Single Vision: NHS Output

It is predictable but deeply depressing. Up goes the cry that any review of NHS expenditure MUST result in cuts to consumers.

The debate on public expenditure cuts need to be focussed on output and not input. Over the first ten years of this Government's life productivity FELL in the public sector while increasing by 26 per cent in privately run organisations.

It is on this mega discrepancy that the debate should be exclusively concentrated. Going for a debate on cutting or non-cutting is simply a cop-out. It continues the error of public sector reform debate for as long as I can remember.

The NHS budget stands at £94.5bn - a tripling since 1997. If the NHS had delivered the same productivity as was registered for the private sector over the same period, they very same NHS output could have been gained on a total bill REDUCED by £26bn. The political kaleidoscope needs a radical shake up.

A first move would be to insist that the poorest performing hospitals equal the productivity of simply the current average. That move alone would save £2.4bn with no increase in resources.

A second move would be to insist that all hospitals perform as do the best units.

A third move would be to move the whole of the NHS in productivity terms to equal simply the average of the private sector.

A final move would be to ensure that the NHS leads the productivity league table of both public and private sector.

How do we make the most important changes in our health services since the NHS was established in 1948? It is by concentrating exclusively on NHS output rather than inputs.

Those who love the NHS have a duty to insist that this is the only debate in town. It will be a far from easy one to win but success will transform British politics.