Dr Alf is right but the Government has yet to really crack down on the UK medical profession and hospital consultants to raise their performance and productivity and is still mealy-mouthed when it comes to telling the public that they need to take responsibility for their own health.

The NHS is falling apart at the seams financially for several reasons, apart from “austerity” and Dr Alf, as a former practicing Chartered Accountant and Financial Director will recognise several of them for the “no brainers ” which they are:

1) Poor procurement of drugs, equipment and supplies, with chronic wastage of materials and up to 8 fold differences in the costs of the same items even in the same department.

These were identified by Sir Philip Green in his 2010 report to the Prime Minister and in 5 years there has been little or no improvement.

2) PPP/PFI contracts poorly negotiated and developed to an almost fraudulent financial formula originated by Arthur Andersen who was rightly barred from doing further consultancy or financial work by none other than Margaret Thatcher who was scandalised by the “rubber stamping” of the accounts of John De Lorien’s company which led to a loss of £70 million gbp for the UK taxpayer who underwrote UK Government grants on the basis of their veracity which were subsequently lost through the failure of the De Lorien venture in Northern Ireland.

One of these contracts lost the Greater Peterborough NHS Trust £55 million gbp and similar contracts all over the UK are causing similar proportionate losses.

3) 20% of the combined annual NHS budget is spent on lawyers, gagging orders, payoffs and misleading PR designed to convince a gullible public that all is well

3) Hospital consultants do not regularly work at weekends as a rule (some do) and rather too many of them engage in lucrative private work, making themselves unavailable to the NHS and thus creating ever longer waiting lists causing people who might have survived to either die because they are not operated on fast enough or for their condition to worsen so that they get to a point where their condition becomes inoperable.

4) The best cancer treatments are available in Germany which has Rife machines in all cancer wards and a system for cooking cancer cells to death.

The NHS has the worst cancer treatment outcomes in Europe and the worst mortality rates in Europe of any country outside of bankrupt Greece.

For heart disease, it is also worst, and since 95% of deaths are caused by heart disease or cancer this represents a loss of UK productivity and tax generation other than for those people who leave enough money so that the Government collects some inheritance tax.

5) Too much spending on Big 4 management consultants and strategy houses like McKinsey. More experienced consultants come at circa GBP5,000 a day, so the costs become eye-watering very quickly. Independent consultants, with blue-chip experience tend to be ignored by government procurement. Cronyism is alive and well!

Currently the UK Government spends £15 billion gbp on management consultancy, nearly all of which goes to the Big 4 Accountancy based practices and their systems integration partners, such as IBM Global Services, BT Global Services and T Systems.

Andrew Lansley, who was Health Minister before being sacked by David Cameron, developed health reforms which the medical establishment resisted and was advised by KPMG, “Choose and Book” a system that never worked and has since been scrapped – this was sold by McKinsey’s to Tony Blair in number 10 Downing Street.

6) The NHS suffers from poor rostering and broken processes, evidenced by the A&E crisis which is caused by too many malingering pensioners who are not genuinely ill going to A&E at weekends having wasted their GP’s time during the week because they claim to be “lonely” or have afflictions like depression caused by drinking on an empty stomach, poor diet and a sedentary lifestyle.

The usual influx of night-clubbers, drunks and miscreants engaged in fighting and violence in sleazy nightclubs and gaudy pubs adds to the confusion and cost to the NHS

7) Health Tourism from Middle Eastern potentates and foreigners who use the NHS for free and then return to their own countries thus lumbering UK taxpayers with a bill that probably runs into billions.

8) We have the fattest woman in Western Europe and the 4th fattest men and this has happened on the NHS’s watch.

They have failed to get people to diet and exercise failed to persuade the Government to put variable taxes on foods, failed to work with local authorities to merge NHS and Adult Social Care, failed to educate the public on the causes of dementia, diabetes and depression, failed to inform the public about antimony in aircraft fuel, the dangers of carbon monoxide poisoning from car fumes, particularly for joggers,cyclists and motorists who do not use the air recirculate facility on their heaters and air conditioners.

No wonder we have the lowest productivity of any G7 country with all that means in lower taxes and funding for the NHS which is now funded out of Petroleum Revenue Tax and part of the doubled ticket price for the National Lottery

There is much more that the NHS could and should be doing but it’s leadership and the public sector Trades Unions need to be collectively put to the sword and replaced with people that will create a new fit for purpose health service, modelled on international best practice.

John Gelmini