It was a real pleasure to attend yet another lively and educational Diagnosis Salon where a nuanced and informative debate was enjoyed by all who attended. Co-hosted with the Faculty of Medical Leadership and Management, we were treated to a panel of experienced speakers put together by the Diagnosis team.
Speaking broadly in favour of the concept of value we heard Dr Rupert Dunbar-Rees and Dr Emma Stanton encourage us to reflect on the ways in which we can get maximum 'value' out of each stage of the health supply chain, which includes efficiency, focus, drive and team working.
Emma drew some fascinating parallels with her time sailing round the world in a yacht race, comparing this to her current NHS work as a neuropsychiatrist hearing about the inefficiencies in a system that causes frustration to staff and patients on a daily basis within the NHS.
The debate hotted up with a contribution from Dr Peter Lachman who suggested that the word 'value' is perhaps bandied about too freely and in such a loosely defined way as not to be entirely helpful to the healthcare debate in its current form. Peter worried that the use of the term 'value' is code for 'cost cutting' and suggested that it is important not to allow this to happen, because combined with competition and free market forces in health we risk eroding the values of the NHS.
Harvard Business School's Michael Porter's controversial 'value in healthcare' paper was discussed during Dr Anas El-Turabi's talk, in which he suggested that although they contain some merit, Porter's ideas for value in healthcare do not correspond to the corporate model from which his concept of 'value' originates through a failure to build in sustainability and factor in equity in the model. This opened up the debate to the floor nicely - from which point we heard several excellent arguments from the audience.
These included a discussion about whether the new 'value' agenda is simply a re-hashing of the pre-recession 'quality' agenda. We also heard an interesting debate about the exact definitions of 'value' and the role of cost, quality, supply chain, health services organisation in all of this.
I had recently had a very interesting discussion with Professor Uwe Reinhardt, Professor of Political Economy and Economics at Stanford University, that any discussion about value ought to take into account the value system of the health service in question - whether this be free market, egalitarian or somewhere in between - given that this will have a clear impact on the 'value' that any given society places on a life. This reflection seems to chime with the theme of the evening - that 'value' is a multi layered, complex phenomenon within healthcare, and that definitions are important, as are practical applications of the theory and concept.
Value seems here to stay (whether we like it or not!) and it cannot be ignored. I was thrilled that the Diagnosis Salon gave me a great opportunity to crystallise my own thinking on the subject and that it has inspired me to find out more! Thanks very much to the Diagnosis team for all their hard work and looking forward to the next Salon!
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