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24th September 2015 3

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New Health Chat

1st December King's Fund 5.30pm

Janet Davies CEO and General Secretary of the Royal College of Nursing.

Discusses the future of nursing, safe staffing, Vanguards and the 5YFV

This will be another sell-out Tickets... here.

A world of difference.

News and Comment from Roy Lilley

Do we have the best healthcare system in the world? Maybe...

My guess is we do have the best 'system'; tax funded, redistributive. Insurance based systems still need infrastructure and people; it all adds costs. If we had competition for our premiums we might see a slice of our hard-earned disappear into the pockets of directors and shareholders.

On the other hand, the 'insurers' might be not-for-profit. The more you plunge into this the more complicated it gets. I can predict one thing; the tighter NHS money gets, the more likely the pressure to consider 'other' approaches.

By 'other' people usually mean top-ups or insurance supplements. Don't forget; if you take taxes from your left-hand pocket and top-ups from the right, it's still your trousers. You still have to pay.

It's a trade-off. What the NHS loses in efficiency by sticking with the world's largest nationalised industry, it makes up for in equity and access. What efficiencies you might gain from an insurance based system, you might lose in access and entitlement.

Do we have the best healthcare in the world? That's a different question. How do you measure that? The Commonwealth Fund (a US think-tank) had a go and put the UK at the top of the list.

If you focus on cancer, you might get a surprise. Cancer data is collected by Eurostat and not all the contributing countries collect data in quite the same way, hence there is room for some unexplained variation.

The US has some of the best individual outcomes but comes at a huge price. France seems to do well but they have a system of reimbursements that is so complicated they are dumping part of it and copying us.

Germany? You might think it lavish. Or, it was. Austerity has taken chunks out of the system and some authorities are busy selling hospitals. We tried that... look what happened at Hinchinbrook.

Spain? Portugal? Systems on their knees. How about Japan, or Korea? Has India got anything to teach us?

What if we had:

"... the funding of the Swiss, the primary care of Israel, the health promotion approach of the Nordics, the choice of the French, the technology of South Korea and Japan, the innovation of the USA, the flair and speed of India, and the community Services of Brazil.

Oh... and the carers of Africa, the diagnostics of Australia, the integration of Geisinger Health System in Wyoming Valley, USA, the quality systems of Virginia Mason Medical Centre in Seattle, Washington USA and the system of elder care of Japan."

You'd have to travel the world to find out.

Fortunately, we don't have to. Someone has done it for us and put it in a convenient book; 200+ pages of wall-to-wall information, interest and facts.

Concentrated, unmissable good stuff. Written in an approachable, easy style, this is an absolute must read.

Knowing what happens in other countries, how they approach the same problems we have; this book should be compulsory reading for managers, politicians and frankly, should be on the national curriculum.

This book is written by a man who knows a thing or two about the NHS. He was an NHS management trainee and has worked in every part of planning, policymaking and delivery of healthcare.

His first management job was running the porters. He moved on to running huge chunks of the NHS and later advising on how the NHS should be run. Now he runs around the world for KPMG, looking at and advising global health systems.

I once asked him; "What's the best healthcare system in the world?"

This book is his answer. There are chapters on 25 different countries, including Brazil and China. This is a practical, succinct guide to the world's major health systems and explores what lessons can be drawn from each, to improve health worldwide.

'In Search of the Perfect Health System' is written by Mark Britnell, buy a copy. He doesn't need the money; the proceeds are going to a charity.

It's easy to get wrapped up in our own world of healthcare, ignoring the bigger world out there. You never know; finding out how the rest of the world works might make a world of difference here.

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Academy of Fabulous Stuff;

Have you looked at the fabulous stuff?

New 'shares' every day.

Make a note; be a sharer this week.

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Contact Roy - please use this e-address

roy.lilley@nhsmanagers.net

Know something I don't - email me in confidence.

Leaving the NHS, changing jobs - you don't have to say goodbye to us! You can update your Email Address from the link you'll find right at the bottom of the page, and we'll keep mailing.

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