Cost-cutting at NHS Lothian

NHS ‘moles’ are like the Malawian Orphans of the British blogosphere.
Doctor Crippen and Devil’s Kitchen think they are soooo clever with their inside information, don’t they? The Doc reports on the persecution of junior doctors, by revoking their right to prescribe drugs; while the Devil has a bizarre story about nurses secretly performing medicals on asylum seekers.
Well, I’ve got one too (actually, I have five or six, but let’s not be boastful). I’ve been forwarded a particularly amusing letter from Mr Mike Grieve, University Hospitals Division, NHS Lothian. He is leading a financial recovery team to reduce over-spending, which is currently running at £1 million per month.

Our immediate task is to return to a position of month-on-month income and expenditure balance … Much of this is incurred in four areas of expenditure namely, the cost of doctors in training, bank and particularly agency nursing costs, clinical supplies and some medicines.

So, they need to cut costs in the areas of: doctors, nurses, medical supplies, and medicine! Is that not, like, everything that goes into making a hospital a hospital!?
To be fair, at least they are on the case, and trying to get back on budget. My source is not impressed:

Without bank and agency nursing staff the service would collapse. There is a high level of sick leave amongst nurses, due to high levels of stress, low morale, poor pay, shift working etc.. A ward not well staffed by nurses is not safe.
What is interesting is there is no mention of managers, the ones who clearly fucked up in the first place.

That’s fine, but I can’t shake the worry that this would be not so different if the running of hospitals were sub-contracted out to private companies. What’s to stop them cutting the same costs and services to maintain profit margins?
NHS lothian logo

3 Replies to “Cost-cutting at NHS Lothian”

  1. Rob, don’t get me started. I am so upset about what is happening to the NHS which we all used to be so proud of.The NHS is in a mess because so much of the new money has gone on IT systems, something called Choose and Book not to mention the PFI(private finance initiative) initiative, the constant reorganisation of the structures PCTs (primary care trusts) etc with big pay outs to managers who find themselves without a job when organisations merge and independent treatment centres(ITCs) which are private centres which do operations at greater than NHS costs and have guaranteed contracts so they get paid even as has happened they don’t do the work. Make no mistake the idea is ultimately to have a low level safely net system, free at the point of use, and everything else will be private for which you will have to pay or insure yourself. And the tragedy is that this is all being done by the labour party and with the Tories we will just get more of the same. We are closing a ward and they try to tell us this will improve services. Its Alice in Wonderland or as they say “we are not in Kansas now Toto”

  2. I am sorry for that garbled response to your post Rob. What I wanted to say was that as I see it for a long time politicans have been worried about the rising cost of running the NHS, largely due to improvements in surgical tecniques, transplants, new expensive drugs and old people living longer with high use of the NHS. They became obsessed with controllong costs and embraced the market philosophy, totally misunderstanding that money is not the main motivator for doctors and nurses. They thought that costs could be capped by competition and set hospital against hospital thus negating the unifying spirit of the NHS. This was combined with an obsession with controlling the professions, trying to reduce medicine to a production line with the tasks of doctors and nurses broken down into units which could be counted and controlled by managers, and the managers have multiplied accordingly. All this was accompanied by buzz words such as patient choice, a service fit for purpose etc. I don’t know why the doctors and nurses allowed this to happen but the whole thing was sold as modernisation and any opposition was portrayed as being old fashioned and protectionist. I should say at this point that there were problems with the “old” NHS, waiting lists were too long, the service was too paternalisitc etc but there were other solutions which would not have led to the fragmentation of the NHS and ultimately I fear its demise.

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