By Dr Helmy Haja Mydin
Efficiency appears to be the buzz word in the political circles of the United Kingdom at present – the various political parties are attempting to outbid each other in the race to establish their credentials as efficient managers of the public purse as the general election looms near.
In the current global climate, the need for austerity is made all the more obvious as each government seeks to protect their credit ratings in the financial markets. It is traditionally thought that such moves would lead to declining investments in social spending. But it might perhaps be more palatable to critically review the investments that have already been put in place and ensure that the funds are used both efficiently and effectively.
Most government healthcare services are monolithic enterprises that slow innovation and act as obstacles to improvements in efficiency. With this in mind, the British government had introduced changes to the National Health Service (NHS) in 2006 that brought in more competition and allowed greater patient choice with regards to the hospitals from which they could receive treatment.
Information was made freely available to the public with regards to hospital quality. And hospitals were given more freedom to choose the methods in which they could increase the quality standards on site.
This contrasted to the previous scenario in which hospitals were not rewarded on the basis of the number of patients they attracted; in fact patients had no choice regarding the hospital they attended, irrespective of quality standards. This meant that the motivation to improve performances was minuscule.
However, since the introduction of patient choice within the NHS, indices of quality have showed improvement – the waiting time to see a doctor has dropped, patient satisfaction has improved and productivity has increased as well. These changes do not only make the statistics look good; more importantly they have led to a perceptible improvement in the patient’s journey through his or her treatment.
Similar lessons can be applied to our healthcare service in Malaysia.
Perhaps most importantly, the first step that should be taken is the dissemination of information with regards to the quality of care that is available in our local hospitals. For example, the culture of performing clinical audits as well as completing the audit cycle in order to ascertain the improvements brought about by any particular intervention should be introduced and these findings should be shared with the general public.
Private healthcare entities should take a page out of this book as well and provide their patients with an avenue to make informed decisions.
The improvements brought about by such a policy are readily apparent to the patient, but may be more opaque to the healthcare providers themselves. However, it is useful to note that the provision of such data will not only empower the patient, but will lead to them having greater faith and confidence in the service that is provided to them.
Government hospitals should be given more autonomy to introduce innovative practice to improve their service, which will lead to the hospitals being looked upon in a more positive light. The system then should allow private institutions to compete with the government hospitals to ensure that the rakyat gets the best range of choices when it comes to the important decision of managing their health.
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Dr Helmy Haja Mydin is Fellow (Healthcare Policy) at the Institute for Democracy and Economic Affairs (IDEAS).