You are abs right Adam, it was meant to improve efficiency, but unfortunately the politicians and the NHS managers and clinicians did not/still do not understand that efficiency and productivity are as different as chalk and cheese, and glibly use the words interchangeably and wrongly, which is why commissioning has underperformed so badly.
Productivity is output divided by input whereas efficiency is outcomes (ie healthgain in health care) divided by input.
Unfortunately Labour was obsessed with productivity, whereas it should have been obsessed with efficiency right from the beginning. This did not matter so much when the NHS money was rolling in, but now it does. The NHS commissioners should be insisting on increased outcomes for their ever
dwindling resource input. This will start to get rid of the huge waste in the NHS. To be fair to Andrew Lansley, he has realised this fatal flow in the NHS and one of his proposed planks is payment by outcomes, not payment by results (or payment for each item of service). My great fear is that this government may not get the definition of outcomes right. It needs to be looking for patient oriented outcomes (POOs) and NOT disease oriented outcomes (DOOs). The moment you start looking for DOOs, you are onto a hiding to nothing and you can't put a stop to the waste in the NHS.
Regards,
Ash
From: "Oliver,AJ" <[log in to unmask]>
To: [log in to unmask]
Sent: Monday, 1 August 2011, 21:38
Subject: Re: "Reducing spending on low clinical value treatments"
It wasn't about creating a commercial market at all. It was about creating incentives to improve efficiency. It may not have worked that well (it worked a