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RADSTATS  November 2011

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Subject:

Re: FAQ's health cuts

From:

Colin Talbot <[log in to unmask]>

Reply-To:

Colin Talbot <[log in to unmask]>

Date:

Wed, 16 Nov 2011 22:35:43 +0000

Content-Type:

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International comparisons are indeed difficult. The USA spends roughly 16% of GDP on health, which is split roughly 50/50 between public and private spending. I don't know how much of the public spending goes thru private providers.

I do know there have been studies comparing the relative efficiency of, for example, the US, UK and Canadian systems. The US system, especially it's purely private sector, is rather inefficient because of the enormous transaction costs involved in itemising every bit of a treatment. The NHS usually comes out as relatively efficient by comparison

This is why research by UK academics suggests that price-based competition does not improve efficiency or quality, whereas non-price, quality-based, competition has had some positive effects. But more 'top-down' target based approaches have likewise improved performance too (compared to Wales, for example).

On the other hand the work on productivity of the whole (English) health system conducted by the ONS suggest that it has declined for most of the last decade. I discuss some of this in my Theories of Performance (Oxford, 2010). The main reasons seem to have had to do with (a) constant reorganisations and (b) the rather generous Consultant and GP contract settlements a few years back.

Hope this helps.

Colin

Prof. Colin R. Talbot
Professor of Government and Public Administration,
University of Manchester, 
Manchester Business School

Latest book: Theories of Performance, Oxford University Press, 2010.

Blogs: http://whitehallwatch.org and http://publicmanagement.Wordpress.com
Web: www.mbs.ac.uk; 
Phone (mobile): +44 7971 674 620
Skype: colinrtalbot
Mail: Room 1.11 MBS, Booth St West, Manchester, M15 6PB Britain

Editor-in-Chief: International J. of Public Administration (IJPA).

On 16 Nov 2011, at 22:19, "Socialist Health Association" <[log in to unmask]> wrote:

> Data from the USA is not, essentially about private sector provision.  It tells us much more about their system - or lack of it, and the evils of conventional insurance as a method of finance.  Most European countries have majority private providers but none have the terrible results of the USA.
> 
> On 16/11/11 18:09, Marchant, Paul wrote:
>> Michael Moore's DVD Sicko is a pretty damning indictment of the USA health system...(but not exactly a statistically based treatise!)
>> 
>> Paul
>> 
>> -----Original Message-----
>> From: email list for Radical Statistics [mailto:[log in to unmask]] On Behalf Of Jane Galbraith
>> Sent: 16 November 2011 18:02
>> To: [log in to unmask]
>> Subject: Re: FAQ's health cuts
>> 
>> What happens in Scandinavia and in Germany and ....?
>> 
>>> Very little chance of UK evidence because private sector does not deliver
>>> comparable services. Nhs pension scheme and training major confounding
>>> factors
>>> 
>>> Martin Rathfelder
>>> Mobile agitator
>>> 07968703740
>>> 
>>> ----- Reply message -----
>>> From: "Jane Galbraith"<[log in to unmask]>
>>> Date: Wed, Nov 16, 2011 17:40
>>> Subject: FAQ's health cuts
>>> To:<[log in to unmask]>
>>> 
>>> Dear Kate,
>>> I would be more impressed if you asked for evidence showing either result.
>>> Politicians look for evidence only to support their argument,
>>> statisticians should assess all evidence.
>>> 
>>> I suggest that what we need is good quality evidence and discussion. Does
>>> that exist in the public\private NHS debate?
>>> 
>>> Best wishes,
>>> Jane
>>> Mrs Jane Galbraith
>>> 
>>>> Can anyone direct me to any good articles or papers, that show that
>>>> privatisation of the NHS is not more efficient, or cheaper, than public
>>>> provided care? Or information about the impact of coalition policies on
>>>> actual cuts or reductions in services?
>>>> Â
>>>> Many thanks
>>>> Kate Bloor
>>>> 
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>> *******************************************************
>> 
> 
> -- 
> Martin Rathfelder
> Director
> Socialist Health Association
> 22 Blair Road
> Manchester
> M16 8NS
> 0161 286 1926
> www.sochealth.co.uk
> 
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> *******************************************************

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