3 ms·

"Local" parties (tories) split NHS trusts into smaller pieces which heavily impacted efficiency (Scotland IIRC escaped it)

• robertlagrant 2y ago
  It's not the number of trusts that's the problem - it's the massive trust-based pushback against centralisation. Remember NHS Digital? NHS England? Things keep being established to try and centralise for efficiency, and it's not working. My observation (caveat emptor) is that trusts push back so hard, and aren't necessarily staffed with technical top performers in the first place, and have such misaligned incentives to centralisation from IT to doctors to everything else, that it can't happen.
  • soco 2y ago
    They way I read it around here, those trusts would love it very much to get a healthcare system similar to the US one. Aren't they already well on the way?
    • robertlagrant 2y ago
      I don't know - what do you mean by "healthcare system"?
  • p_l 2y ago
    I see it as a case of forced decentralisation leading to bad incentives. When you had few NHS trusts covering entire UK, you could easily handle common issues because their scale matched close enough to cover entire vertical slice. Now you have trusts cut in size creating incentives against cooperation if only because of how funding is going to be arranged, and even if there's centralised service like NHS Digital... it's not the entity that is going to fight for budget for trust-local employee training and support needs.