“Of $4 billion NHS spent in 2009 on health service projects and innovation, only $224 million had impact on patient care, chasm must be closed”
The above was my response to Bob Hudson, whose article “Annulling competition rules is the most important NHS battleground” appeared in the guardian on April 2nd.
It has been suffice to say, an interesting exchange with Bob because I am not disputing the importance of placing patient care as the main priority of any procurement policy. You simply have to read my coverage of the Veterans Health Administration’s ongoing procurement “difficulties” and the impact it has had on patient care viz-a-vie the Bay Pines fiasco, to understand my position.
My problem with the debate that is raging across the pond has nothing to do with intent of focus but instead with the approach to a balanced resolution.
While many are bristling at the thought of tighter controls being implemented at the expense of patient care, the veiled “threat” of privatization looms in the background. As a result instead of moving the discussion towards a resolution, it now seems to be descending into a personalization of rights and responsibilities. In such scenarios inertia almost always proves itself to be the winner as opposing factions dig in.
This impasse is reminiscent of the old saying that you cannot see the forest for the trees.
To start, and referencing my twitter exchange with Bob Hudson, when only $224 million of $4 billion spent on health service projects and innovations have an impact on patient care there is something seriously wrong. Especially when you consider the fact that prior to the recently proposed changes the “level of patient care in the UK had fallen behind those of comparable countries.” This clearly demonstrates that the present system is seriously broken. Or to put it another way, the reasons for the proposed changes are at least in part, the result of steadily declining levels of care for patients.
Something has to be done! But what?
In Part 2 of this post, I will present the concept associate with a Relational Governance Framework that I believe represents an approach to the problem that has not yet been considered.