Why do the NHS savings matter?


It is easy to be lulled into a false sense of security about NHS efficiency savings.

The doors to GP surgeries and hospitals remain open and, come what may, patients always seem to get treated - eventually.

In fact, the very term itself sounds rather innocuous.

But make no mistake: how the NHS fares in the next few years in achieving its £20bn target will go a long way to determining what sort of health service the country has in the future.

If it does not achieve what it needs to it will be patients who suffer.

The £20bn figure equates to a saving of about 4% a year until 2015. That is unprecedented for a health system.

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Despite the NAO [National Audit Office] calling it the first year of the savings, the health service has still had plenty of time to prepare for the savings drive”

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If the NHS does not become more productive it will simply have to cut what it does to cope with the rising demand from factors such as the ageing population and obesity.

And what is worrying about the National Audit Office (NAO) report - despite the praise for the good progress that has been made to date - is that there are signs this could be starting to happen.

The watchdog found evidence of rationing in areas such as cataract surgery. The tactic, which involves making patients wait until their eyesight deteriorates further before they get treatment, makes a huge difference to an individual's quality of life.

As does the trend - noticed by orthopaedic surgeons - of leaving patients in pain for longer before they are entitled to hip or knee replacements.

Public Accounts Committee chairman Margaret Hodge - like many monitoring what is happening - is worried about what lies ahead.

Responding to the NAO report, she urged the Department of Health to be careful that the efficiency drive did not lead to the NHS "shutting the door" on patients.

But what makes the watchdog's findings even more startling is that despite the NAO calling it the first year of the savings, the health service has still had plenty of time to prepare for the savings drive.

NHS chief executive Sir David Nicholson first proposed the target three years ago and told the NHS to start looking for them in 2010-11 - the last year in which it got a significant increase in its budget.

That is why inside the health service the alarm bells are ringing loud and clear.

Nick Triggle Article written by Nick Triggle Nick Triggle Health correspondent

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  • rate this

    Comment number 33.

    The government has made doctors and nurses NHS middle managers. These silly people make the ‘savings’ and the higher up folk pretend the cuts are clinical decisions. Eton, Oxford, Bullingdon-they are clever people.

  • rate this

    Comment number 32.

    NHS 'savings' as described here mainly matter for Cameron's privatisation coup. That is the main drive here.
    As for the NAO,of the long list of its worrying unreliabilites, that it is assessed by teams of academics from Oxford University and the London School of Economics says it all.
    Government is trying to strangle the NHS.
    That is the simple matter if it.

  • rate this

    Comment number 31.

    Let us look at the cost of breast cancer screening in the light of the recent report on its efficacy. It costs £96m per year, saves a mere 1300 lives p.a. yet commits nearly 4000 women p.a. to unnecessary treatment. Scrap it and save 10% of the required sum whilst not maiming almost 4000 women per year !

  • rate this

    Comment number 30.

    These are CUTS not savings. Let's call a spade a spade please.

  • rate this

    Comment number 29.

    I know how to make my job easier and more efficient, but my managers do not want to hear it or will make a bodge of implementing it later and claim the credit.
    Just like the government, too much managerial interference.

    When we struggle staff pull together, managers go online shopping.
    Or they get caught on their 2nd break in 1hour.
    Nothing will be done. Managers stick together.

  • rate this

    Comment number 28.

    Having poorly designed "targets" is another big issue that often results in higher costs & poorer service.

    Quality of life isnt a "target" for a start

    But with waiting list and treatment targets consultants often play "pass the hot potato" where proper diagnosis & effective treatment come second to playing ping pong sending back to your GP in order to get you off their waiting list target

  • rate this

    Comment number 27.

    I'm a Hospital Consultant in both the NHS and private. My Trust is run by an army of managers and compliance bunnies our local private hospital is run by a handful of women of a certain age. I know they are not comparable institutions but guess which one is most efficiently managed.

  • rate this

    Comment number 26.

    For too long the NHS was seen as a cash cow for the private sector. The abject wast of money thay was laughingly called World class commissioning, all the rage 3 years ago is now obsolete. Consulting firms many of whom,spawned Tory MP's got their snouts in the trough too. Tower Hamlets alone spent over £9m in consulting fees. That is where the money has wrongly gone and should be clawed back.

  • rate this

    Comment number 25.

    Dozens of MPs have interests in private health care companies. The Government is denying the NHS of cash to say that it has failed and then use that as justification for privatising it. The writing is on the wall.

  • rate this

    Comment number 24.

    The problem lies with blinkered Spreadsheet cost management

    Stopping minor treatments saves money (initially) but later when they develop into more serious conditions the cost is greater

    I saw a consultant (01/12) who was looking for solely one issue (& not to solve the problem) I had to go back 6 months later for another procedure that could have been done the first time

    More speed, less haste

  • rate this

    Comment number 23.

    the nhs wil not survive if private co's get all the work,,,nice shiny hospitals,nice goods,,,it might as well be a phs private health service now.......... remember the debt systemis fake abraham lincoln used non repyable money constutional law........free speech or limited speech,this nver comes out !

  • rate this

    Comment number 22.

    19. Mayna
    Exactly right. The NHS should provide comprhensive care for all for significant diseases BUT we all have different views on what is significant hence we need a national debate but dont hold your breath as it's firmly in the governments "too difficult" pile

  • rate this

    Comment number 21.

    The NHS seems to lack the same sense of coordinated leadership as does the rest of Britain.
    Has it occurred to Govt that the people who know how to make savings, NHS workers themselves, probably do not have the time to attend to suffering pateints far less attend to a suffering budget?

  • rate this

    Comment number 20.

    I would like to impeach this government on mental grounds.

  • rate this

    Comment number 19.

    14.Cave Canem

    Agreed. But in a bureaucracy how else would they run it & that is part of the problem, state bureaucracy or private with business interests.
    We are also our worst enemies, we expect so much from the NHS (due to medical advances) yet refuse to see these far exceed the original vision & accept there are limits to what we should or can ask expect.
    At work so no time to chat :(

  • rate this

    Comment number 18.

    Looking at the muddled incompetence of our political "leaders" I confidently predict a large taxpayer investment into neurology. Unless, of course, they are claiming their BUPA subs on expenses.

  • rate this

    Comment number 17.

    The elephant in the room here is that the country simply cannot afford to continue to deliver all aspects of care to all free at point of delivery. When the NHS was setup many diseases were simply not treatable - now we expect to be cured of everything - even the self-inflicted smoking, alcohol, drug, violence, bad-driving) related ones. No government of any stripe is wiling to shoot the elephant!

  • rate this

    Comment number 16.

    I have to wonder how all of this has come about. There have always been (to use a 'Westerns' vernacular) far more 'Indians' than 'Chiefs'. Yet we have allowed these 'Chiefs' to tax us to the hilt, sell out to the greed of 'profit over people' private enterprise, plead fiscal poverty, yet find countless millions of....dollars-for their own pet projects.
    Dollars? I mean Australia-so damn familiar.

  • rate this

    Comment number 15.

    Comment from a retired GP in the family who worked pre & post NHS. The pre NHS hospital he worked in had less managers & admin staff than you have fingers on 1 hand. So a thought to ponder is why the state run Hospital & NHS does require so much none clinical staff.

    Honest to god, what is there to ponder - the pre-NHS hospital had a hell of a lot less patients! Most couldn't afford it!

  • rate this

    Comment number 14.

    12. Mayna
    Probably to manage and meet all those government imposed targets. Trying to run public services like an office was always a mistake imo.


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