David Taylor-Gooby: There is no reason why the NHS cannot do things more efficiently

Journal columnist David Taylor-Gooby says the future of the NHS poses us some hard questions - but we must try to answer them

Yui Mok/PA Wire An NHS logo
An NHS logo

Much was said about the NHS at the party conferences.

I think most of us realise more resources will be needed if we are to keep an NHS of which we can be proud. The politicians came up with some good ideas (the commitment to mental health in particular) but the resource issue was not seriously considered. I am uneasy about the Labour Party’s proposals to tax people we don’t like, such as those in large houses and tax evaders because I simply do not think these measures will do the business. In any case they dodge the obvious truth, that if we want a collective service we all have to pay into it one way or another. We cannot assume someone else will do it.

I don’t think either the Liberals or the Conservatives have thought seriously about the resource issue, although the Liberals, more than the Conservatives, are willing to address it. But I appreciate too, that we cannot expect hard-pressed people to fork out much more. So what is to be done?

I attended a lecture by Alan Milburn last week. He used to be Secretary of State for Health under Tony Blair. That government addressed the funding issue by increasing national insurance, which was a popular move at the time. It was also at a time of economic growth and prosperity, so it was much easier to make such a move than in the present climate of austerity, where many people have had no wage rise for several years. Alan addressed the issue head-on. He argued that most businesses do their best to make better products for less cost. Cars and mobile phones are good examples, where the product is better, but the price relatively less. Should the NHS not try and do the same?

Before you all point out that a service like the NHS, relying on human input, is not like a manufactured product - I realise that. But there is no reason why the NHS cannot do things more efficiently. Alan Milburn pointed out four areas where this could be done:

Better integration with social care;

More prevention

Engage patients better

Use technology more.

I would agree with all these points, but there is a big problem. Social care is part of local government, and prevention is dealt with partly by the NHS and partly through Public Health which is run by local government. Local government is in the front line for government cuts, half of which are still to come.

It is no good arguing for more integration between the NHS and social care if the latter is having its funding reduced. Instead of regarding it as a soft target where cuts can easily be made, Government has to recognise the value of services which local government provide and fund them accordingly. Effective policies to prevent bad health are also going to require more backbone by the government to stand up to food and drink companies, and reduce the substances in what we eat and drink which can cause bad health.

But what about technology? I was lucky enough to meet some young people last week from Framwellgate Moor School Durham who have been doing a project about health. They looked at what happened in the Emergency Department at University Hospital Durham, and made some suggestions for improvements. They suggested free wi-fi should be made available, and there should be facilities for charging mobile telephones.

Their reasons were very cogent. It would make it much easier for people to contact relatives with news of loved ones, and if someone had to wait several hours for an appointment, they could go somewhere a bit pleasanter and receive a text message when they were needed.

They also pointed out that the internet and skype could be used more widely for patients to interact with clinicians. This would be particularly useful in cases of mental health where quick access is often needed.

I came away very encouraged. Here we have thoughtful young people who want to improve the NHS and are offering serious suggestions as to how to do it.

David Taylor-Gooby is a freelance writer.


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