Key Issues in the Health and Care Value Chain
13th October 2016 | Tom McGuffog
Tom McGuffog, author of Building Effective Value Chains, shares his insights of the health care value chain
- Given the increasing number of elderly people, along with advances in treatments for many ailments, the costs of caring well for our population are rising substantially faster than the funds being allocated by the government. The UK spends less than 8% of GDP on healthcare (however defined – the Office for Budget Responsibility forecast a fall to 6.8% by 2020) compared with 17% for the USA, 12% for France and Sweden and 11% for Germany and Holland, according to an August report in The Times Raconteur. The NHS and all healthcare need to be protected, enhanced and improved in terms of services, resources and performance in order to support society and the economy.
- Alternatives for the NHS receiving the funds it needs include: a rise in taxation to pay for the funds needed by the NHS and associated services; or an introduction to more and higher charges, or the discontinuation of offering certain treatments. Perhaps all three actions will be needed. At present there is a conspiracy of announcements, which implies that we shall all be looked after even if there are temporary difficulties with current services and resources. In addition, better public health must be promoted via education, facilities and challenges to adopt healthier lifestyles.
- Given the pressure on local authority budgets, the resources available to support the elderly in the community are declining. For example, one city council has promised to develop a small number of modern care homes, but has already closed most of the existing homes. It has no realistic and funded plans to spend more to support homecare. Bed blocking in acute hospitals is bound to increase (or people will be dumped at home with inadequate support) unless there is a sustained and substantial increase in resources to support care in the community.
- Private care homes are under substantial financial pressure, and some companies running these homes have gone into liquidation. Private home care companies are struggling to manage sound services profitably. Furthermore, their management needs substantial improvement.
- Health and care facilities depend too much on lower paid and overseas staff. Turnover is high within these groups. Command of English needs to be improved, particularly when communicating with the elderly.
- Over many years, the Department of Health has proved incapable of forecasting the required numbers of doctors, nurses and other professionals. Forecasting and planning can and must be done much better. It is immoral to raid the medical staffing of developing countries, and it is uneconomic to depend so much on agency and other temporary staffing. Nevertheless medicine cannot thrive within narrow national boundaries – movements of trainee and experienced clinical staff must be wisely planned over decades.