for the past six weeks while he waits for a heart operation. He can get up and walk around but he needs to be in a ward for monitoring. As you can imagine he is going stir crazy. One reference puts the bed day cost to the NHS as £255, so that is 47 days x £255 = £11,985 so far. The delay is due to the long waiting list for heart operations. The delays are so bad that the uncle is being shipped off to Dublin for his operation at a cost to the NHS of £26,000 (versus £15,000 for the NHS to do it. These operation costs were provided by a friend who is a senior NHS administrator).
Now the bottom line is he is in a safe environment, he will get his operation, and it will not cost him a penny. But you have to query a system whereby a procedure that should cost £15,000 balloons to £38,000. All over the NHS you hear similar stories of delays or bed-blocking.
I was talking with a local politician who is involved with some of the health boards and I was telling him the uncle’s story. He told me that he suspects many surgeons are on a ‘go slow’ to boost their private work. It works like this: Mr X (surgeons are called Mr not Dr) works for the NHS Monday to Wednesday. On Thursday and Friday he works privately. If the operations cannot be done Monday to Wednesday he kindly offers to do it during his private time (for a large fee of course). It gets even better because the private operations are performed in NHS hospitals with NHS nurses assisting all at no cost to the surgeon.
It costs half a million to a million for the NHS to train a surgeon. But somehow we don’t mind when they take all this largess and do private work. My politician told me about one very industrious surgeon who flies through dozens of operations a week. Needless to say his colleagues hate him as he makes them look bad.
When you see a consultant he can tell you it will be six months till you get your operation. But if you are happy to go private, does next Tuesday suit you?
There are two ways we can look at this:
- NHS surgeons should be full time on NHS work, not creaming off the private work. If they go private they should be expected to repay their training costs.
- We embrace the market. Surgeons get no salary. They become private contractors and are paid a set fee per operation. This will encourage them to do more operations and clear the backlog.
Can I say my own experience with the NHS has been excellent. I fractured my ankle last year and my treatment was superb. Likewise I have been in and out of hospitals with relatives and the treatment they got was generally excellent. Some doctors and surgeons are greedy sods but most of them are hard-working and committed to the aims of the NHS.
But it is clear there are flaws in the system. The health service is a massive beast that sucks in a huge amount of public money. It is extremely good at deflecting attention from itself (the photos of sick babies and old ladies are wheeled out any time anyone asks awkward questions). But with an ageing population that will see more pressure on the health service, we need to be asking how we can improve the system for the good of all.
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