Can New UK Health Czar Cure NHS's 'Enormous Sickness'
By Staff News & Analysis - March 13, 2013

Cameron's new health tsar Don Berwick The NHS is suffering from "enormous sickness" in the wake of the Mid Staffordshire hospital scandal, David Cameron's new patient safety tsar has told The Telegraph. Prof Berwick is one of the world's foremost authorities on patient safety. In his first interview with a British newspaper since his appointment, Professor Don Berwick said that trust in the health service would only be restored by instilling a new culture that tolerates not "a single injury". – UK Telegraph

Dominant Social Theme: Government monopolies don't need to compete to perform better, they just need expert leadership.

Free-Market Analysis: Another article in this issue analyses a "bill of rights" issued by the European Union to try to make air travel more tolerable. But the same problems that afflict air travel also bedevil Britain's one-size-fits-all National Health System.

Government-run health care is a truly dangerous mechanism because over time inefficiencies will cause health care to become intolerably expensive. Unfortunately, when it comes to cutting costs, the easiest expense to minimize is care itself. This inevitably leads to bureaucrats deciding who is to die and who is to live.

That is no doubt already happening at NHS despite denials. Eventually, this sort of decision-making will be a feature of the US's Obamacare, as well. It is inevitable.

Don Berwick, the new man in charge of NHS, has not focused on NHS death-decision mechanisms, but according to this article, he is determined to make health care "as safe as the aviation industry." Here's more from the article:

Prof Berwick, who used to advise Barack Obama, said wholesale changes to the "attitude or culture" of the NHS were needed if this was to happen.

He said the "tragedy" of events at Mid Staffordshire NHS Foundation Trust, where up to 1,200 people died due to substandard care, could act as a catalyst to drive improvements throughout the NHS.

"Zero harm is morally and ethically the right way to go. Why should we tolerate a single injury?" he asked. "There is no reason why English health care cannot aspire to be and become the safest health care in the world."

The NHS needed an "attitude or culture" where "no harm should be regarded as acceptable", he said. "That may be very aspirational, but in the world-class safety systems they generally have an attitude that even a single injury is problematic. Airlines have now achieved safety that many would have thought impossible in such a complex area."

Prof Berwick is one of the foremost authorities on patient safety. For almost 20 years he headed the Institute for Health Improvements in the US, advising organisations domestically and throughout the world. He led the US president's "Obamacare" reforms but in 2011 was forced to resign, in part for citing the NHS as "an example" for the US.

It does not matter, unfortunately, whether Professor Berwick is a foremost health care authority or not. The system does not need expertise. It needs competition.

Unfortunately, in so many ways competition is in short supply in Britain. The government constantly glorifies its military and the Royal Family – promoting the idea that all of England is organized as a kind of family, though it obviously is not.

But even were this the case, the calcified industrial elements of Britain are evident in the size of the main players in a given field and the amount of regulation aimed at them.

Regulation is an empower of the status-quo and when one freezes an industry and its participants via regulatory dictates, then the only way to create change is via further regulations and the threat of their enforcement.

When industries and participants are not exposed to competition, there is no incentive to maintain performance. When this takes place within the context of health care, lives are at risk. Over time, there are needless deaths.

According to the article, Professor Berwick is now to head up a panel "to make zero harm a reality in our NHS." And we learn further that, "The 12 members of the National Advisory Panel on the Safety of Patients gather for their first face-to-face meeting next month."

Will such a panel really help? NHS is long-in-tooth and inevitably corrupt. Additionally, when mistakes are made, patients die – and thus the ability to gloss over the NHS's increasing incompetence is not in the long term an option.

Professor Berwick informs us that his reading of the British is that "they value enormously the NHS … When a tragedy happens, and it was avoidable, they are alarmed and they want reassurance. That doesn't mean all is lost but that there's some enormous illness in the system."

Mike Farrar, of the NHS Confederation, which represents managers, said the health service could learn from aviation and supports Professor Berwick's analysis. He is quoted as saying, "In five years' time I'm very confident that the NHS will have got more consistency, it'll have reduced this variation in experience, it will have supported its staff well … I'm very confident that the public will see an NHS which has reduced error and harm dramatically."

Our prediction would be that NHS problems will get worse and worse and that the entire system will eventually be overturned. From what we can tell, the only reason the public tolerates it currently is because many of the problems associated with it are not reported.

After Thoughts

The illness in the system is a lack of competition that no amount of caring staff can compensate for.

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