BRITAIN’S National Health Service has been told millions of pounds could be saved by outsourcing more NHS administration to India.

The call was made by the head of a government-backed company leading healthcare efficiency reform in Britain.

However public unease means these savings are unlikely to be realised.

Patients may not like calling an operator in Delhi to book an appointment with their GP, or having their medical notes stored on overseas databases. But as pressure on NHS budgets intensifies, John Neilson suggests the alternative is cuts to services.

Call centres and offices in Delhi and Pune already handle invoices and other administration for a significant number of NHS trusts for a fraction of what British-based labour would cost.

Mr Neilson, managing director of NHS Shared Business Services (SBS), said Indian workers were so good that it was only the potential for controversy that stopped medical records or bookings being similarly outsourced: “There isn’t a capability issue, there’s more a local UK sensitivity issue.”

After a decade in which the NHS budget increased by 70 per cent, managers were able to let efficiency slip down the list of priorities as they focused on improving patient outcomes. Now as spending cuts are enforced across Whitehall, waste of public money is back in the spotlight.

A report last October by Sir Philip Green, the retail billionaire, found “shocking” levels of government waste, which could save the taxpayer billions of pounds a year if eliminated. Sir Philip has since been deluged with complaints about NHS inefficiency.

Mr Neilson’s company, which is half-owned by the Department of Health, believes that its new database of NHS spending will make managers more accountable for what they spend.

NHS trusts are allowed to draw up their own contracts. Central contracts are available instead, but are not compulsory and are used for only 30 per cent of buying. Mr Neilson said that this meant that the health service was not making good use of economies of scale or expert knowledge.

Even more could be saved if managers clubbed together to standardise equipment and exploit the potential bulk buying power of the NHS, he said. At the moment, managers buy a bewildering variety of different equipment to do the same jobs.

“Out of 130 trusts we work with, only 30 of them buy the most commonly bought item. And that item is a Dell PC,” Mr Neilson said. “Even if they all just bought the same PC, just think of the savings that would produce.”

John Appleby, chief economist of the King’s Fund think tank, said that the NHS had made improvements in procurement, notably in controlling the drugs bill, but that similar savings needed to be made on other supplies. “I’m sure there’s some way to go for the NHS to exert its power. There are lots of areas where it could do more to extract a better deal,” he said.

Yet attempts to trim the cost of administering the health service by using private-sector methods have met with furious resistance. Only a few weeks ago, a Government-commissioned report recommended that 600 million pounds ($914m) a year could be saved by handling GP appointments through a national call centre. Outrage from doctors and campaigners quickly forced officials to back away from the plan. SBS has itself been criticised in the past for letting addresses and NHS numbers be accessed from India.

While Mr Neilson said his company was not pushing trusts to send more activity overseas, public touchiness about foreign call centres meant that most trusts were not exploiting this as much as they could. He believes that “significant” savings could be made.

“For certain aspects of our service, if the client said ‘I would really like to do more offshore’, there would be some things we could do additionally,” he said. “That isn’t what the market demands, but there’s no reason why we couldn’t do it. It’s something they could think about.”

SBS now has almost 700 employees in India, mostly engaged in data entry and financial administration – there were barely any five years ago. “That’s been a reflection of people’s increasing comfort in what we’re doing. And clearly what we’ve tried to do is focus on those activities which are not contentious,” Mr Neilson said.

“There is no clinical data, medical record data or anything with that level of sensitivity or anything that involves direct customer contact. None of that sort of activity happens in India. We’re sensitive to the market need that people feel more comfortable with that sort of data being managed in the UK.”

He said, however, that people must recognise the tension between complaints about inefficiency on the one hand and outsourcing on the other. “With the type of person who might make that comment about offshoring, they’re also potentially the first person to say ‘actually, this area isn’t as efficient as it should be in the public sector, you should do it more like this way in the private sector.’”

However, Katherine Murphy, Patients Association chief executive, said that outsourcing was often a false economy. She believes that when functions such as hospital bookings have been moved to India the service has become less responsive to patients. “If the health service is going to be joined up and patient-centred we need to be careful about this. Efficiencies have to be made, but not if the result is that patients are often getting a worse service,” she said.

With Andrew Lansley, the Health Secretary, determined to devolve most of the NHS budget to family doctors, SBS is in talks with GPs about managing their new commissioning powers. “The basic principles of purchasing apply.

Source:-http://www.theaustralian.com.au/australian-it/britain-urged-to-outsource-health-it-to-india/story-e6frgakx-1225980937411