The economic regulator, Monitor, warns that, unless the NHS looks abroad for new ideas, it will face a £30 billion funding shortfall by the start of the next decade. It suggests that the NHS will have to open its doors to international health companies from nations such as India and Mexico to tackle the long-term crisis in its finances.
Monitor concludes that there are potential savings of up to £12.1 billion from improving hospitals' efficiency, and up to £4 billion from reducing beds and shifting patients into community. It states that there is evidence from other health systems around the world that patients could be treated at a far lower cost. It suggests that the NHS should be more radical by borrowing ideas from countries such as India and Mexico.
For instance, in India a hospital group specialising in cataract surgery, Aravind, delivers 60% of England's NHS eye surgery volume at less than one sixth of the cost. Monitor suggests that applying the Indian company's approach to NHS orthopaedics could save £800 million from a £2 billion budget. Also highlighted were schemes in Ghana where patients send mobile phone pictures of their wounds to a doctor “at a different location” to assess and in Mexico where two-thirds of patients sort out their problems in a phone call with a nurse. Other proposals include getting patients to better manage their own health and increasing the number of people seen in the community rather than by hospital consultants.
The Guardian reports that Monitor has outlined a radical reshaping of the NHS, arguing that billions could be saved and patient care enhanced by centralising services, encouraging GPs to add extra appointments, and stopping around 30 elective procedures which were 'relatively ineffective'.
Bringing in private companies to the NHS, however, has sparked controversy. Concerns include the suggestion that independent companies would demand higher prices to treat patients and cherry-pick operations. In addition, there are wider concerns that this signifies a hidden government agenda to privatise the NHS – something strongly denied by ministers.
Lucie Prothero, associate in the clinical negligence team at Penningtons, said: “There can be no doubt that the NHS is in need of change in order to tackle the major financial challenge it faces. It will be vital, however, that the key issue of patient safety is not compromised by such cost-saving measures. In our clinical negligence team, we see many sad cases where patients have poor outcomes after being discharged too soon from hospital or after being inadequately managed at the emergency care stage. Calls to reduce beds and shift patients into the community, for instance, must be measured against the potential risks to patient safety.”