Minimally invasive therapy: The economic challenge of the second generation

Summary

This paper reviews how the health economics/management dimension of minimally invasive therapy (MIT) is likely to develop in the second generation. The second generation will be about raising patient and purchaser confidence in mature MIT programmes through new approaches to management, audit and standard setting. The paper sets out how MIT will bring about basic changes in specialty balance and cost structures within surgery. There will also be new players, such as purchasers and NHS Trusts, with different agendas. Suppliers in industry will be under pressure to reduce costs in a more competitive environment. The new players are likely to contribute to the emergence of larger units, pressure to reduce costs and greater use of delegation. The paper concludes with some case study evidence on how a new unit might develop in the UK. The second generation will bring a new agenda where MIT will develop in a dimension of economics, as well as under impulsion from technology. There will be potential for surgeons to work in new partnerships in which managers, health economists and others will contribute. This raises problems and questions: but also the possibility of creative dialogue and rapid development as more ‘parties’ become involved in contributing ideas and perceptions. From science fiction for the few, MIT will become an accessible technology for the many, with consequences that should be positive in falling cost and increased patient access to benefit.

Key Words:

• MIT
• health economics
• service development