I attended a conference today hosted jointly by the Imperial College’s Institute for Global Health and the Lancet which discussed public financing of health in developing countries. The centre-piece of the conference was a presentation by Professor Christopher Murray of the paper published by him and his colleagues in the Lancet. The main conclusion of Professor Murray’s study was that development assistance for health from donor countries can lead to a reduction in direct government spending on health in developing countries. In contrast, when development assistance for health was given to non-governmental organisations, this effect was not present. The study was a very impressive achievement, particularly given the limitations of the data that Professor Murray’s team had to use. The study raises some important questions for both donor countries and recipients of development assistance for health.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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