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Blog: Reductio ad absurdum

Blog: Reductio ad absurdum

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GP Gavin Jamie's humorous blog explores what 4% efficiency savings could actually mean in the long run... 

I am a fan of Randall Munroe’s XKCD web comics. Covering science, maths, computers, life and a bit of medicine, part of the joy is occasionally having to look up some of the more obscure references. Poster versions of some of the drawing are plastered over my son’s bedroom wall, largely because my wife tells me that I can’t plaster them over ours.

He also writes a “What if?” page weekly that takes an apparently simple question such as “What would happen if we all shone laser pointers at the moon?” and answers it, often to destruction.

It was shortly after reading the latest of these that I saw that providers are expected to make 4% annual efficiency savings. This is hardly new, this has been going on for a while and there does not seem to be much end in sight. After all there are always efficiencies that can be made, and 4% seems a fairly moderate change. 

The question I asked myself was what if I personally became that much more efficient?

GPs are open 8am to 6.30pm daily and I can imagine that the days are long for commissioners too but for the sake of the maths let’s assume that I work 9-5.

Well in the first year a 4% efficiency would mean that I get all of my work done a little over nineteen minutes earlier and can set off home just after twenty to five - hopefully missing the worst of the traffic.

In the second year, and there is little sign that efficiency savings targets are going to stop, I would leave work around twenty two minutes past four. By the end of the traditional five year plan I could be pulling out of the car park by half past three. In ten years (the predicted length of austerity in the NHS) I would be done by twenty past two and be able to pick my children up from school. Actually, my children will all have left school by then but I could certainly pick up someones children.

There seems little reason to think that the target will last a fixed number of years. Over a forty year career what started as a full time job would take only around an hour and a half. If we could have kept this rate up since the formation of the NHS in 1948 then I could complete all my work in less than thirty four minutes. And so should everyone else. This is not the best achievement, this is an average. A full day’s care in less time than it takes to watch an episode of “Casualty”. 

It may be true that there are always efficiencies to be made, but that does not mean that efficiencies are infinite.

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