In Public sector, UK productivity, Uncategorized on March 5, 2010 by Tim Aikens

The NHS is of course the UK’s largest single employer.  A report by the Centre for Policy studies calculated that productivity in the NHS had fallen between 4.5% and 8.5% between 1997 and 2003!  Not sure what has happened since, but I doubt if there has been a sudden turn round – especially as much of the money poured into the NHS has gone on pay rises for the clinical staff.

Debating NHS productivity is a minefield. Should we even expect something as important as health to focus on productivity?  Well as a taxpayer, I believe the answer is undoubtedly yes.  Interestingly, in the private sector there is evidence that the more productive firms are also safer and produce a higher quality of output.  It is possible to have a focus on productivity without sacrificing quality or service.  So why is the NHS so bad? Where is the root of the problem?  I doubt if there is one single source.  More like a massive oak tree, the roots that hold productivity down are many and go deep, making change almost impossible without killing off the tree.  If you’re going to move a tree, you normally cut around the roots some time ahead of the move to allow new roots to shoot. These then grow and can be moved with the tree to support it in its new location, having left many of the old roots behind.

Trying to tackle NHS productivity in one post is a step too far. But from the analogy above there is an obvious question – where should we start? Indeed is the problem so bad it doesn’t really matter as long as someone picks up the flag and says we are going to start doing things better? Should the doctors lead – or should it be the army of administrators that sit behind the platoons of medical staff? I simply don’t know. All that is clear is that despite the NHS being cost-effective compared to many private based schemes as in the USA, the NHS is very unproductive.

Where do we start?

As I warm to my theme in this blog, I want to move on into what should actually be done to make change and be more productive.


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