In a perhaps somewhat surprising result, an overwhelming majority voted in favour of the motion ‘This House Believes that the NHS should be run by Tesco’ at this year’s PharmaTimes Great Oxford Debate.

The event, which took place in the world-renowned debating chamber at the Oxford Union, certainly delivered on its promise of being a highly entertaining and fun-packed evening, but was laced with the pinch of seriousness that inevitably goes hand-in-hand with any discussion on the future of the National Health Service.

Proposing the motion was Roy Lilley, former Health Authority vice chair and NHS commentator, as well as independent health policy analyst, writer and broadcaster. His main points focused on the NHS’ problems with cleanliness and primary care accessibility.

Thousands of patients lose their lives every year to infections they pick up in hospital, and yet, behind the meat counter at Tesco, Lilley says he watched a staff member wash his hands thoroughly between each customer, and asked why this level of hygiene cannot be achieved in the NHS. And, in terms of accessibility, he said that, outside of office hours GP surgeries are always closed, but Tesco is always open. “Patients are customers but the NHS is blind to that. Every little does help,” he concluded.

Lilly was supported by Clive Humby, chairman and co-founder of dunnhumby, the marketing company behind the Tesco loyalty card, and celebrity GP and comedian Dr Phil Hammond. Illustrating the poor business management of the Service, Humby pointed out that that a whopping 26.6% of NHS costs lie in central administration, a figure he says would bankrupt any commercial organisation.

Private-sector lessons

And Dr Hammond added that, although increased funds have been pumped into the NHS, there has been no measurable boost in productivity. “Clearly there are things we can learn from the private sector, such as how to run an organisation from the top down. We need management not managers,” he stressed.

Leading the opposition, Professor Aidan Halligan, former Deputy Chief Medical Officer of England, claimed that Tesco should not run the NHS because the very nature of each organisation is conflicting: “The NHS is empowered by emotion. Tesco is powered by market share.”

His arguments were backed by Dr Philip Brown, previous owner-published of a stable of pharma industry publications, including Scrip, who stressed: “You cannot transfer the management of one company to another.” He did, however, concede that a “top-down revolution” in NHS management is essential.

Also opposing the motion, Laurence Wood, Obstetric Lead Clinician at the University Hospital, Coventry and Warwickshire, said that, while Tesco is undoubtedly highly efficient, “efficiency does not automatically generate excellence,” and that you “can’t run clinical decision making.”

Convincing arguments

Both sides certainly presented convincing arguments, but the yes’ won the night, as the majority seemed to agree that a drastic change in the management of the NHS is crucial to its future directions and progress.

But there are already signs of change on the horizon. For one, Health Secretary Alan Johnson has tasked Health Minister Sir Ara Darzi with conducting an “unprecedented” review of the Service, and some believe that this will lead to a complete overhaul of its management, including handing control over to an independent body.

And just last week, the government announced its ideas to enlist the help of private companies such as Tesco and Virgin in driving primary care further into community with the opening of high-street surgeries.

Look out for the full write up of this year’s Great Oxford Debate and the surrounding issues in the November edition of PharmaTimes Magazine.