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If only we had any evidence that the NHS was a planned, integrated, health care service

Summary:
A usual and typical argument against the idea of increased marketisation in the National Health Service - That Wonder of the World - is that it would fracture it. Only an integrated service can be a planned one and planning is what makes for efficiency in the use of resources. We had rather thought that 1989 and a look east from the Brandenburg Gate had killed that idea of planning efficiency but the national religion dies hard. But we’ve not exactly got great evidence of the contention that the monolithic NHS is in fact a paragon of planned efficiency:An extra 300,000 operations could be carried out in England if surgeons planned their holidays in advance and managed their time better, watchdogs have suggested.Regulators said better scheduling of surgery, and planning ahead could mean

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A usual and typical argument against the idea of increased marketisation in the National Health Service - That Wonder of the World - is that it would fracture it. Only an integrated service can be a planned one and planning is what makes for efficiency in the use of resources. We had rather thought that 1989 and a look east from the Brandenburg Gate had killed that idea of planning efficiency but the national religion dies hard.

But we’ve not exactly got great evidence of the contention that the monolithic NHS is in fact a paragon of planned efficiency:

An extra 300,000 operations could be carried out in England if surgeons planned their holidays in advance and managed their time better, watchdogs have suggested.

Regulators said better scheduling of surgery, and planning ahead could mean around 290,000 more operations carried out annually.

NHS Improvement on Monday urged hospitals to use a simple model, which means surgical staff agree their annual leave six weeks in advance and plan their surgical lists afterwards.

The watchdog is concerned that patients are being forced to suffer needlessly long waits - and suffer cancellations - because of haphazard planning, late starts and early finishes.

In particular, it is concerned that too often surgery lists are planned without knowing if there are sufficient staff on duty to carry out the work.

This is something that the private sector industry of Lancashire had worked out by 1906, scheduling work and holidays so as to maximise capacity. For that’s just what Wakes Weeks were.

That the NHS is a little inside the technological envelope, say offering proton beam therapy a decade after other systems, might be a reasonable price to pay for the system’s greater equality of bad treatment. We don’t think so but it’s possible to do so.

But to find that it’s well over a century behind in such a simple thing as holiday scheduling does seem a bit much and not a great piece of evidence that central planning even manages the planning bit.

Tim Worstall
Tim Worstall is a British-born writer and Senior Fellow of the Adam Smith Institute. Worstall is a regular contributor to Forbes and the Register. He has also written for the Guardian, the New York Times, PandoDaily, the Daily Telegraph blogs, the Times, and The Wall Street Journal. In 2010 his blog was listed as one of the top 100 UK political blogs by Total Politics.

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