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The "funding" problem that I never see discussed is that the NHS costs massively more per-person now than when it was introduced. ex. How many ambulances at a
by lbriner 4y ago
The "funding" problem that I never see discussed is that the NHS costs massively more per-person now than when it was introduced.
ex. How many ambulances at a few pounds in 1948, which were vans with a stretcher in the back and a couple of blokes to drive it. What about 2022? The cost, roughly £150K for the ambulance, goodness knows what to train up ambulance technicians and paramedics. If the kit is broken, the ambulance can be out of service, which means more units to provide cover (or not if you can't afford it!). The on top of all that, many more people go to hospital because the care is leagues above what you got in 1948.
Ditto for equipment costs like Digital XRays, MRIS etc.
All of that is not surprising or even undesirable but it would be interesting to see the additional tax that you should be taking per-person to pay for all of this additional equipment. If the NHS costs around 30% of expenditure i.e. 30% of my tax then roughly 7.5% of my income covers the cost of the NHS, maybe £6K per year. When we look at things that way, you can see why the Government doesn't want to take any money in tax because that sounds like a lot of money. You can also see how they can't reduce costs by going backwards in replacing high-tech with no-tech.
- rcarr 4y agoFrom what I read it’s not the equipment, but a bloated layer of bureaucratic management on massive salaries that is the real issue. The front line staff get pittance in comparison.
- daedalus_f 4y agoNHS management overhead takes up approximately 8% of the total NHS budget [1] In the US that number is more like 15-20% [2]. [1] https://www.kingsfund.org.uk/projects/health-and-social-care-bill/mythbusters/nhs-managers https://www.kingsfund.org.uk/projects/health-and-social-care... [2] https://jamanetwork.com/journals/jama/fullarticle/2785479 https://jamanetwork.com/journals/jama/fullarticle/2785479
- rcarr 4y ago> It is extremely difficult to find an accurate figure for the number of managers in the NHS, and most sources of information use different definitions for who is counted as a manager. I’m not sure I can take the report seriously after that. You can’t write a report on management in the NHS and refuse to give a definition of manager. Also, how many of these managers are directly employed by the NHS and how many are employed as consultants? I’m not saying you’re necessarily wrong but that report is hand wavey.
- DanBC 4y agoThe Kings Fund is a credible source of information about the NHS systems in England, Scotland, Wales, and NI. One of the reasons that they're credible is because they're cautious about definitions. In your quote they're saying "lots of people have written about this, and they all use slightly different definitions for management, and so they all give different numbers". What is a manager? Are you only including non-clinical staff? Or do clinical staff count too? If you're including clinical staff, how many hours of their working week are you counting as clinical hours and how many are you counting as managerial hours? Are you converting people who work part time as managers to Full Time Equivalent positions, or not? If you want to poke the data it's here: https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforce-statistics https://digital.nhs.uk/data-and-information/publications/sta... If you want more description of the complications of counting managers in the NHS I found these useful (if a bit old now): https://www.kingsfund.org.uk/publications/future-leadership-and-management-nhs/managers-and-the-nhs-2010 https://www.kingsfund.org.uk/publications/future-leadership-... https://www.kingsfund.org.uk/projects/general-election-2010/how-many-managers-2010 https://www.kingsfund.org.uk/projects/general-election-2010/... https://www.kingsfund.org.uk/projects/health-and-social-care-bill/mythbusters/nhs-managers https://www.kingsfund.org.uk/projects/health-and-social-care...
- lbriner 4y agoI think that's the problem with "what I read". I think the "man on the street" would probably agree but not necessarily from hard data, just from the fact it is easy to blame inefficiency rather than structural or human problems. "The NHS is full of bureaucracy" but it is a bureaucratic system so of course it is. People to charge hospital costs back to GPs, people to investigate trends and make sure that some GPs are not under-referring people to hospital, etc. but when I worked in the NHS many moons ago, it didn't seem particularly disproportionate to the size of the organisation. There were many more problems with people not doing their jobs properly but that was everyone, not just this nebulous "middle management" that everyone likes to cite! Certainly, some hospitals under-perform and have issues with culture and discipline but that's the same as any business.
- TheOtherHobbes 4y agoIt wouldn't need any more tax. There's a black hole in the budget caused by inefficient tax collection, almost entirely to the benefit of large corporations and very high net worth individuals. There are also some quite ridiculous cash handouts for little or no taxpayer benefit. Like the notorious £37bn that failed to provide an efficient Covid test and trace system. Or the >£100m in the Michelle Mone scandal, which seems to have been just one of many. Or the £45bn in tax cuts in Kwasi Kwarteng's recent budget, which were supposed to "promote growth" but have done the opposite. The UK is one of the richest countries in the world. It has also become one of the most corrupt. A penny or two on tax is not the problem.
- gadders 4y agoThe Kwasi Kwarteng tax cuts were all reversed by Jeremy Hunt, I thought?
- kmlx 4y ago> It wouldn't need any more tax. i don’t think you realise how much the health service costs. you can tax all of the richest and it will represent a few days of the health budget. a new funding model is needed. otherwise there will have to be tax increases.
- nradov 4y agoThe NHS also costs more now because the population is sicker than in 1948. Older, fatter, more sedentary, heavily impacted by preventable chronic diseases. Demand for services is way up. Higher taxes might help a little but won't address the root cause.