For some strange reason the healthcare sector manages to escape the sort of forensic analysis others are subjected to. There’s this strange coalition of patient confidentiality, ethics, professional integrity and public policy. These combine to create this “opaque soup” of information which nobody understands and even fewer believe.

In the UK we get bombarded by PR campaigns funded by the government and intended to persuade us to change our lifestyles. My favourite example is posters on Edinburgh buses telling us not to rinse after brushing our teeth.

Of course they’re really telling us its our fault the NHS is so expensive – because we use it.

For anybody as confused as me the new book from Levitt and Dubner – SuperFreakonmics – is a fascinating read, because this irreverent pair takes the lid off the pan and clarifies the soup with real research.

Initially I’d planned to quote from the book, explaining their discoveries but decided that would dis-service both the authors and readers. So please buy it.

They explain in terms anybody can understand the ways vested interest and incompetence (not on the part of doctors or nurses) get in the way of everybody understanding more of the choices and consequences.

Most importantly they point to real research results confirming the benefits of aggregating and analysing patient data to get past the obfuscation and find new ways of delivering more value at less cost.

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Researchers – please visit our Clinical Research Hub page and register for our Clinical Research Collaboration Forum. Commercial organisations are invited to visit our Partners page. Press please contact Press.Office@avantrasara.com.

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Tagged as: Add new tag, Dubner, Ethics, Forensic science, Government, Health care, Levitt, National Health Service, NHS

Despite 30 years of North Sea Oil Scotland has one of the lowest growth rates in Europe, and in some places lower life expectancy than parts of Africa. This is the same country which gave the world some of the greatest scientists, engineers, clinicians, entrepreneurs and financial managers. How does this happen.

At the beginning of the credit crunch we watched a leading politician boast Scotland would suffer less than the rest of the UK, because of the public sector. More public sector jobs meant less contraction during the recession, and a faster recovery. But now the squeals of rage can be heard across the country. It turns out the UK parliament will insist on public spending cuts in Scotland, probably meaning more of contraction in Scotland than south of the border. Now the facts are showing through. The public sector turns out to be a weight the economy can’t carry, without the English helping out.

For years politicians have seen the public sector as a mechanism for improving quality of life. Perversely economists have known public sectors constrain economies ability to grow. Politicians need growth in the economy to fund public sector programmes, and the private sector needs governments to provide for citizens incapable of looking after themselves.

Most countries have found a balance between the two, with Europeans choosing more public sector, and the USA and Asia choosing less. Both have recognised the need to keep the public part below 40% of the total economy. Above that economies start to shrink.

In Scotland the public sector has been 50% of the economy, and growing. Politicians have been able to keep the public happy by asking little of them, and handing out a lot through it. But they’ve only got away with this because the English economy’s been paying for it. Scotland votes universally left of centre, maintaing a socialist government, run by Scots, in power in the UK Parliament. But the rules are changing.

Why is the public sector so bad? Here’s 3 reasons.

Emigration

Public sector jobs have improved considerably in pay and conditions, but the organisations are hide bound with vested interest and inefficiency. Not places for dynamic young people wanting to make their way in the world. They need vibrant, going places, private sector organisations to provide opportunities. They all leave Scotland because private sector chances are few and far between. The country loses its brightest talents to markets in the south. What’s left? The ones who didn’t think they could live with the competition. The average and the under performers. They’re the ones managing the public sector, sort of averagely.

No Value Add

In the private sector businesses have to create value. Outputs greater then the sum of inputs. Profit to pay for more investment, and innovation. Public sectors don’t have the same motivations. They just spend money. It’s a public sector thing. Status is infinitely more important than performance. Politics is more important than leadership. All day meetings are more important than staying late to get the job finished. What counts in the public sector is arguing for more budget, and winning new grants – not working harder for longer finding new ways to do more with less.

Nepotism

Understandably the people with the power aren’t going to let anything rain on their parade. The last thing they want is change to the status quo. So they make sure to favour their mates. The public sector in Scotland is a swamp of “nothing to do with me” and “more than my jobs worth”. Don’t rock my boat – promise I won’t rock yours.

It’s not hard to understand why the public sector is bad for Scotland. More than half of the economy, run by average performers in their own interests, and subjugating any green shoots with the temerity to rise above the ground. Meanwhile the value add created by the private sector is shrinking.

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Tagged as: Add new tag, Audit and Purchasing, Economy, Government, Money, Politics, Private sector, Public sector, Scotland