Monday, March 07, 2011

In good company

Just in case you thought it was just the United States health care system that is facing financial issues, here comes this story about the British system from today's Financial Times: "Reforms of NHS take back seat to cash fears." (Sorry, I can't find a link to the story.) Here's the lede:

Health bosses are far more worried about keeping control of the NHS finances over the coming year than they are about implementing the government's sweeping reforms, warns the NHS confederation, the body that represents health authorities and trusts.

And later in the story:

[S]aid Nigel Edwards . . . "We are already picking up worrying signals from a number of hospitals and primary care trusts about significant money pressures emerging -- and this is before the challenging rigours of next year's tight financial settlement."

After years of sustained growth, the NHS faces a real-terms freeze in spending for the next four years.

. . . The service is being asked to make £15bn to £20bn of efficiency savings by 2014 at the same time as administrative costs are being cut by a third and management costs by 45 per cent.

It is no surprise that these pressures are emerging. The same demographic, technology, and patient care issues exist throughout the developed economies.

What is sadly surprising is that, whether in the US or elsewhere, there seems little coordinated interest in the use of process improvement to redesign work in the health care environment, which would improve quality and safety and also garner financial savings. Why can't the lessons of Spear, Toussaint, and Kaplan take hold?


Mark Graban said...

The management habits of "cost cutting" are really hard to break apparently, combined with the long-standing traditions of "command and control" leadership styles.... Lean really runs counter to much of the MBA style management that's been taught in so many industries, including healthcare (and I type this looking up at the MBA on my wall).

76 Degrees in San Diego said...

Competitors compete. You didn't see Toyota working with GM, Mercedes Benz, and Ford. Their investors want differentiation in the hope of future profit.