Pierre Theodore | NHS

Pierre Theodore is the Vice President of Medical Devices at Johnson and Johnson. That means he helps different health care services with their technology. He is also a teacher of medicine around the world. He was delighted with the questions you asked and has answered some of them.

As the NHS begins to evolve, how much money would be required to upgrade all of the necessary equipment?

From: TheXandieraianReporter | Malcolm Arnold Academy

The way to think about healthcare is having three aims. They are challenging aims because they conflict a bit.

The first aim is that quality of healthcare should be high. Aim number two is that it is cost effective. If something works slightly better but is a lot more expensive, the provider should probably go with the cheaper option. The third is access to the care. So if you have really good medicine but only a few people can get access to it, because of where they live, how much money they have or their gender, that isn’t good. As many people as possible should be able to access health care. An ideal system is cost efficient, it is of high quality and it is available to many different people.

Alright, so once you have that as a back drop, many of these other issues fall into line. This question is impossible to answer because it’s really not a goal in health care systems to upgrade old systems but rather for their systems to evolve and improve over time. So generally speaking, the amount of money that a society can spend is a percentage of that society’s GDP. The US and UK, are a bit at opposite ends of the spectrum. In the US, we spend too much and the UK spends too little. So the UK government probably needs to devote a little more money to healthcare. But the idea is not so much to upgrade equipment; it is to pay for research and innovation. This is so the quality of the care goes up and the cost of the care goes down.

How can we change our spending on the NHS […]?

From: Elaine Primary Academy

The thing the NHS is actually leading the world in, and is something that we’re following in the US, is that it is more efficient than the US system. The NHS gets good quality healthcare for the majority of people with generally less money spent per person, although that isn’t saying much because we spend more per person than any other country in the world…

The goal is to move to what’s called ‘value-based reimbursement’ which means that the doctors and hospitals are paid based on the how well they do. However, a downside to this is that the doctor and the hospital are essentially handcuffed to their goals. They don’t have the freedom to make different decisions. That is a bad idea because then people end up feeling like they don’t want to work there and end up leaving the profession or moving to another country.

Should doctors be paid less and have the money spent on equipment?

From: Gilwern Primary School

I do not think, particularly in the UK, that doctors’ salaries are what is causing the NHS problems.

Doctors in the UK are not paid handsomely at all. What risks happening is that as you drive their pay down even further, which causes lots of doctors to leave the profession and then they are replaced by people who aren’t as good at the job. That would lower the quality of health care.

What hospitals spend more on is the equipment, research and development of the healthcare. So for example, someone comes in for hip replacement and their bill for staying an American hospital might be £50,000 pounds but the amount of that which actually goes to the doctors might only be £800. That shows doctors’ salaries are a very small part of how much health care systems cost.


What is going on in [health care]?

Why is there less money?

From: R.L | Chiltern Way Academy

I don’t know if there’s less money… I think that are there are greater demands. As things get more expensive, the cost of medicine, research, development and technologies gets more expensive. But, we can’t increase the cost for patients at the same rate so health care ends up costing more to provide than it brings in.

As long governments shrink the budget for healthcare whilst the expense is increasing, we are going to always come up short. So I think it’s a question of what, as a society, do we consider are our priorities?

The NHS is a helping hand to most people, but right now the NHS is struggling. […] Some ideas are to improve technology or recruit more doctors or nurses. […] My main question is what should we do about it?

From: PikachuPanda3 | William Patten Primary School

This is a very interesting question from pickachupanda3. One of the goals is to try to replace technique with technology. That means trying to replace humans with technology to make things safer and more reliable.

Humans will always be an important part of healthcare because the discipline requires passion and care and looking at someone in the face. However, I think technology with human input is probably part of the future.

I believe that technology in the end will reduce costs and allow us to accomplish things with patients that currently take many more people to accomplish. So I don’t think the answer is necessarily that we need a more doctors; I think we need more people that can often do many jobs; who can be nurses and surgical technologists. Those people can often stand in to add those human elements at a much lower cost.


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