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by albertgoeswoof 2708 days ago
Can you elaborate on how the NHS is inefficient? I.e. what metrics measure this? What in comparison to?

Ideally with data and not anecdotes

4 comments

The "reasoning" I usually hear about this is basically:

- The public sector is inefficient (1)

- The NHS is in the public sector

- Therefore the NHS is inefficient

[1] Apart from the bits that the person repeating this argument is proud of (e.g. SAS) or scared of (e.g. GCHQ)

Re waste they haven't worked in the private sector then.
From my experience:

1. Hardly any way to see a GP outside work hours, so you have to take time off.

2. Cannot see a GP near to where you work, it has to be near to where you live. Which, combined with point 1, is a pain.

3. If you don't use the NHS and go see a private GP instead (which makes economic sense given how much your time off costs vs a private GP costs), you still have to pay for it.

4. Hard to get an appointment at short notice; registration is a pain and very inconvenient.

5. Unless you are dying, they are unlikely to offer any real help/proper tests, but then again that depends on individual GP and is probably not that different between NHS/private.

6. No personal accountability for your health. You end up paying for all the clowns that drink too much on a Friday night and end up in an ambulance and other people that do not take care of their health. Old people seem to go to a GP just because they are lonely.

I have not had to use NHS hospitals luckily, but I am guessing if you are not dying the wait times could be bad.

But these are all great efficiencies. It’s a total waste of money to optimise gp locations for people that are well enough to go to work and can afford a private gp if they want it.

If you’re really sick you’ll be seen very quickly, and you’ll be extremely glad the doctors aren’t busy pandering to people with minor conditions.

That's what some one pointed out its the receptionists job to filter the worried well and prioritise those that need it more.
> From my experience:

> Old people seem to go to a GP just because they are lonely.

I somehow doubt the above.

That's not inefficiency, it's quality. Anyone who has lived in France for example will tell you that the NHS isn't that good. However, it's very cheap. Hence the efficiency
So most people have sick pay to go the doctors
There are inefficiencies in the NHS. Mostly due to it not actually being national, but regional. NHS is split into england, wales, scotland and NI. Then in eact country a county will be split up again into Primary Care Trusts, which cover between 100k-500k people.

This leads to oddities like there is a national contract for medical staff (nurses, surgeons and doctors etc) but hundreds of different employers.

Each PCT negotiates it's own suppliers, and has a number of stakeholders who are normally GPs. Its all totally ballsed up.

Thats not even touching the IT systems.

However using per capita spend on health, it is ridiculously efficient https://data.oecd.org/healthres/health-spending.htm

It can cause problems if you have serious conditions and you are having to be treated in two or three trusts eg my local hospital cant do all my bloods.

The outsourced local Patient transport fiasco in my trust caused no end of problems people missing dialysis treatments etc.

> That's not even touching the IT systems.

Yeah, there's a disparate mix of up to date tech and unpatched Windows XP systems, since there's no centralised tech management - some trusts care about patient data and external threats, others don't.

lower survival rates for cancer

longer waiting times

an inflexible system with no opportunities to pay for top ups to standard care

https://iea.org.uk/wp-content/uploads/2018/07/Healthcare-Bri...