Healthcare in a recession24th November 2008
Dr Andrew Jones, group medical director of Nuffield Health and policy adviser to Andrew Lansley, on healthcare in a recession.
While we may not be officially in recession, I have been asked what the impact would be on the public sector and wider health economy and the implications for quality and safety.
While my answer on quality is always the same – that high-quality healthcare is more cost efficient and best delivered at scale by centres of excellence – the impact on health in an economic downturn required more thought.
Healthcare is not recession proof; public sector allocations are affected and healthcare inflation has consistently outstripped spending and the current resource allocations.
In these times, specific management principles become paramount.
Productivity must be improved. The need to monitor patient volumes, episodes and input costs has never been greater and the fall in productivity in the last decade must be reversed.
Costs – both staffing and in supply chain management terms – will also have to be closely controlled. With staffing accounting for 60% of health spending, reviews of senior management, departmental leadership, support and administration posts are necessary.
While cash generation is not easy, acute and foundation trust finance directors will be aware of the need, while my final point is that a review of capital spending programs is required.
These are challenging times but success in them for the health sector will be judged on "how much we improve health outcomes and reduce avoidable mortality or morbidity".
But the key to that remains "information, co-ordination and collaboration".
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