Thursday, 2 April 2020

Fun With Numbers - the NHS

From the BBC:

The government has confirmed that 2,000 NHS frontline staff out of half a million in England have been tested for coronavirus since the outbreak began.

Half a million? And how many people does the NHS employ in total?

Factcheck says about 1.2 million in England.

So it's not a health provider with a minority of necessary non-medical staff - admin people, IT geeks, cleaners, maintenance. It's a large bureaucracy with a minority of nurses, doctors, ambulance drivers etc.

By the way, I am still a big fan of the general idea of the NHS, somehow it seems to work well in practice, but how much better could it be?


Lola said...

According to wiki it the NHS employs 1.7 million people.
I am not a fan of the NHS....I am a fan of the people in it, the clinicians and their tech support.

Nessimmersion said...

I tend to disagree- the NHS is nowhere near even the least worst way to run ahealth service, hence why no first world economy has copied it.
As an example see table below

mombers said...

Private insurance adds an ENORMOUS overhead to healthcare. In the US it's estimated at about 30% (THIRTY PERCENT!) of spending is on pushing claims around the system. The NHS could be much better but a crucial part is it is very cheap.
'You can get better, but you can't pay less'

If spending as % of GDP was brought up to OECD average it would be a lot better. Admin fat could be trimmed but it's a lot less than a private sector arrangement to begin with

Lola said...

Mombers. There are other reasons why US healthcare is costly, and the way that their insurance is structured adds a huge overhead. e.g. an insurer in say, New York, may not be able to compete in say, Ohio because of local protectionism.

This is a good watch

It is said that New Labour doubled the cash going into the NHS with pretty well zero increase in productivity.

If you hurl money at an unreformed structure like the NHS only a small proportion will end up at the coal face. That is just the way with big bureaucracies.

ontheotherhand said...

It is also the US legal system and vested interests around that which make everything including medicine more expensive than it should be. I knew a brain surgeon in the US who volunteered time at state hospitals to patch up motorcycle accidents (they don't wear helmets). This enormously increased his personal liability insurance, because he could be sued by the people that he was trying to help to the tune of millions.

This paranoia about being sued means that if you visit your family doctor with a temperature they will order a string of $100 tests just in case you are the 1 in 10,000 that has meningitis and they haven't covered their arse. A GP here will tell you (cheaply) to take 2 paracetemol and monitor the symptoms.

Nessimmersion said...

UK health spending is round and about OECD average.
PHE pissed away 4.5 billion last year which could have been spent on either the NHS or public health precautions.
There are other countries than the USA & UK, no Austrian or Swiss for example would want to leave their insurance based system for a barely coping system like the NHS, they would think you were deluded to suggest it, France for example again has an insurance led system.
Note: the reason why insurance led systems work, may well be that they are not monolithic, the central problem with the NHS is it is a stalinist structure

Lola said...

Nessie. 'Stalinist structure'. Exactly.

Lola said...
This comment has been removed by the author.
Lola said...

Another 'fact'. I had a mate who ran a medical negligence insurer at Lloyds. He reckoned that 50% of a USA doctor's charges to his patients were absorbed by med neg premiums.