I have no good news.
In most of Western Europe growth in productivity is at near-record lows. The banking crisis meant financial services went from boom to bust.
Some countries stimulated recovery by funding public services….
In the UK we cut our public services…
There was no time to recover before we were all plunged into the Pandemic and now…
… there may not be a World War, but the world is at war. The impact on trade and supply chains, yet to be felt.
As is the impact of defence spending and overseas aid, which could create a long-term drag on recovery.
‘…a job-rich, productivity-weak recovery, with low value-added… high hours-worked growth… a broad-based decline with a distinct lack of productivity-accelerating sectors.’
Global productivity growth fluctuates over time but it’s been declining since the 1960s. Today stands near historic lows.
In the UK, hours worked have increased, ‘value added’ has fallen, as has productivity… McK suggest, by -2.5%.
The latest ONS numbers show a 0.8% uptick in January, with horrible cost of living increases, pending.
Industries able to perform a digital transformation, he likes of Amazon, Ocado and others, have done well but there is a problem with ‘digital diffusion’.
How do we get businesses and public services to buck up, plug-in and click-on
Health and social care have four particular problems:
Barriers to adoption; including public mistrust, the legacy of failure and low levels of digital skills.
Time-lag; investment in digital takes longer than a Parliament to mature. Thus, no incentive for politicians to drive the agenda.
Digital maturity is complex; half of Trusts are not very digi-mature, social care, not at all… and bringing them all to a half-way-level-ish-playing-field is probably the work of a decade?
Transition costs; we’re talking millions.
Cannibalisation of current revenues; there’s no headroom in finances to do this. Some Trusts still struggle with the cost and inefficiency of having no electronic patient record system. Social care is skint.
On the bright side; the NHS, living in the pencil and paper past, has done well, providing; 16.5% more care, pound-for-pound in 2016/17 than they did in 2004/05.
The productivity growth of the economy, as a whole, was only 6.7% .
But…
… it is a long way from No19’s potty idea that the NHS is going to be able to increase its productivity by 30%. Even pottier the thought that the NHS can sustain an annual efficiency target as high as 5%. Or is the Chancellor really going to double the NHS efficiency target?
I know, recently, I have been critical of the NHSE/I Board.
Well, I’m sorry and I apologies…
… because I’ve not been critical enough.
The NEDs and the chairman cannot be oblivious to the facts I’ve recited here.
If any of them think the NHS going to be able to:
- deliver 30% efficiency savings,
- with 5% less money
- with no proper digitisation investment programme,
- no workforce plan,
- no recovery plan for social care
- and an NHS recovery plan that depends on IT investment…
- with a fragile economy and likely flat-line funding…
… they are dangerous and dreaming.
The NHS is being bounced around for political effect, by a bemused secretary of state taking advantage of a befuddled, floundering, un-apprenticed group of non-executives.
I’m sorry to say it but the executives don’t come out of this well, either.
Global health expert, Mark Britnell posted on Twitter, an extract from his book;
‘… WHO projects a [worldwide] 9 million shortfall of nurses by 2030. In the UK, 35% of nurses are aged over 50+. In USA, it’s 40%. Canada 30%, Australia 39%. We’re sleepwalking into a crisis…’
… how right he is!
… yet the chief nurse has no workforce plan.
… a finance director who seems to think you can do 30% more, for 5% less, and has agreed to doubling the efficiency target?
… a medical director who knows there will not be 5,000 more GPs and there are 800 new doctors with no training placements. And, doctors leaving in their droves.
… David Behan’s HEE with responsibility for training, invisible, missing in action.
… an IT Digi-director in the midst of another reorganisation without a comprehensive Digital Health and Care Plan. Cart-before-horse management.
… the chief executive exposed and buffeted by whatever wind blows from No10.
… the chairman is new, rudderless with no connections with NHS, civil society or politics and whose Board only meets 6 times a year.
No compass, no charts, no rudder, we are heading for the rocks.
News and Comment from Roy Lilley
Contact Roy – please use this e-address roy.lilley@nhsmanagers.net
Reproduced at thetrainingnet.com by kind permission of Roy Lilley.
