Another week. Another bad news story about the NHS. This time it was the revelation, in a report by the Policy Exchange think tank, of just how much money goes missing in the NHS through health tourism. One of our local NHS trusts, Imperial Healthcare, was ranked top for the worst performance at claiming it back, losing just shy of £30m over three years.
I grew up during an era when the NHS was revered. Anyone who criticised it was given short shrift. When my normally hugely loyal aunt recounted failures in her treatment, others listened then changed the subject. It is this head-in-the-sand approach that led to the long-term deterioration in the management of the NHS and its ability to balance the books.
I remember watching the 2007 BBC documentaries – Can Gerry Robinson Fix the NHS? – agreeing with him, a well-known Labour Party donor. Later, he commented after the 2013 Mid Staffs crisis. His analysis included the need for the NHS to share information and best practice; have centralised systems; set processes in stone to minimise mistakes; hold regular reviews; and, significantly, not to gag people who want to speak up – he said everyone should be a whisteblower. It has been distressing to read about recent high-profile cases where keeping silent led to tragic deaths. Gerry Robinson was clear: the NHS must put patients first.
We know that the NHS is no longer the envy of the world. We all want it to be.
The principle of a universal NHS, free at the point of use, transcends party politics, supported enthusiastically by all whether left or right or in the moderate middle.
We want to be proud of it.
We can’t solve national problems locally, but we can make savings locally – and we should. At the borough council meeting on Tuesday this week, seconding our amendment to a Labour motion, I offered a case study looking at waste – wasted resources, wasted time, wasted appointments and wasted money.
It was my experience, earlier this year.
I had recently had an x-ray in one of our local hospitals. Not long afterwards, at A&E at another local hospital, I was told I needed an x-ray. Knowing that nothing new would be revealed, I explained – suggesting an MRI scan. With no information sharing between the two hospitals, the consultant said an x-ray would be done first as it was cheaper. It revealed that I needed an MRI scan.
Later, the orthopaedic consultant sent me home with three boxes of injections, a sharps bin and on crutches. At a follow up appointment, with another orthopaedic consultant, I was told I should never have been prescribed the jabs and to stop taking them.
I tried to return the crutches but that hospital doesn’t take them back. Hospitals in other areas charge patients who do not return them, and the NHS England website says that ‘if just two out of every five walking aids were returned, the average hospital could save up to £46,000 a year’. With about 900 hospitals in the UK, that’s £41m a year.
I was sent to a physiotherapist for rehabilitation advice. He recommended exercises and booked me into a class a few weeks ahead. On arriving, I was surprised to be the only person waiting. I had been booked into a duplicate rehab advice appointment; there was no class.
So, how much did I cost the NHS unnecessarily? I’ve done some research:
- X-ray: £90
- Injections: £91
- Sharps box: £3
- Crutches: £20
- Duplicate physio appointment: £60.
That’s £264. One patient. One incident. Multiply that by tens of thousands of patients across the NHS and we’re talking millions lost that could have been spent on care.
This says nothing of the kindness I experienced at A&E and later. At times it moved me to tears.
But good care must be supported by efficiency.
Our amendment was about improving the national institution we all need. It sought to make it better through positive actions that will, if implemented, make us all immensely proud – and make the NHS the envy of the world again.
Unfortunately, Labour disagreed with us and voted against our amendment.
