> CCGs buy services from organisations of different shapes and sizes – from NHS trusts that run hospitals and community services, to GPs and others that provide NHS care, including organisations run by charities and the private sector.
Right, so “the government” funds a few public agencies which themselves pass on money to the CCG’s, which also seem to be quasi-autonomous public agencies. The actual care providers are sometimes in the private sector. I’m not sure what distinguishes NHS England or the CCG’s from “the government” other than semantics, but sure.
This is still more administrative overhead than other “universal” systems and does not seem to address the tradeoffs between cost and availability of care. Per Wikipedia:
> A survey of CCGs by the Health Service Journal in April 2015 found that more than a third were planning to save money by restricting access to services, particularly on "procedures of limited effectiveness", podiatry, IVF, and limiting access to procedures based on aspects of a patient's health, for example whether they smoke or are obese, which can affect outcomes.[30] A similar survey by the GP magazine Pulse, in July 2015, found that many CCGs were planning to restrict access to routine care in various ways.[31]
They're not run by a government minister; they're not staffed by civil servants; they're not a government department.
> This is still more administrative overhead than other “universal” systems
It really isn't though. Of course some management exists, it's a budget of over £100bn. But compared to other healthcare systems the NHS is relatively efficient. "The NHS is over-managed" is a persistent myth. See for example chapter 2 of this study: https://www.nuffieldtrust.org.uk/files/2018-06/the-nhs-at-70... (This study does contain a lot of stuff that the NHS is poor at).
>> They found that the NHS spends relatively little on overseeing and planning care, relative to other comparable systems. In 2014, the UK, Portugal and Ireland all devoted 1.5% or less of their government or compulsory health care expenditure to administration. This compares with an average of 3.1%, with 4.1% in France, and 7.9% in the United States.
> "procedures of limited effectiveness"
They're not going to fund things that don't work. Why is that a bad thing?
But, again, I've said that there are problems caused by the choice to de-fund the NHS and that if we had comparable funding as other nations we'd start seeing better outcomes.
That isn't what happens in the English NHS. https://www.kingsfund.org.uk/audio-video/how-does-nhs-in-eng...
Current inefficiencies in the NHS are caused by lack of investment in buildings and in staff. The NHS has less management than similarly-sized commercial companies, and none of that management is The Government.