Because that's part of the problem and why it is struggling. As the population grows and

diagnosis gets more frequent, the number of patients requiring attention is growing fast. It is extremely difficult to be able to keep up with growing demand if you have so much bureaucracy and so many disjointed departments, suppliers, processes etc. All the willy-nilly outsourcing (for example) with civil servants coming up with more and more process to try to bridge the gaps has created an absolute mess on a procedural level.

The leaner the organisation (and no, I don't mean less people, just more efficiently utilised), the more possible it is to grow simply because you've put in thought into how to abstract processes and structures which will survive with increased demand in the future. Of course at some point that too will reach a limit. Nobody has a crystal ball, but it just makes sense to set up in a way that you anticipate change.

Assuming Trump doesn't press the button, the population is going to grow and grow further. If attention is not spent on cleaning out the whole system and structure then it will be continue to be incapable of growing to meet demand, just as it is showing already. What happens then is that you need to throw exponentially more money at it to achieve small improvements.

Posted By: Steve in Holland on January 8th 2018 at 17:08:53

Message Thread

So there's a new health secretary. Good riddance Hunt. (General Chat) - essexcanaryOTBC, Jan 8, 12:12:04
- Bit premature....... ? (n/m) (General Chat) - helvegtheowl, Jan 8, 15:45:24
  - See...... (n/m) (General Chat) - helvegtheowl, Jan 8, 20:12:17
- He's an NHS doctor isn't he? Presumably also does some private work like all the (General Chat) - Jim, Jan 8, 13:16:00
- Is this politics? (n/m) (General Chat) - CB41, Jan 8, 13:14:03
- Controversial but personally I think the UK should replace the NHS with a subsidised (General Chat) - Steve in Holland, Jan 8, 12:30:32
  - it's far less to do with the system and far more to do with the level of funding (General Chat) - Ralf Scrampton, Jan 8, 12:46:39
    - Good chart here of how funding picture has changed since 2010 (General Chat) - Tricky Hawes, Jan 8, 13:22:40
      - Bit deceptive that one isn't it because its as a % of GDP (General Chat) - Jim, Jan 8, 13:25:31
        
        That's the only sensible way of showing it (General Chat) - Tricky Hawes, Jan 8, 13:37:28
        
        (Spending per head of population ignores price and wage increases every year.) (n/m) (General Chat) - Tricky Hawes, Jan 8, 13:38:46
        
        It should be a combination of % of GDP and per head that should be looked at (General Chat) - Jim, Jan 8, 13:57:07
    - Its both in my view (General Chat) - Jim, Jan 8, 13:21:44
      - Of course, when the population is growing by 500,000 ever year (General Chat) - Tricky Hawes, Jan 8, 13:25:19
        
        yes thats true, just saying that there are "capacity" issues (General Chat) - Jim, Jan 8, 13:29:24
        
        yes, years of under-funding and investment in infrastruce will create capacity issues. (n/m) (General Chat) - Ralf Scrampton, Jan 8, 14:16:14
    - I disagree. Funding is important but the system is far more important. I am pretty (General Chat) - Steve in Holland, Jan 8, 12:53:26
      - The UK system is broken. Therefore funding is inefficiently deployed. Redesign required (n/m) (General Chat) - essexcanaryOTBC, Jan 8, 13:37:46
        
        That's the short version of what I'm saying. Perhaps the (General Chat) - Steve in Holland, Jan 8, 14:03:04
        
        you keep mentioning the scalability of the NHS. Why? (n/m) (General Chat) - Ralf Scrampton, Jan 8, 15:26:39
        
        Because that's part of the problem and why it is struggling. As the population grows and (General Chat) - Steve in Holland, Jan 8, 17:08:53
      - The amount prescription drugs cost and agency staff is also pretty mind blowing (n/m) (General Chat) - Jim, Jan 8, 13:22:36
      - equally important in my book (General Chat) - CWC, Jan 8, 13:20:43
      - While I am here I'll mention the other unmentionable thing... (General Chat) - Steve in Holland, Jan 8, 13:07:31
        
        Serious question SiH (General Chat) - Gob on a Stick, Jan 8, 13:41:08
        
        Considerably higher. Here are last year's brackets (General Chat) - Steve in Holland, Jan 8, 14:06:57
        
        This is the chart / data you want (General Chat) - Tricky Hawes, Jan 8, 13:45:25
        
        Not quite that simple. This year the NL government underspent the budget! (n/m) (General Chat) - Steve in Holland, Jan 8, 14:08:06
      - yes and it includes private spending in the UK too. (General Chat) - Ralf Scrampton, Jan 8, 12:59:25
        
        You can throw shitloads at it if you like, but (General Chat) - Steve in Holland, Jan 8, 13:22:21
        
        so you want the UK to increase private provision which will have the effect of increasing (General Chat) - Ralf Scrampton, Jan 8, 14:09:54
        
        No I do not. I am saying that we put more in and that's why there is more spend. The (General Chat) - Steve in Holland, Jan 8, 14:16:22
        
        in what way is the NL system more scaleable than the NHS? (General Chat) - CWC, Jan 8, 14:49:04
        
        In that it doesn't rely on massive government projects to make adjustments. They are able (General Chat) - Steve in Holland, Jan 8, 15:39:11
        
        there's no doubt that the coalition's health reforms actually managed to introduce many (General Chat) - Ralf Scrampton, Jan 8, 14:27:39
        
        I am not. My initial response was about system, not spend. You brought up the spend. I was (General Chat) - Steve in Holland, Jan 8, 14:40:21
        
        LESS about system, MORE about funding (my post) (General Chat) - Ralf Scrampton, Jan 8, 15:22:32
        
        "Public does not automatically equate to bad management" (General Chat) - Steve in Holland, Jan 8, 15:40:53
        
        that's not very open minded of you Steve. (General Chat) - Ralf Scrampton, Jan 8, 16:08:21
        
        I am open minded. But I'm also not blind to my experience. (n/m) (General Chat) - Steve in Holland, Jan 8, 17:11:31
        
        isn't that exactly what he's done? (n/m) (General Chat) - paulg, Jan 8, 16:19:37
        
        no he hasn't. (General Chat) - Ralf Scrampton, Jan 8, 16:39:50
        
        so I shouldn't listen to either of you? (n/m) (General Chat) - paulg, Jan 8, 16:54:04
        
        well you seemingly haven't done so so far (n/m) (General Chat) - Ralf Scrampton, Jan 8, 16:56:16
        
        ? (n/m) (General Chat) - paulg, Jan 8, 16:57:36
        
        Perhaps there is a way to implement it efficiently as a state run service, but (General Chat) - Steve in Holland, Jan 8, 14:50:20
        
        It's become politically intractable (General Chat) - paulg, Jan 8, 13:32:34
        
        Hagman's unsubstantiated post above is a perfect example (n/m) (General Chat) - Steve in Holland, Jan 8, 13:36:33
  - tbf the conflict point is a positive (General Chat) - CWC, Jan 8, 12:45:56
  - To add to that... (General Chat) - Steve in Holland, Jan 8, 12:35:26
    - that's my experience of the NHS also (General Chat) - paulg, Jan 8, 12:40:13
      - The NHS (system) has become a SHAMBLES. Not fit for purpose in 2018 (n/m) (General Chat) - essexcanaryOTBC, Jan 8, 13:36:11
        
        That's certainly the narrative the right wing papers want people to believe (General Chat) - Tricky Hawes, Jan 8, 13:41:21
        
        I'm far from right wing and it is exactly what I see. (n/m) (General Chat) - Steve in Holland, Jan 8, 14:08:42
      - Yes, I should add that individual carers were lovely (as they are in any system). But (General Chat) - Steve in Holland, Jan 8, 12:47:24
- Your analysis (General Chat) - jonncfc, Jan 8, 12:18:05
  - To which the answer isn't getting Branson to sue the NHS when he doesn't get a contract... (General Chat) - DrDublin, Jan 8, 13:06:34
  - Welcome to the WOTB (n/m) (General Chat) - paulg, Jan 8, 12:30:48
  - Yep, thought the same. (n/m) (General Chat) - Hulk Rules, Jan 8, 12:20:50

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