Tuesday 31 August 2010

Daily Mail takes a "Do it yourself" attitude to healthcare

I try to make a rule of not blogging about the Daily Mail talking bollocks more than once a day because, quite frankly, it's even easier than predicting when a Pakistani fast bowler will send down a no-ball and, as such, not much fun. But hey, as Salman Butt would probably say, rules are there to be broken.

Today's paper has a special investigation into how the medical industry over-charges the NHS for products, an expose written by a medical sales rep. The headline?
In B&Q they cost 20p. So why does the NHS spend £99 for a screw to put in your hip?

Now, I'm no expert in medical matters. I watched a couple of episodes of Grey's Anatomy once (in my defence, I was drunk) and at university I lived next door to a couple of medical students (who, most of the time, were drunk), but that's about it. Yet I think even I can probably hazard a guess why the NHS's finest orthopaedic surgeons don't pick up their supplies at B-AND-FUCKING-Q on the way to work each day.

Even if you're not a complete fucking moron and still can't figure out why the NHS doesn't use bamboo garden canes from Homebase in lieu of hypodermic needles, you only have to make it to the fifth paragraph of the story for the author to answer his or her own question:
"We sell screws that are barely any different from the ones you see in B&Q, priced five for £1. Yet ours cost between £30 and £40 — each. And while they cost us, at most, £10 to make, we justify the mark-up because they are slightly finer. Oh, and sterile. "
Right. So they cost you £10 to make, and you sell them for between £30 and £40. Charging three times the manufacturing cost is certainly a hefty mark-up but it's not totally off the scale - nor does it compare to the 495-times difference mentioned in the headline. Plus, of course, the £10 cost of "making" a surgical screw does not take into account the scientific development and so forth that have to be paid for too. Nor the £100,000 salary of the sales rep - your average B&Q sales stacker isn't on quite that much, and your average B&Q screw is not super-fine (something that is more complicated and costly to achieve without losing structural integrity) and is not produced (and shipped and stored) in a sterile environment.

There's the root of a potentially interesting article here - the paper could take a serious look at the problem of medical suppliers charging unjustifiably large prices to the NHS, driving up the cost of treatment and reducing the number of patients who can be treated as a result. But this doesn't fit with the Mail's agenda. Far from it. The paper despises the NHS, seeing it as a socialist construct packed with "pointless" managers and bungling foreigners.

So this story draws the staggering conclusion that the problem lies with the NHS and that the only way to overcome it is for the NHS to learn "smarter shopping". The deranged commenters agree, one saying that supermarket managers should be brought in because they know how to drive down costs (chiefly by bankrupting farmers, but that's another story). The angle here perfectly reflects the paper's take on Avastin, the bowel cancer drug that costs £21,000 per patient. All coverage focussed on how evil bureaucrats at NICE were denying people the drug because it's too expensive. At no point did they question WHY it's so expensive.

As a final thought, can you imagine the horrified Mail headlines if it was revealed that the NHS WAS buying its hip screws at B&Q?

1 comment:

charlie said...

You are right about the need for NHS purchasing practices to be examined. As a worker in a hospital pharmacy I see plenty of example of inconsistent pricing.