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Why not fine those who waste the NHS’s resources?

1 April 2014

4:07 PM

1 April 2014

4:07 PM

What do I want from the budget, I was asked. So I had a think. One plea was for no more pasty taxes, which I argued distracted from the more serious changes that would actually affect most people. So Osborne decided to cut the Bingo Tax, and we ended up with #bingogate. Someone obviously hadn’t been paying attention at the back. But among what I like to think of as the more serious requests to the Chancellor, I suggested the implementation of a charge of, say, £10, each time a person missed an NHS appointment.

The Chancellor didn’t listen to me then, either. (Well, to be fair, why should he?) But I see that a think tank has released a study, co-authored by former Labour health minister Lord Warner, which recommends charging a £10 monthly fee for use of the NHS. I can see where they’re coming from – which is, essentially, the same place as I’m coming from. That place being the idea that the NHS does, somehow, need to cut its costs and find alternative sources of funding. But even if we are both coming from the same basic angle, I can’t say that I agree.

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As an NHS spokesman told The Telegraph: ‘The founding principles of the NHS make it universally free at point of use’, and I for one think it should remain so. That’s not to say that I’m backtracking on my original request; I’m not. I’m asking for charges for non-use of the NHS. And anyway, how would a ‘NHS membership’ even work? Someone turns up at hospital with a broken leg, or a life-threatening illness, but no membership. Then what?

I’m all for helping the NHS to save money. But how about we focus on trying to cut down on health tourism, and preventing wastage – of both time and money – instead?

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Show comments
  • Frank

    The Spectator keeps removing my comments that any sane manager of the NHS would start by sacking 10% of the managerial class, see how that improved things and then do another 10%. I then mentioned that the inefficiencies seen in the NHS are seen elsewhere, eg in the police force where the chief constables object to centralised buying despite it being shown to be capable of saving hundreds of millions of pounds.

  • Frank

    Very strange, I have just had a comment removed for making two innocuous statements: (a) that any normal commercial manager sent in to the NHS would start by sacking managerial staff and (b) that the type of inefficiencies seen in the NHS are also seen in police forces across the UK, where chief constables refuse to have centralised equipment buying, even though it is established that this would save hundreds of millions of pounds.

  • http://english-pensioner.blogspot.co.uk/ english_pensioner

    Two local hospitals were “merged” although they are about 15 miles apart. In the business world, this would produce “synergies” allowing for the reduction of the backroom staff. The hospitals each had a Head of Finance (or some similar title). In business one would have been made redundant, in the NHS they both stay and there is now an Executive Head of Finance, plus of course all the associated staff. Additionally, a new Inter-site liaison team was established to ensure “conformity of practice”.
    However, the A&E at one hospital was closed to produce savings but that at the other wasn’t enlarged to cope with the extra load.

  • Wessex Man

    You can see where they are coming from, where’s that then, we are taxed to despair, pay national insurance as another tax, VAT at 20% outrageous fuel duty and you can see where they are coming from?

    I am informed by someone who should know, working near the top at a very large Hospital nearby that adminstrative staff there now outnumber medical, this sacred cow the NHS needs to be culled back to the times of pre Blair, who told the lie that he had 24 hours to save the NHS.

    Let’s instead of charging people £10 a month on top of eveything else charge non attendees whose missed appointments which run into thousands at this one Hospital £10 for the first missed appointment and £50 for the next throughout the country!

  • Frank

    It is wonderfully timed to discover that Hunt wants the NHS to offer Chinese medicine, regardless of the un-proven health benefits (he is also keen on homeopathic medicine). Heavens, lets just tear up all the sensible cost-analysis on what drugs work and start issuing bear spleen to everyone. NB Hunt is a conservative minister!

    • 2trueblue

      If you have not tried either then you should. They are not without merit. Half of the drugs prescribed and given out by pharmacists are just wasted by the public, courses of drugs unfinished, not taken, etc.

      • Frank

        I am delighted that you are happy with these approaches, but I do not think the NHS should financially support anything that isn’t proven to be cost effective.

        • 2trueblue

          Look at the number of drugs that are not proven but used currently. A lot of drugs that are used across the board are not proven. They are produced by powerful companies whom the NHS are reliant on.

      • Dai Station

        Placebos are not without merit either!

  • Hexhamgeezer

    Agreed. Fine UNISON, UNITE, AMICUS and the BMA

    • Tom Tom

      Dept of Health has no role in matters seemingly

    • Fergus Pickering

      But old people dying is just what we want. They use the NHS a lot. So do poor, stupid people. We want ot get rid of them.

      • telemachus

        Fergus
        You are in overdrive
        But that is unbecoming even in jest

        • Kitty MLB

          Well, all you lefties need to stick together.

          • telemachus

            “you?”

            • Kitty MLB

              Yes, what is the problem with the word ” You ” ?

              • telemachus

                Were you implying Fergus was a lefty

                • Kitty MLB

                  I have to be careful how I answer this, and I am still quite new.
                  Most say that Labour and Cameroons are lefties- do they not ?
                  I am a Right Wing Conservative and both the above are my political enemies ( although I do get on with some labour & cameroons) Some Cameroons are more leftie then others
                  such as Hooky. And although I do not know Mr P as well as I do others here. I would say he’s a conservative that can fly in either direction, but not as left as Hooky might-
                  Did you expect a direct answer… I am learning Telemachus.

                • Fergus Pickering

                  I am a supporter of Mr Farage.

                • Kitty MLB

                  And I am the Lady of Shallot. Stop tormenting Mr Farage
                  and pretending you are not effervescently devoted to
                  David Cameron- blind loyalty and all that.. totally devoted to
                  you hero David..

                • Fergus Pickering

                  My vote in the European elections goes to Mr Farage, just as it did last time. You should vote for him too.

                • Kitty MLB

                  Mr Farage should not believe you. Inveiglements, artful talk
                  and maneuverings are all part of the Cameroon plan.
                  The lot of you are plotting. And if you voted for Mr Farage
                  last time I shall eat my foot.
                  I also think you are after a few Brownie points from the Kippers
                  here…but you just remember… some of us are like Sherlock
                  Holmes.

                • kyalami

                  Never mind. We won’t tell anyone.

                • Kitty MLB

                  You had better not, if true ( And I have a Sherlock Holmes
                  hat for this type of jiggery- pokery) Cameron would be devastated by this loss, he will be wandering around in
                  a world of eternal gloom. It will be his undoing,
                  a dagger through his very soul.

                • Fergus Pickering

                  Abd who do you back? I have quite forgotten, if I ever knew.

                • kyalami

                  The good guys, of course! 😉

                • Wessex Man

                  The Good Guys, hey come on pal, tell us all about the good guys, then everyone can give the Con/Lab/Lib/dums the heave ho!

                • Kitty MLB

                  I can see you are shrouded in mystery, a clandestine
                  figure who wanders around the shadows, but please tell
                  who are the good guys?

                • kyalami

                  Not … (in alphabetical order) the

                  – BNP
                  – Conservatives
                  – Greens
                  – Labs
                  – Libs
                  – UKIP

                  So, who does that leave? This is not a rhetorical question.

                • Kitty MLB

                  Well this somewhat esoteric person will not need to read her
                  Orphic Scrolls for the answer to this puzzle.
                  You also produced a clue, embedded within Fergus.
                  You are someone who has somewhat
                  managed to find themselves beguiled by the enchanting siren song and entrapments of that ne’er do well and scoundrel with a fondness for huskies.

                • Wessex Man

                  oh no, now I’m embarrassed!

                • Kitty MLB

                  Don’t worry Wessex Man, I shall defend the honour of you party despite the rapscallions and chameleons who endeavour
                  to join your ranks… Quite nifty with a sword yer know !!

        • Fergus Pickering

          I would have thought it was just up your street, tele, admiring Stalin as you do. He had no sentimental scruples when it came to killing people.

      • Kitty MLB

        Unfortunately not everyone can be affluent, sapient, and granted with
        eternal youth.. Only rabid Lefties want the NHS to stay the same
        allowing elderly people to be treated as if they are in a third world
        country. Some humility would be nice.

  • mrsjosephinehydehartley

    I don’t think the NHS should be open to the business of charitable donations, co-payments or phoney contracts because if it was it couldn’t possibly be %100 dedicated to the ones it’s intended to serve.

    The artificial import of such business concerns, together with their investors would surely detract from the sole purpose of dedicated NHS workers because they should have to spend some of their time thinking about whatever those investors want from them.

    So much for professionals eh?

  • Terence Hale

    Hi,
    Why not fine those who waste the NHS’s resources? I’ve said this a number of times the problems with the HNS are the managers, Mr. Nicholson being a good example.
    Paramedics could do 70 % of the work load of a GP using simple medical technology that you can buy in a pharmacy and determining a medical triage to a GP or hospital.

    • saffrin

      True.
      Many a GP could do their own medical tests too rather than waste the ten minute appointment limit patients are allocated before sending their patients to a practice nurse who will waste another ten minutes doing what the GP should/could have done in the first place.
      Maybe if GP’s and their managers started picking-up fines daily they’d stop wasting everybody’s time including their own.
      If GP’s were forced to pay compensation for loss of earnings to patients that have their appointment cancelled an hour before their appointment after taking the day off work to fit in with practice timetables.

    • Tom Tom

      I am happy for you to be excluded from GP care – sign a consent to be treated by paramedics and free up a slot

  • kyalami

    Could we also fine staff who waste NHS money?

    • Fergus Pickering

      How? Wh would decide on the fining?

      • kyalami

        Me.

  • James Strong

    In anticipation of outrage from our friend telemachus, I will say quite clearly that in my ideal world there would be no state provision of health care at all; it would all be in the private sector. But getting there from here is not possible.
    Private industry is more efficient and more accountable to its customers than anything the state provides. If I am right in that assumption, then if we really want the best health care for our nation then we need to de-nationalise health care.

    • mrsjosephinehydehartley

      Ordinary members of the general public are not the subjects of medical regimes. This is why it’s probably best to avoid selling what’s left of our heritage to the private sector.

    • Tom Tom

      Which country has private health care ? ?The US spends a higher proportion of GDP on taxpayer funded healthcare than the UK long before Obamacare

    • Tom Tom

      Private “industry” ? ROFL….. energy cartel, LIBOR/Forex Fixing Banks peddling PPI and CMOs……oil companies……insurers….telcos…..airlines….law firms……

  • James Strong

    ‘free at the point of use’ is one cause of some of the problems in the NHS.
    People tend not to value things that are free.
    Two ways this can manifest itself from patients is in trivial use and missed appointments.
    From staff, some staff seem to forget that the patients are, in fact paying customers, because the link between payment and use is broken. So some NHS staff do not act with the efficiency and courtesy that customer-facing workers in private businesses need to.
    Charge for appointments, not the economic cost necessarily but an amount that people can see coming out of their pockets.
    Cut taxes so that people have more money too.
    AND impose fines for those who misuse or abuse the system.
    Bring in a perceived link between the service and paying for it.

    • Tom Tom

      Why not have hospital pharmacies and labs work at weekends so hospitals can function ?

    • Rhoda Klapp8

      You seem to suggest people are going for fun. Just MAYBE some folks go to the GP with trivial complaints, but for most it is to be avoided. This is not a real problem, just NHS propaganda. Keep it free. It isn’t always a first-class service, but it does not require its clients to show the money first.

  • CharlietheChump

    Everything that is free has no value. Charge for the NHS, deducting from a notional individual, personal NHS budget. All else is folly. Or socialism.

    • Tom Tom

      Really ? Go ahead and charge, it will be mainly women who pay. It will lead to some interesting occurrences in ethnic surgeries, it will cause problems in collecting, and there will be exemptions for the heavy-users of services on the usual bulk-discount = no pay principle

  • MirthaTidville

    I would be much more impressed if the NHS actually started to seriously look at its own waste, profligacy and ignorance of its own rules and procedures, before trying to raise more cash it would only waste, by virtue of the first point I raised

    • telemachus

      And the biggest waste is the wasteful interface between health and social care

    • Tom Tom

      Yes the arts coordinator the TPA flagged up and the PR departments. Camilla Swift is clearly on the side of The Bureaucracy, Motto: Punish The User to Protect Privileges of The Bureaucrat

  • DWWolds

    The founding principle of the NHS might be that it is free of the point of use. However, that should not mean it is free to anyone who turns up on our shores and appears to be able to register with a GP without any questions being asked.

    • saffrin

      Not to forget the ‘travellers’ the last Labour Government gave the right to jump straight to the front of any queue.

      • Kitty MLB

        Oh lest we forget our delightful benefit tourists. Who have benighted the NHS.

  • In2minds

    The problem is that many of the people who waste NHS resources are NHS staff. What to do about that? Also don’t forget that HS2 is another waste of public money.

    • Fergus Pickering

      HS2 is an irrelevance. We are talking about the NHS. Try to keep up.

      • In2minds

        Yes, when it comes to public spending and waste we are all trying to keep up with it.

  • Rhoda Klapp8

    And why can’t we leave it alone in the way it has worked for years? Many a time have I waited long past the appointment time while reading the poster which makes such a fuss about missed appointments. Shouldn’t they be able to see me sooner? Where is their loss? The staff are there anyway, there’s an endless supply of patients.

    • Fergus Pickering

      Rhoda, this is not up t your usuel standard. If the doctor/nurse is there at 9.00 and the patient cheduled for 9.00 does not turn up then there is a gap when nothing is happening. Why not take the next patient? Because the next patient is not there. Why not take some other patient? Think about it for a minute.

      • Rhoda Klapp8

        Fergus, I don’t believe it is a problem. Maybe because waiting rooms are always full. I have had a time when they forgot I’d booked in and only noticed when they were all going to lunch. They made up for it by giving me a free immediate cat scan when the ultrasound I’d come in for showed nothing helpful. This when the cat scan queue was three months or more.

        This all at Stoke Mandeville, where if the best way to find a late patient is to look in the car park, where he is probably stuck looking for a very expensive parking spot.

        Further, if they break the charging taboo, how easy is it to raise the £10 to £12.50 then £20 and so on. It WILL become a revenue stream. That’s how they work. Bad idea.

        Oh, and during that time I once turned up for my 0900 and found the department empty, lights off. Could I fine them?

        • dmitri the impostor

          Have you heard the one about the man who took his ferret to the vet’s and the vet said sorry son it’s pegged out and the man demanded a second opinion so the vet whistles and in walks a black labrador and looks soulful and shakes his head and so the man demands a third opinion and so the vet whistles and in walks a cat and miaows and shakes its head and the vet says that’ll be three hundred quid please and the man says what and the vet says well if you had taken my word for it it would have been fifty but it’s extra because of the lab report and the cat scan boom boom!

      • DavidL

        I’m reading this on the day that my wife turned up for a scheduled 9.10 appointment at a London teaching hospital; only to be told that there was an hour-and-a-half delay (and eventually to be seen after two-and-a-half hours). Explain to me how there can already be a one-and-a-half hour delay first thing in the morning!

        • Fergus Pickering

          I have no idea. Why do you think it was/ Were the doctots bloody-minded? Did they harbour personal resentment against your wife? Were they all playing billiards in the common room? Did she ask?

  • Frank

    Excellent idea if we can also fine the people / firms who waste our money, eg the £1Bn NHS computer system. Perhaps we then fine the people responsible for the avoidable deaths of old people in hospital?

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