A Case in Point

As if to underscore my earlier point, compare this:

The NHS in England could save more than £2bn (€3bn; $3.7bn) a year through better productivity and efficiency, says the Department of Health.

Potential savings calculated from the figures for the first quarter of the financial year 2006-7 include £975m by reducing variation in length of hospital stays; £510m by reducing use of beds before operations; £348m by reducing emergency admissions; and £278m by reducing variation in outpatient referrals.

The biggest potential savings lie in discharging patients earlier, and the data show that several hospitals could save more than £10m each if they matched the performance of the top 25%. University Hospitals of Leicester NHS Trust is listed as having the biggest potential savings: £17.9m.

With this:

Ministers are planning to force GPs to improve their performance by posting patients’ comments about them on an NHS website, the Guardian can reveal.

Ben Bradshaw, the health minister, wants to make it easy for patients in England to rate their family doctor’s competence and bedside manner on bulletin boards on the NHS Choices website. Officials have been told to have the appropriate software ready next year.

He hopes consumer power will make GPs offer a better service for fear that as patients may switch to another practice with better website reviews.

Now, we should include the caveat that the BMJ article is specific to hospital care and the Guardian piece relates to GPs, but you can still see the existence of two different and seemingly contradictory trends. On the one hand we have a government taking a much greater interest in a patient’s satisfaction with their care, which all the talk of ‘compassion’ in the earlier post is related to, and on the other we have this perpetual efficiency drive, born out of a need to reduce waste and an attempt to ensure that funding cuts won’t have a detrimental impact on frontline services.

There are going to be times, of course, when these trends aren’t contradictory; those with busy schedules, for example, will be thankful for reduced waiting times before and after having an operation. But there will be many occasions when a patient’s expectations of the care they receive is far higher than the care a hospital wants/is able to provide. Under those conditions, care provision and patient satisfaction seem irreconcilable, which makes me wonder why the government regards it as so important.