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Text of Dr Gary Marlowe's talk at the Hackney KONP election hustings April 2015
Good evening and welcome.
My name is Gary Marlowe and I am a local GP as well as a Board member of the C&H CCG and City & London HWB. I shall try to be brief as it's the candidates we want to hear from. However, I would like to set the picture from my perspective.
GPs in London undertake @ 90% of all first patient contacts and deal withthe majority of these themselves. They do this for only @ 7% of London's health Budget of £15.1bn.
Hospitals at the moment are in £900m deficit.
Social care spending has decreased by 17% in 2AB/14 compared to 2010 whilst the >65 pop has increased 10% and >80's by 85%
The NHS 5yr plan identifies a £20bn gap by 2020. However, this is contingent on £22bn efficiency savings. Where are these efficiency savings to come from?
GPs are hugely overstretched with the threat of 'around 20% of GPs in East
London saying they are going to retire in the next 5yrs. Meanwhile around 8000 health professions have applied for Certificate of Good Standing in the last year. The first step to emigrating.
A+E departments are struggling to recruit staff. Around 30% of midwives are due to retire in the next 5yrs. Overall there is likely to be a massive implosion of staff in the NHS. The remaining overstretched and demoralised staff cannot produce efficiency savings anything Iike the f22bn whilst increasing productivity by 2-3% each year that underlies the current assumptions.
All the political parties have to honest about NHS funding and to tackle the PFI debacle that is haemorrhaging money from the NHS.
lf we could save the Banks it is not beyond the wit of Government to solve the PFI problem
Cons, Lib Dems and all the smaller parties have promised to invest extra money in the NHS though they remain hazy about where/how and for me more importantly completely silent about efficiency savings. I understand Labours desire to appear economically competent but interestingly they are the only ones to decline to sign up to the f8bn.
Several parties have said they would repeal the HSC Act asap. As a CCG Board member I have had briefings from specialist lawyers who are clear that repealing the Act would have the unintended consequences of defaulting contracts back to EU competition legislation.
The only real way of removing the strictures of procurement legislation from the NHS is to remove the market entirely from the NHS. Of note is that transaction cost (in large part the costs of running the market) rose form around 7-9% pre-market to 14-2A% now. This equates to as much as £25bn.
The threat of TTIP could make this even more.
At the moment we have an NHS that is advised by procurement lawyers not clinicians. ln terms of its organisation this is a fundamental issue and all else is tinkering around the edges.
A number of the players have talked about combined health and social care as if this could magically solve the problems. Even if the social care budget was protected (it is not ) this would not help. 2 leaking ships lashed together does not a seaworthy vessel make.
As for access most of the pledges are knee jerk reactions redolent with unintended consequences.
ln summary we have an NHS that from 20tO has delivered f 19bn of efficiency savings whilst still increasing productivity of @ 1..5% a year leaving a weary and demoralised staff. You cannot get more blood from this stone
Good evening and welcome.
My name is Gary Marlowe and I am a local GP as well as a Board member of the C&H CCG and City & London HWB. I shall try to be brief as it's the candidates we want to hear from. However, I would like to set the picture from my perspective.
GPs in London undertake @ 90% of all first patient contacts and deal withthe majority of these themselves. They do this for only @ 7% of London's health Budget of £15.1bn.
Hospitals at the moment are in £900m deficit.
Social care spending has decreased by 17% in 2AB/14 compared to 2010 whilst the >65 pop has increased 10% and >80's by 85%
The NHS 5yr plan identifies a £20bn gap by 2020. However, this is contingent on £22bn efficiency savings. Where are these efficiency savings to come from?
GPs are hugely overstretched with the threat of 'around 20% of GPs in East
London saying they are going to retire in the next 5yrs. Meanwhile around 8000 health professions have applied for Certificate of Good Standing in the last year. The first step to emigrating.
A+E departments are struggling to recruit staff. Around 30% of midwives are due to retire in the next 5yrs. Overall there is likely to be a massive implosion of staff in the NHS. The remaining overstretched and demoralised staff cannot produce efficiency savings anything Iike the f22bn whilst increasing productivity by 2-3% each year that underlies the current assumptions.
All the political parties have to honest about NHS funding and to tackle the PFI debacle that is haemorrhaging money from the NHS.
lf we could save the Banks it is not beyond the wit of Government to solve the PFI problem
Cons, Lib Dems and all the smaller parties have promised to invest extra money in the NHS though they remain hazy about where/how and for me more importantly completely silent about efficiency savings. I understand Labours desire to appear economically competent but interestingly they are the only ones to decline to sign up to the f8bn.
Several parties have said they would repeal the HSC Act asap. As a CCG Board member I have had briefings from specialist lawyers who are clear that repealing the Act would have the unintended consequences of defaulting contracts back to EU competition legislation.
The only real way of removing the strictures of procurement legislation from the NHS is to remove the market entirely from the NHS. Of note is that transaction cost (in large part the costs of running the market) rose form around 7-9% pre-market to 14-2A% now. This equates to as much as £25bn.
The threat of TTIP could make this even more.
At the moment we have an NHS that is advised by procurement lawyers not clinicians. ln terms of its organisation this is a fundamental issue and all else is tinkering around the edges.
A number of the players have talked about combined health and social care as if this could magically solve the problems. Even if the social care budget was protected (it is not ) this would not help. 2 leaking ships lashed together does not a seaworthy vessel make.
As for access most of the pledges are knee jerk reactions redolent with unintended consequences.
ln summary we have an NHS that from 20tO has delivered f 19bn of efficiency savings whilst still increasing productivity of @ 1..5% a year leaving a weary and demoralised staff. You cannot get more blood from this stone
