I’m Dr Pritpal S Tamber and I explore why health systems fail low-income communities. 

In the US, I do what I do as the CEO and Co-Founder of Bridging Health & Community. In the UK, I do what I do as part of the group behind Beyond Systems.

This is my personal blog. See About for more.

Flu, Crisis & Conflation

I’m on my third day of bed-rest with the flu. It’s the 3rd of January 2018 so you can see that the new year has started well. I started sneezing uncontrollably on New Year’s Eve and so began my thus-far, horizontal 2018.  

Infleunza is bad. Seriously bad. It’s only when you’ve had it can you really understand why people need hospitalising with it, and why people die from it. I’m otherwise a fit and healthy person, but the flu knocks me out like I’m immunocompromised or something - which makes me wonder what it’s like if you are immunocompromised.   

I’ve started to recover so I won’t need the NHS. My recovery was enabled by my parents. I was still at my family home for Christmas when it struck. They’ve let me lay in bed, give me food, and clean up behind me as I coughed and sneezed my way through the last few days.  

Others need the NHS. And it’s part of the reason why the NHS is overwhelmed. It’s in crisis. The usual annual crisis, during which so-called routine operations are cancelled as more resources are diverted to the frontline. A&E, principally. Make-shift wards. 

The crisis is soon followed by the usual calls for more funding. From the usual people. I can agree that the NHS in England needs more money. I’m yet to hear a convincing argument as to why we spend about 10% of GDP on health care compared to the 12% spent in France and Germany. And yet, at the same time, I worry that the NHS is a poor steward of these financial resources. 

There are two things that the NHS needs to do and is just not doing. The first is shifting tasks to less expensive clinicians. The second is decommissioning services that are not beneficial. Both require one thing to make it possible: long-term outcomes data. 

To my mind, it’s only when we have a strong sense of what is beneficial and what is not, can we start to have a conversation about how we want to spend our tax revenues on health. With a strong understanding of possible benefits, we can strategically focus on task shifting and decommissioning. Until then, it’s all just empty talk.  

Ploughing more money into a health system with little to no understanding of its own performance would be idiotic. So, while I have sympathy for the views of the ‘more funding’ brigade, I find their argument hard to support. There’s no doubt that more funding would aid the current crisis, but that’s nothing more than a band aid on a system whose configuration no longer makes sense and whose leadership doesn’t seem to have as strong a focus on outcomes data as it should. 

This post may be muddled. I know that. I’m working through a flu-hazed brain and definitely not thinking straight yet. But I wanted to write something in response to this morning’s headlines about the crisis in the NHS and the need for funding. We’re conflating issues, which is preventing us from getting to the fundamentals. 

 

Pritpal S Tamber

I’m the CEO & Co-Founder of Bridging Health & Community (BH&C) and the Founder of the Creating Health Collaborative. Before all this, I was the Physician Editor of TEDMED, Medical Director of Map of Medicine, Editorial Director for Medicine at BioMed Central, the company that pioneered open access publishing, and an editor at the BMJ. I have an MBChB (a UK equivalent to an MD) from the University of Birmingham, UK. This is my personal blog. If you're interested in BH&C or the Collaborative, check out the BH&C website, including the updates, which you can receive by email. My speaking agent in the US is Executive Speakers Bureau; elsewhere I'm represented by London Speaker Bureau.

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I’ve had every single symptom, my favourite being the vomiting on day one. Lovely.  

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