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The reports described here of closure of clinical services in England due to financial pressures are worryingly inconsistent with previous contributions to this journal which suggest that, if a consistent definition is applied, the proportion of GDP spent in the UK on healthcare is much the same as in other Western European countries that are not experiencing the same reorganisation (BMJ 2016;353:i3094).
The explanation must be that a higher proportion of the UK health care budget is wasted in non productive activity. My experience, both as a provider and consumer of healthcare, leads me to believe that this waste does not occur in clinical areas. I could of course be mistaken.
I suspect a significant proportion of our health care spending is wasted on legal advice, information technology, management consultancy and, of course, the infamous “Private Finance Initiative” (PFI).
But we may never know the truth about my suspicions because of the secrecy caused by the ”commercial confidentiality” which surrounds so many of the NHS contracts for these services. It would help us all if The BMJ could shed some light on this murky world.