The End of the NHS?

Last day of #economicsfest speaking about robots, gigs , inequality and NHS

End of the NHS? Not with a bang but a whimper #economicsfest panel now @CastelliAdriana @khcheck @PJTheEconomist @BBCHughPym Carol Propper  http://www.ideasfestival.co.uk/events/the-end-of-the-nhs-not-with-a-bang-but-a-whimper/ …

About to chair debate on future of NHS @FestivalofIdeas with health economists - short term financial needs and long term direction #economicsfest

. #economicsfest Future of the NHS wth @khcheck @CastelliAdriana @PJTheEconomist & Carol Propper chaired by @BBCHughPym

.@khcheck is a GP as well as a prof, says her NHS experience since 1980s has been feast & famine, & now it’s famine #economicsfest

.@khcheck says squeeze in NHS finances means the most important metrics are "dropping off a cliff" #economicsfest

Waiting times up & outcomes are dropping off a cliff at the moment. High GP workloads mean productivity is up! @khcheck #economicsfest

Tax is a price we pay for living in a civilised society, is @khcheck’s closing quotation on future of NHS #economicsfest

Checkland: freeze in NHS salaries 2010 onwards prevented disaster but meant big drop in real wages for nurses & other staff. #economicsfest

Carol Propper highlights great variation in performance in the NHS, & that the reasons aren’t really understood #economicsfest

Carol Propper: hospitals vary greatly in what they achieve with same money, same patient mix. #economicsfest

Crisis, what crisis? The reality of life in general practice in England - GP & health policy prof @khcheck #economicsfest  http://blog.policy.manchester.ac.uk/posts/2015/10/crisis-what-crisis-the-reality-of-life-in-general-practice-in-england/ …

Carol Propper highlighting future staffing crisis in NHS, because of ageing workforce & especially because of Brexit #economicsfest

Propper: large proportion of NHS staff come from overseas. Hence NHS staffing crisis and Brexit are inseparable. #economicsfest

When NHS under pressure some people use private services, and this threatens political support for NHS, says Carol Propper #economicsfest

Strong support in UK for NHS & it’s efficient & cost effective, but we need to change how it’s managed, says @CastelliAdriana #economicsfest

Change needed because of ageing population with chronic conditions, needs link to social care funding too, @CastelliAdriana #economicsfest

It’s nice not to be the gloomiest person on a panel, says @PJTheEconomist on the NHS! #economicsfest

.@CastelliAdriana : healthcare needs are different now from when NHS founded. More chronic conditions, more of population with medical needs. #economicsfest

.@PJTheEconomist says 1/3 of government spending goes on health/social care. NHS not an organisation so much as a sector #economicsfest

The NHS doesn’t deserve our hero worship: we need to ask how it can change for the better, @PJTheEconomist #economicsfest  https://www.ifs.org.uk/publications/9682 …

.@PJTheEconomist : to keep the NHS we recognise, we have to find more tax money, or cut other public services, or (miraculously) make care much cheaper. #economicsfest

UK health spending, @TheIFS briefing note, #economicsfest debate on The End of the NHS?  https://www.ifs.org.uk/publications/9186 …

All developed economies facing same cost pressures on health costs - we have to decide how much we want to spend and where from - @PJTheEconomist at #economicsfest debate

@FestivalofIdeas haven’t heard the word “prevention” yet..... 🤔🤔#festivalofeconomics #economicsfest #declineofnhs

Propper: ring fenced money for NHS means that, in tough times, other essential services are especially squeezed. #economicsfest

Bed occupancy of over 95% in NHS is actually inefficient, limits ability to manage effectively, says @khcheck #Economicsfest

Funding social care - Dilnot Commission 2011 report being discussed at #economicsfest debate  http://webarchive.nationalarchives.gov.uk/20130221121534/http://www.dilnotcommission.dh.gov.uk/our-report/ …

Carol Propper says Netherlands is the one country to have integrated successfully health & some social care. #economicsfest

Propper: Netherlands an example of success in integrating funding of health & social care; less of a political football than the UK. #economicsfest

Audience question: would user charges discourage overuse of NHS services? Propper: they discourage the wrong kind of users/usages such as preventative care. #economicsfest

Health and social care devolution: it’s complicated, @khcheck #economicsfest  http://blog.policy.manchester.ac.uk/posts/2016/03/health-and-social-care-devolution-its-complicated/ …

Question: can tech increase productivity in health? @khcheck says new techs tends to increase demand too. #economicsfest

Carol Propper thinks there is scope for significant tech-driven reorganisation. #economicsfest

And she adds robots better at surgery than surgeons with a drink problem! #economicsfest

Can technology improve healthcare productivity? Some evidence @TSEinfo, #economicsfest  https://www.tse-fr.eu/sites/default/files/TSE/documents/ChaireJJL/newsletter_1.pdf …

Johnson: new tech might make more conditions treatable, so expand costs of healthcare, or might reduce costs of existing care. Net effect remains to be seen. #economicsfest

Propper optimistic on AI in medicine. Robots can't lose sleep over problems at home; can't develop drink problem. #economicsfest

Can healthcare IT save babies? US evidence @MITSloan, #economicsfest  http://mitsloan.mit.edu/alumnimagazine/2013/spring/catherine-tucker.php …

“Robots are a lot better at surgery than people whose hands are shaking because they drink too much” - Prof Carol Propper at #economicsfest NHS debate

Surprised no mention yet at #economicsfest of multiplier-effect benefits from NHS funding. We have NHS for good moral/political reasons, but there are economic arguments as well?

What drives variation in hospital trusts' productivity in the NHS? Study by @CastelliAdriana #economicsfest  https://pure.york.ac.uk/portal/en/publications/hospital-trusts-productivity-in-the-english-nhs(5ab91094-254d-4c40-b0e8-930cd61117d6).html …

Why don't they just develop a robot that can just breathalyse surgeons? #Economicsfest  https://twitter.com/ruskin147/status/931893891065839617 …

NHS employs 1.2m people, government shouldn’t force same model on all of it, including how to contract out - Carol Propper #economicsfest

Healthcare: how competition can improve management quality & save lives - Carol Propper @micro_econ #economicsfest  http://microeconomicinsights.org/healthcare-how-competition-can-improve-management-quality/ …

GPs are technically private providers, although steeped in NHS culture points out @khcheck - & that enables rapid change #economicsfest

There’s room for competition in public health care, Carol Propper @globeandmail, #economicsfest  https://www.theglobeandmail.com/opinion/theres-room-for-competition-in-public-health-care/article34956444/ …

Marking their own homework? The management of conflicts of interest in the NHS, @khcheck #economicsfest  http://blog.policy.manchester.ac.uk/health/2017/11/10104/ …

Hard to integrate a means-tested and non-means tested system, says @khcheck on why health & social care can’t be integrated #economicsfest

Even if we are approaching a cliff, NHS still vastly better than 20 years ago on any measure, says @PJTheEconomist #economicsfest

Care suffers when hospitals aren’t forced to compete, @AEAjournals study by Carol Propper @imperialcollege #economicsfest  https://www.aeaweb.org/research/when-hospitals-compete-do-patients-win …

Carol Propper reminds us what healthcare used to be like by referring to The Citadel by A J Cronin  https://en.wikipedia.org/wiki/The_Citadel_(novel) … #economicsfest

NHS financial woes are diverting attention from efforts to increase competition, which benefits patients, #economicsfest  https://www.economist.com/news/britain/21697829-junior-doctors-strike-health-secretary-mollifies-other-medics-operating-costs …