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NHS Trying to Balance Costs and Care

Posted on Jan 04, 2012 by Sergio Ulloa ()  | Tags: healthcare reform, National Health Service, NHS

In the midst of enacting QIPP (Quality, Innovation, Productivity and Prevention) policies, Britain's National Health Service is en route to save £5.9 billion (US$ 9.23 billion) for the 2011-2012 financial year at the same time as some are protesting the effects that the cost-cutting measures will have on vulnerable members of society, and their levels of healthcare. Britain's government has been analyzing and implementing a number of ways to shave costs or reshape health services in efforts to streamline the NHS. QIPP efforts are intended to create £20 billion worth of savings, largely through efficiency measures, by 2015. The NHS has already saved some £2.5 billion (US$ 3.9 billion) between April and September 2011, putting them on track for their full yearly savings of £5.9 billion (US$ 9.23 billion) which mostly derives from reduced hospital care expenditure, but does include large savings on community services, mental health services and prescription drugs. With medical care arising from hospitals services being one of the most expensive items on the healthcare budget and many hospitals facing dire financial straits, the government is attempting to retool the system through the Health Bill so that hospitals are not so heavily relied upon to provide treatment which they may be ill equipped to provide. Intentions are to place General Practitioners at the center of the system and place them in charge of purchasing healthcare services for patients. However, as belts begin to tighten and proposals to redesign facets of the healthcare system begin to filter through, there are growing concerns from some quarters that the drive to cut costs and the plans to reorganize the health system may result in increased inequalities in the system, with some worried that vulnerable members of society may face great difficulties in procuring care. One concern raised recently by some public health experts is that the increasing marketisation of the NHS will result in widely varied care throughout the country, resulting in health outcome disparities, especially for vulnerable socio-economic demographics and regions. This may be further exacerbated through pressures to cut costs and save money. Others are more concerned with the growing need for extensive long term care for the elderly and disabled. At least half of the 2009-2010 healthcare budget was devoted to caring for older UK citizens, however this number is going to grow as the population continues to age. An earlier proposal, spearheaded by economist Andrew Dilnot, indicated that it was more effective and efficient, in terms of both cost and health outcomes, to treat older people through social care rather than acute healthcare in hospitals. However, the proposed change would require greater funding for social care and financial assistance for older age patients. Dilnot's proposal suggested raising the level of means-tested support and the introduction of a lifetime cap on how much money each individual would have to spend on adult social care, with the government picking up any extra costs over £35,000 (US$ 54,801); this would prevent the elderly from having to sell most of their possessions to pay for ongoing social care. However, while this proposal does dovetail nicely with the plan to reduce hospital services and spending, it does require a potentially greater outlay from the government on social care which may garner a more tepid response from politicians and treasury officials focused on austerity measures. With a diverse group of parties touting the benefits of different courses of action, the issue may become increasingly contentious as the Health Bill comes closer to being fully enacted. However, with an increasingly sizable healthcare budget and growing economic uncertainties, it seems like not committing to some type of reform is one of the only unavailable options.
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