The "Aha!" Moment
For months now, I've been stymied by the NHS insistence on looking primarily at qualitative outcomes for most things. I simply believed that the leaders had given up on reason and on objective, quantitative outcomes. Like Captain Jack Harkness in Britain's "Torchwood" television series, I've had a flash of insight and I think I finally figured it out.
The British people are not consumers when it comes to health care. They are not used to speaking out when things don't go well, they don't question doctors or nurses and they can't shop for better services (some can, but only the 10 percent with private insurance). The government is now insisting that they give their voice and is getting the NHS to teach them how to be consumers in the process. We must focus on the patient "experience" and "journey." This comes naturally when one practices in the USA since it is a competitive marketplace and you have to earn your customers. But it is a new concept here in the UK.
The government is preparing the public for privatization! People will soon be willing to voice dissatisfaction, commissioners will make purchasing decisions based on the results of consumer opinions and the NHS will have to fight alongside "any qualified provider." Already in some trusts, services are being commissioned to private, non-NHS providers, and NHS trusts are losing business.
Margaret Thatcher's attempts at privatization failed in the 1980s because the culture wouldn't allow it. Cameron is changing the culture so that they will demand it!