What is wrong with the NHS in Scotland?

A friend of mine who was an anesthetist in NHS Scotland once lamented at the waste in the system.  £30m a year out of your, the taxpayers, pocket for example, went straight down the drain when people, amazingly, didn’t turn up for operations.  Of course there are cases when at the last minute a person can’t come.  For example, if they have caught a cold.  But they were in the tiny minority. 

And GPs experience the same sort of thing.  People not turning up for appointments.  You would be staggered if you knew how common this was. And the cost?  As a taxpayer it is costing you £16m every single year in Scotland. If you were ill enough to want to see a doctor, why on earth would you just not turn up?  And by not turning up in both cases you have cost the rest of us taxpayers money and you have deprived someone else of an appointment they desperately wanted.

So that's us just saved £46m a year.

Then when I pop into my local hospital for a regular check-up I’m met by a clerk who asks my name, then asks me to go to sit down and wait.  Past another person who is sitting waiting to call out patients when their time has come.  Why are two people doing a job that could be done by one person?  You can see where this is going. We are wasting money that should be going into patient care.

The real problem with the NHS is that it is a monolithic throw back to days when it was thought the State had to be cradle to the grave in its provision.  These days have long gone in most peoples minds.  But not in the minds of those who benefit most from a monopolistic health service.  I’m not referring to the nurses and doctors and porters and clerical staff as being the ones to blame.  No, the real problem lies in the place where change and reform are dirty words.  The Unions who are bankrolled by the millions of NHS staff and the Government who, no matter the political colour, are scared to do anything significant to reform the NHS.  No competition means no innovation.  No innovation means things never change.

Everyone wants a better NHS.  But we will never get what we wish for if we keep living in the past.  The NHS should be a concept, a vision, an ideology.  Not a monopolistic delivery service.   We have made it an institution with none of the disciplines and tools that would allow it to become what we all want it to be.  The best in the world.