So, what’s the big idea?
The government aims to make hospitals run like businesses.
Problem: hospitals only have one customer and that’s the government.
Now, “Trusts” are being formed, with a degree of financial independence. How exactly do they “make” money?
They do more operations. Except, the “Trust” next door wants to do the same.
Soon, G.P’s will be choosing where people go for operations, which is supposed to reward “good” hospitals and penalise “bad”. This is supposed to reward the efficient and penalise the inefficient.
Problem: a Hospital can’t get new work by encouraging A and E work; the rules state that every case above the 2008 level is only paid for at 30% of cost. So, a successful A and E becomes a financial disaster.
So, hospitals will fight to do planned (elective) surgery.
What’s the effect of this “survival of the fittest”, in terms of inter hospital rivalry?
1) If the battle is to win elective surgery from G.P’s, this allows private provider’s to take work from the NHS.
2) If local NHS hospitals are trying to steal work from each other then hospitals will have to close. Just how that will work out in practise will be the subject of posts to come.
(a don’t stop till you drop production)