Why the NHS reforms are massively inefficient

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The evidence is mounting, from the Kings Fund, the Nuffield Foundation and others that the revised NHS bill adds massive more admin complexity at considerable extra cost to the NHS.

It's worse than that though. It also encourages massive inefficiency. Let me give two examples. The first is nationwide. If the reforms go through GPs will not be able to set practice boundaries in future. As a result a person in Banbury will be able to register with a GP in York and, apparently, the GP in York will have to service their needs. Including visits when they are sick.

Now, how does that work? OK, the example is extreme. but suppose GPs in future attract patients from 20 miles away who demand visits - and four of them do so in a day - and they're all 20 miles from the surgery.  So a doctor spends much of the day out of the surgery in a car. How on earth does that work? Doctors already work 11 hour days in many cases. What gives if they have to do this? I don't know: doctors don't know, but the point is that practice areas don't exist to restrict competition - which is the government's mad logic - no, they exist to make the NHS work. And it won't without limited practice areas because doctors won't be seeing patients, they'll be driving.

Now take another example, which is local to me. My local hospital - Queen Elizabeth, Kings Lynn, has closed its laboratory for blood samples sent in by GPs in the afternoon. They're now sent to Norwich and come back the next day. What's the result of this move which is intended to result in savings in cost? Simply that GPs who can't get blood results for patients about whom they are concerned during the course of an afternoon will refer them into hospital instead. They'll have to. That's the only way they'll be able to manage their risk, and the patient's potential need. The result? Costs are bound to go up. It is inevitable.

This is what the NHS reform is going to deliver: increased admin costs and increased cost of supplying NHS services. That's the wonder of the Tories for you.

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