D Walker
Member
- Messages
- 9,827
From Bob Stewart MP fb page
Over the last 4 weeks I have been contacted by four separate companies variously saying that they have NHS equipment such as masks, gowns and ventilators but they are having great difficulty in dealing with those that procure such items for the NHS. They told me that, in their experience, the NHS preferred to deal with people from whom it had always bought equipment and they were effectively frozen out. Their request to me was how could they get their produce into the health system as there was a pressing need for it?
I suppose NHS procurers have been inundated with offers of help from potential providers of tests or ventilators or protective equipment who have been trying, in effect, to sell their services to a single customer. Perhaps our NHS system is overwhelmed and cannot cope. By the way I did try to get the 4 potential suppliers alongside the NHS procurement department but I have heard nothing back (but don’t really expect to either).
It has made me think though. We are all in total admiration of what the staff in the NHS are doing – especially the risks they are running. But is the NHS as an organisation, not its magnificent personnel, as good as it can be? Is it institutionally fit for purpose? After all, when this is over perhaps, perhaps we should look again at our National Treasure. We often think the NHS to be beyond compare but is it really?
Looking around Europe at other health systems Germany stands out clearly. The figures are indicative. As of today, Germany has lost 4,586 people killed by Coronavirus whereas more than three and a half times that number of citizens (16,060) have died in the UK. Have we got something wrong?
Nobody doubts that the NHS is filled with dedicated and very brave people and parts of it are superb but have they been let down by its structure and governance? Germany seems to have been much more successful at managing the COVID-19 crisis than any other major European country and yet it doesn’t actually have a national health service in any way like ours.
Each of its sixteen federal states has individual responsibility for its own health service which is paid for by compulsory health insurance levied on those who work. It is a very complicated system which involves payments from individuals, companies and government subsidies but it works.
Anyone who wishes it can go to any specialist doctor they like and there is no need for a middle man/woman (a GP) before so doing. There don’t seem to be waiting lists or delays for rehabilitation. Wow, that seems great. Obviously, the German health system needs over-capacity but in a crisis what an advantage. I understand that at the start of this COVID-19 Crisis Germany had 34 intensive care beds for every 100,000 of its population. We had 6.6 beds and the European average was 11.5 beds for the same numbers of people.
Germany does not have our unwieldy central diagnostic system. At the start of the crisis it had 176 testing centres, part of localised arrangements. We compared very unfavourably with that. I cannot find the exact numbers now but seem to recall we had less than 50 such laboratories.
I know this may not be accepted by those who love the state running everything but in Germany laboratory efficiency and capacity seems much higher than here at home because of a high degree of de-centralisation, privatisation as well as competition. Their health system is not centrally controlled and all sixteen federal states can make their own choices and decisions. It works too.
But the German health system comes at a cost. According to the Office of National Statistics, in 2017 the health costs per person were £2,989 a year whereas in Germany £4,432 was spent. It is a blinding glimpse of the obvious that spending more gets a better health service. So, would each of us be prepared to pay 33 per cent more on that part of our taxes dedicated to health? Right now, I know we would and I’m pretty certain, even before the crisis, such additional taxes just for the NHS would have received a fair wind too. But it is not just about money – although that seriously helps. As it is set-up at the moment, I wonder whether a cash injection of another third would give us the choice and over-capacity of the German health system?
We often almost by instinct – and with national pride - defend our NHS as being beyond reproach and a model for the World to follow. After all, it has been around long enough for other countries to copy our lead. I wonder why they have not then? In truth though there is no other country with a system anywhere near the NHS in its set-up.
When the COVID-19 Crisis is over so much will never be the same again. That probably includes the NHS as well. I repeat that individuals and parts of the NHS – maybe not its procurement side though - have performed magnificently. We all know that. Please do not think I am not knocking the NHS. It looks after everyone – rich or poor – regardless. That is superb. But I am just suggesting that we might consider, after this crisis is past, how the NHS can be adapted to be even better in the future.
Over the last 4 weeks I have been contacted by four separate companies variously saying that they have NHS equipment such as masks, gowns and ventilators but they are having great difficulty in dealing with those that procure such items for the NHS. They told me that, in their experience, the NHS preferred to deal with people from whom it had always bought equipment and they were effectively frozen out. Their request to me was how could they get their produce into the health system as there was a pressing need for it?
I suppose NHS procurers have been inundated with offers of help from potential providers of tests or ventilators or protective equipment who have been trying, in effect, to sell their services to a single customer. Perhaps our NHS system is overwhelmed and cannot cope. By the way I did try to get the 4 potential suppliers alongside the NHS procurement department but I have heard nothing back (but don’t really expect to either).
It has made me think though. We are all in total admiration of what the staff in the NHS are doing – especially the risks they are running. But is the NHS as an organisation, not its magnificent personnel, as good as it can be? Is it institutionally fit for purpose? After all, when this is over perhaps, perhaps we should look again at our National Treasure. We often think the NHS to be beyond compare but is it really?
Looking around Europe at other health systems Germany stands out clearly. The figures are indicative. As of today, Germany has lost 4,586 people killed by Coronavirus whereas more than three and a half times that number of citizens (16,060) have died in the UK. Have we got something wrong?
Nobody doubts that the NHS is filled with dedicated and very brave people and parts of it are superb but have they been let down by its structure and governance? Germany seems to have been much more successful at managing the COVID-19 crisis than any other major European country and yet it doesn’t actually have a national health service in any way like ours.
Each of its sixteen federal states has individual responsibility for its own health service which is paid for by compulsory health insurance levied on those who work. It is a very complicated system which involves payments from individuals, companies and government subsidies but it works.
Anyone who wishes it can go to any specialist doctor they like and there is no need for a middle man/woman (a GP) before so doing. There don’t seem to be waiting lists or delays for rehabilitation. Wow, that seems great. Obviously, the German health system needs over-capacity but in a crisis what an advantage. I understand that at the start of this COVID-19 Crisis Germany had 34 intensive care beds for every 100,000 of its population. We had 6.6 beds and the European average was 11.5 beds for the same numbers of people.
Germany does not have our unwieldy central diagnostic system. At the start of the crisis it had 176 testing centres, part of localised arrangements. We compared very unfavourably with that. I cannot find the exact numbers now but seem to recall we had less than 50 such laboratories.
I know this may not be accepted by those who love the state running everything but in Germany laboratory efficiency and capacity seems much higher than here at home because of a high degree of de-centralisation, privatisation as well as competition. Their health system is not centrally controlled and all sixteen federal states can make their own choices and decisions. It works too.
But the German health system comes at a cost. According to the Office of National Statistics, in 2017 the health costs per person were £2,989 a year whereas in Germany £4,432 was spent. It is a blinding glimpse of the obvious that spending more gets a better health service. So, would each of us be prepared to pay 33 per cent more on that part of our taxes dedicated to health? Right now, I know we would and I’m pretty certain, even before the crisis, such additional taxes just for the NHS would have received a fair wind too. But it is not just about money – although that seriously helps. As it is set-up at the moment, I wonder whether a cash injection of another third would give us the choice and over-capacity of the German health system?
We often almost by instinct – and with national pride - defend our NHS as being beyond reproach and a model for the World to follow. After all, it has been around long enough for other countries to copy our lead. I wonder why they have not then? In truth though there is no other country with a system anywhere near the NHS in its set-up.
When the COVID-19 Crisis is over so much will never be the same again. That probably includes the NHS as well. I repeat that individuals and parts of the NHS – maybe not its procurement side though - have performed magnificently. We all know that. Please do not think I am not knocking the NHS. It looks after everyone – rich or poor – regardless. That is superb. But I am just suggesting that we might consider, after this crisis is past, how the NHS can be adapted to be even better in the future.
