Making things more expensive by trying to make them cheaper


All Hail Central Planning! We seem to have another quite wonderful disaster from the bowels of the NHS.

Despite restructuring and a hiring freeze, documents presented to the board of NHS Direct show that so far this year the "total cost per call answered" has been £16.54.

OK, NHS Direct is the idea that we'll save money by having nurses at the end of a phone line rather than people going to their GPs for a meatspace consultation. Does it really save money though?

The British Medical Association estimates that it costs the NHS between £20 and £25 every time a patient sees a GP...

Well, yes, it appears. Except, except, it's a lot easier for a patient to make a phone call rather than schlepp down to the surgery, so we might be getting more not very much less expensive phone calls than we did GP consultations. No figures on whether that is true or not unfortunately.

More than a third of patients treated by the organisation's nurse advisers are referred to their GP or hospital accident and emergency unit.

Ah, the savings by using the nurses are about one third. But one third of the calls incur the costs of the nurses plus the costs of the GP (or A&E, even more expensive). So we've managed, by the glories of central planning, to make the system more expensive while trying to make it cheaper.

All Hail Central Planning! 

Did no one think this through? GPs are independent businessmen, if a nurse on the phone was indeed a great saving, wouldn't at least some practices have done this themselves? And if they were, then why the central system? And if they weren't, then why did anyone think it would be a great saving?