Every person in Britain needs access to PPE, and the NHS must undergo massive reform for that to happen

Healthcare systems must now prepare for the next big challenge: giving protective equipment to the people so that we can go about our daily lives.

The people’s PPE will, of course, be different from that kind needed by healthcare staff – think gloves and hand sanitiser rather than visors and goggles – but it is no less important. Our health system is currently bloated with inefficiencies – it needs drastic reform to pull it off.

Many countries, including the UK, have more respect and admiration than ever for their health systems. Behind the platitudes and clapping campaigns, however, are organisations which are too often bureaucratic, sluggish and open to fraud.

As a result of recent legislation, the NHS has become riddled with organisational complexity. The service has ranked 35th out of 56 in a study comparing the health efficiency of healthcare systems around the world, pointing to bloated budgets delivering substandard results. Britain is ranked below Chile and Algeria when it comes to the efficiency of its healthcare. Recent government measures to centralise procurement are not likely to have a net effect, since this centralisation is itself reliant on outside consultants.

In order to cut excessive costs, NHS trusts have spent millions on management consultants to locate and trim the fat. But this has only made matters worse – the trusts who hire management consultants end up spending more as a result, not to mention the cost of hiring the consultant firms in the first place. It’s a vicious circle that no one at the top wants to end.

The NHS has been overrun by companies charging it extortionate amounts for medical equipment. Drug companies have been investigated for increasing the price of drugs sold to the NHS by 6000 per cent over a ten year period. Furthermore, hospitals across the country have routinely overpaid for basic equipment, leading to an excess bill of £2bn per year.

The coronavirus pandemic has made this even worse, with private companies seeking to use taxpayer money to profit from a global crisis. Trusts have reported being bombarded with offers to provide PPE, but at an 825 per cent increase to the usual price. Our healthcare system needs organisational strength in order to withstand such shameless profiteering. Unfortunately, this simply does not exist.

The national procurement system has come under fire for its inability to obtain vital PPE for NHS staff, but the reality is that this structure has been set up to fail for years. England currently has no single centralised system of procurement – the supply chain is instead a mishmash of different procurement routes, which leads to ramped up costs and a lack of accountability.

The lack of a centralised body means that we are now poorly prepared to deal with the sort of crisis that we have been thrust into. Officials are now scrambling to set up a single system, but are doing so in the dark with no previous experience.

This has already cost the lives of NHS staff. And as the lockdown eases and the public need more protection, it is likely to cost lives there too.

As NHS staff are forced to reuse PPE, many businesses have complained that the government ignored or missed their offers to manufacture it, perhaps as a result of the labyrinthine procurement complex. This comes as a hospital investigates the death of a doctor who pleaded for PPE for his colleagues.

The system is clearly on its knees – and this weakness has left it vulnerable to attack by those looking to do it harm. Procurement and commissioning fraud accounts for a staggering £266 million lost to the NHS in England every year – money which could have been spent saving lives.

The opacity of the procurement system also creates potential conflicts of interest. At a time when supplies are running short, an NHS senior procurement official is being investigated for setting up a business to profit from selling PPE privately.

In order to move into the next phase of the coronavirus response, we need a dramatic overhaul of our healthcare system. Delivery of millions of items of hygiene and protective equipment to every Brit is no mean feat, and can only be achieved by repairing the cracks in the system charged with executing it.

This means making the procurement system more transparent, with better access to it by proactive suppliers and even members of the public looking to contribute to the cause. Instead of ignoring the efforts of well-intentioned businesses and individuals, we should be harnessing them. In Israel, a volunteer army has 3D printed 25,000 items of PPE for hospitals. This is happening in pockets across the UK, but the government should be coordinating these efforts and helping to increase production.

This also means removing unnecessary red tape and sluggish bureaucracy. In this fast moving crisis, we need health decision makers who can move as quickly as the virus itself. This can only happen through dramatic reform of the commissioning and purchasing structures currently paralysing our healthcare system.

The head of the Army recently commented that PPE delivery to hospitals was the greatest logistical operation he’s ever tackled. This will pale in significance compared to the job of distributing it to every Briton across the country. The NHS is the best of Britain, but the bureaucracy behind it is the worst of us.