The Problem: The NHS needs reform, but it cannot be achieved effectively from Whitehall.
The Solution: Use the Academy school approach for hospitals.
The NHS is the single biggest cost to taxpayers, providing treatment that is free at the point of use for everyone in the UK. While the principle behind the NHS is fantastic, reform is needed to provide better quality care at a lower price, including overhauling A&E departments.
The NHS will not be overhauled from Whitehall; any top-down approach for such a massive organisation is doomed to fail.
More power needs to be devolved down to the hospital level, to allow greater space for innovation and patient-driven care, with hospitals providing the services patients in that locality need and being accountable to people living in the area.
The Academy system has achieved a lot of success with improving poor quality schools, despite some failures, so I suggest following a similar model for hospitals, allowing not-for-profit organisations to take control of, and run, particular hospitals and wider local health care services.
The key principles behind the idea are to provide more local control over healthcare and to attract talented people into the sector to reform failing institutions, something that is unlikely to happen in the civil service bureaucracy.
Leaders of these organisations would be accountable for their actions, and wherever failings were taking place they could be identified and new management brough in to fix the problem. Healthcare would become better designed for the particular local setting in which it operated and there would be far greater space for innovation as more decision-making was devolved. Lessons from Army field hospitals, for example, could be used to improve A&E services, particularly focused on triage.
The NHS needs reform if it is to continue to provide treatment free at the point of use and still be affordable to the taxpayer. With 10% of the budget spent on Diabetes, for example, better solutions to saving such costs are needed, but they have not been forthcoming in the current, over centralised management, so a more local process should be trialled, even if it starts just with a few hospitals in a few particular areas to assess how well the concept could work.
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