Thursday, June 24, 2004

Traffic Jams & Health

Gutted. I'm typing this after a terrible journey, made worse when I got home just in time to catch the end of the England match. I spent a very irritating couple of hours in traffic jams which meant that I missed an important meeting in Cromer. Nothing I could do about it, but I just hate it when it happens. Tomorrow I'm on North Norfolk Radio at 10am, am meeting some GPs in the afternoon and then catching up on work in the office later. On Saturday I'm off to Norwich to a coffee morning in aid of Alzheimers and then having a fundraiser at my house in Swanton Abbott. God alone knows what we'll do if it rains. On this occasion I don't have a Plan B!

I was very impressed by our health announcement this week. I really think this policy will be attractive to people. It's simple to understand and will mean that waiting lists should be a thing of the past. Labour will attack it in their usual tribal manner but if you actually stop and think about it it makes so much sense. People are sick of the "If I can't have it no one should" attitude. In the end no one cares who treats them - NHS or private - as long as they get the treatment they need when they needs it. If the NHS is for whatever reaosn incapable of providing the treatment I see absolutely no reason why the private sector cannot step in. It frees up more capacity in the NHS without depriving it of funds. I'll be interested to see what the healthcare professionals make of it all.


Westbury-on-Trym Lib Dems said...

What do you make of the Financial Times' criticism of your policy? In essence the FT says that the proposal to pay half a patient's bill for going private will (like any subsidy) dramatically reduce incentives for private hospitals to deliver services efficiently. There have been reductions in bills charged by private healthcare providers to the NHS in the last couple of years as waiting lists have reduced (to some extent) and competition has been provided by foreign companies. The FT considers that your proposals are "thoroughly bad" because they will reverse this process. Any thoughts? Or do you feel that this important part of the policy should be dropped?

Iain Dale said...

I don't acceot your assertion that waiting lists have been reduced. Talkto a GPand they will explain to you that because of the Government's attempt to massage the waiting list figures many seriously ill patients are having to wait longer even though they need urgent attention. It's the large number of more trivial, non urgent cases, that are being dealt with more quickly at the expense of the more urgent cases. I met with a GP on Friday afternoon who explained this to me.

I haven't seen the FT so don't really feel in a position to comment, but I don't see at all why this should lead to inefficiency in the private sector. If there was no inefficiency in the public sector we wouldn't even need to be debating this.

Westbury-on-Trym Lib Dems said...

The article is shown below:


Normally when the National Health Service becomes a political football ahead of a general election it is thoroughly bad news for both patients and staff - witness Michael Howard's faux pas this week over a constituent who turns out not to have been waiting 20 months for radiotherapy (although 14 weeks, it must be said, is more than bad enough).

This time round, however, the party political battle over the NHS is leading to apotentially new settlement for Britain's best-loved, if far from always best-performing, institution.

Both Labour and Conservatives now accept that the NHS will become increasingly a funder of care, less a direct provider. Both are emphasising a growing degree of choice for patients - not only over where and when elective operations are performed but over longer-term care and the types of treatment patients receive. Both are seeking to use market-like mechanisms to devolve power and responsibility to those who provide care and to those who receive it. Both are looking to move regulation and standard-setting out of the hands of politicians and into the remit of relatively independent bodies.

Both parties' plans, however, are predicated on changed behaviour by the private sector. To meet either of the parties' ambitions it has to start providing routine treatments at prices that match, or at worst are extremely close to, those of the NHS.

This is why the Conservatives' idea of a voucher worth half the price of an NHS operation that could be topped up in the private sector is such a thoroughly bad one.

At present, it is doubtful if there are even one or two private hospitals treating NHS patients at NHS rates. But, under pressure from new overseas providers and falling NHS waiting times, the sector is beginning to reform itself. Private prices for treating NHS patients are starting to fall - and, as a by-product, they should start to fall, or at least rise less quickly, for private patients too.

But this revolution - one that will benefit both NHS and private patients - is just beginning. It is nowhere near complete. And it will not happen unless the market forces to which the sector is suddenly being subjected remain firmly in place.

Offering a subsidy to the private sector, as the Tories plan to do, would be one guaranteed way to stop this revolution in its tracks - while at the same time providing every incentive for NHS surgeons to encourage long waits in order for the business to transfer to their (subsidised) private practice.

Added to that, it makes the Conservatives look more interested in subsidising the 12 to 15 per cent of patients who already go private than they are in ensuring swift treatment for the 85 per cent who rely on the NHS for elective care - and who share a common interest with private patients in seeing the cost of privately provided care fall. It is a policy that should be dropped.


If I may say so, I think your comment on inefficiency in the public sector misses the point somewhat. Inflation in the health sector has run ahead of RPI recently but nobody argues that the UK does poorly compared with other European countries (and even less the US, where healthcare costs are significantly higher) in terms of cost per hip operation (or whatever). The key problem is capacity/waiting times which is very different from efficiency. The FT's point is that by picking up half the bill (including for people like me who are already privately insured by employers) you unnecessarily and unwisely encourage inefficiency in the pursuit of capacity. By analogy, if the Government started paying half your customers' bills at Politicos, it would make business sense to raise your prices.