Putting a price on health care

Your investigation into NHS finances (News, last week) highlighted the debt of £630 million-£1 billion.

My colleagues and I at St George's Hospital, London, have demonstrated that increasing the flow of blood from the heart, leading to more oxygen being delivered to the tissues in the patient post-operatively in intensive care units, leads to a reduction in post-operative complication rates. This has reduced length of stay in hospital by an average of 12 days per patient.

There are approximately 40,000 patients a year who could benefit from this, which would save the NHS up to £160m a year.

In addition, I am a member of the Improving Surgical Outcomes Group, which has been working on a specific initiative within the NHS, together with colleagues, to address this issue.

There are at least 500,000 patients where a similar approach could reduce length of stay by between two and four days per patient. This could potentially save the NHS a further £600m a year. This equates to a total annual saving for the NHS that would wipe out the current deficit.
Prof Monty Mythen
Prof David Bennett
Mr Eddie Chaloner
University College of London St George's Hospital Lewisham, London


The dismal statement on the funding of the NHS will surprise few professionals who work in it. What is rather perplexing is the source of this latest 'leaked memo'.

The chief medical officer, we thought, was meant to advise the government on health policy and inform and advise health professionals and the general public. He now seems to be instrumental in delaying or cancelling the very policies which are supposed to promote the development and improvement of health care.

A few weeks ago Sir Liam Donaldson said he was thinking of resigning because the government did not impose a complete smoking ban in public places. Does he regard the recent developments as more palatable?
Dr M Schachter
London NW6


You rightly identify the effect that financial instability in the NHS is having on patient care (Leader, last week).

However, it is unfair to imply that part of the problem is greedy doctors and nurses grabbing pay rises that may not be 'justified'. The NHS is a service industry and, as such, staff pay accounts for a substantial proportion of its expenditure. Even so, the cost of implementing new contracts for GPs and consultants has been a drop in the ocean compared to the overall size of NHS debt.

It is frustrating for GPs to know that the operations their patients need are being delayed for purely financial reasons.
Dr Hamish Meldrum
Chairman
General Practitioners Committee
British Medical Association