Just occasionally the people who are in charge read this blog. Dr Grumble has been thinking of listing for them the ways the English NHS could make enormous savings without adversely affecting patient care. You might think that our masters have no idea how they could save money and that that is why they have brought in management consultants. Reading between the lines of what some of them say (Dr Grumble is not going to embarrass any of them by putting in a link) it seems likely that quite a few of those at the top do know how money could be saved. The problem is the thought police. Both the present government and its likely replacement are heavily blinkered and there are some solutions they will not countenance. Our masters' minds have been poisoned by outside advisers with their own private agendas. The politicians either do not realise how they are being used or they are prepared to be used in order to bolster their party coffers.
In short there is no hope. Dr Grumble knows that. But whether anybody was going to listen to him or not Dr Grumble has been planning for some time to list the many painless ways the NHS in England could save money.
But happily there is no need. There is just one lone voice in the wilderness who has done the job already. This is just one of her suggestions for saving money:
Take for example the costs of the new market bureaucracy; for more than 40 years administration costs were in the order of 6% of the total budget a year, they doubled overnight to 12% in 1991 with the introduction of the internal market. We have no data today for England, but what we know from the US is that the introduction of for-profit providers increases administrative costs to the order of 30% or more.
So why hasn't McKinsey advocated making savings along the lines of Scotland and Wales by reintegrating trusts into area-based planning structures and thereby abolishing billing, invoicing, the enormous finance departments, marketing budgets and management consultants, lawyers, commercial contracts? In this way one could project savings of anything from £6-24bn a year for England.
Who is this lone voice? Find out here. She's Dr Grumble's heroine. Do you think she knows?