Health Service Woes

Once again, budget cuts are in the news and, once again, the health service is in the firing line. Increased costs, more expensive treatments, and an ageing population are identified as some of the problems. Budget cuts and reduced services are identified as the solution. Is it really that simple?

When the health service comes under pressure budgets are cut and savings found to satisfy targets set by senior management and administrators.

Temporary and contract staff are let go, the hours people work cut, suppliers and supplier costs reduced, and spaces and facilities closed in an effort to save money.

Before senior managers and administrators round up the usual suspects, however, a number of issues should be considered.

One, clinicians and others working in front-line services should be included in the decision-making process to ensure the right staff and patient choices are made.

Two, the type and mix of staff best suited to deliver services should be identified and agreed; or unforeseen, unintended and more costly consequences and complications will arise to challenge future budgets.

Three, an appropriate balance and ratio of administrative, support and clinical staff should be retained to ensure the correct level of skills, patient care, efficiency and productivity.

Four, creating an imbalance in support services and the skills available to clinicians will lead to longer waiting times, poorer patient outcomes and increased expenditure.

Five, reducing the space and facilities needed to provide services proves costly when it leads to the underutilisation and underemployment of skilled staff given their high relative cost.

Six, finding easy short-term savings in isolated budget lines leads to greater overall costs, as expenses in other areas disproportionately increase.

Seven, reducing budgets through underinvestment in staff, equipment and resources leads to false savings as overall costs rise.

Eight, reducing the number of suppliers and the prices paid to suppliers can hide the need to reorganise and manage suppliers and how supplies are used and consumed within the system.

Nine, the setting of higher patient targets that force clinicians to spend less time with patients leads to higher costs, as patient outcomes are adversely affected and thus more care and services are needed.

Ten, cutting isolated ‘soft-target’ budgets rather than comparing and contrasting clinical and management best practice in different areas leads to recurrent budgetary overspend.

Health service budgets will remain under pressure as demand for services increase but the current approach of making reactive and short-term cuts will not solve the problem.

SO, falling budgets and associated health service cuts will continue to dominate the headlines but a new approach must be taken if solutions are to be found.

What do you think?

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