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Public-service productivity
公共服务效率
"What would you like to see?" asks the scrub nurse as a surgeon beside her feeds a wire through a patient's urethra. It is a Friday afternoon in Theatre 2 at Huddersfield Royal Infirmary in West Yorkshire, and the surgical team is showing your correspondent their equipment.
"你想看什么？"手术室护士问道，旁边的外科医生正在将一根导线穿过患者的尿道。这是一个星期五下午，在西约克郡哈德斯菲尔德皇家医院2号手术室，手术团队正在向本文记者展示他们的设备。
That patient--call him Mr Jones--can count himself comparatively lucky to live where he does. Calderdale and Huddersfield Trust has climbed the ladder for hospital waiting lists in recent years: 72% of patients are seen within the target time of 18 weeks compared with 59% in England overall.
那位病人----叫他琼斯先生吧----可以认为自己住在哈德斯菲尔德是相对幸运的。近年来，科尔德代尔和哈德斯菲尔德信托基金会在医院候诊名单上的名次不断攀升：72%的患者在18周的目标时间内就诊，而英格兰的整体比例为59%。
Mr Jones's path through the system shows how the National Health Service (NHS) could use its resources better. Wonks and politicians alike agree that productivity--the ratio of treatment the NHS provides to its inputs, such as labour, equipment and drugs--is a pressing problem.
琼斯先生在医疗系统中的经历表明，国家医疗服务体系（NHS）对资源的使用还有改进空间。专家和政客都一致认为，效率----NHS提供的治疗与其投入（如劳动力、设备和药物）的比率----是一个紧迫的问题。
Hospitals have more staff than ever, yet they are doing less than they were before the pandemic. Between 2019 and 2023, the amount of surgery carried out by each surgeon decreased by 12%; the numbers are almost as bad for outpatient appointments and significantly worse for emergency care.
医院的员工比以往任何时候都多，但他们做的事情却比疫情前更少。2019年至2023年期间，每位外科医生进行的手术量减少了12%；门诊预约的数据几乎一样糟糕，急诊的数据则糟得多。
A paper published for an NHS England board meeting in May identified some reasons for this. Chief among them was industrial action, which since late 2022 has led to the cancellation of more than 1.4m appointments and operations.
5月份在NHS英格兰董事会会议上发表的一篇论文指出了其中的一些原因。最主要的原因是罢工，自2022年底以来，罢工已导致超过140万次预约和手术被取消。
Other factors included an increased use of agency staff, longer hospital stays, maintenance backlogs and rising prices of new branded medicines and technology. That still left a mysterious productivity gap whose likely cause, the authors concluded, was a lack of "discretionary effort" from staff.
其他因素包括代理员工的使用增加、住院时间延长、设备维护积压以及新药和新技术价格上涨。这仍然留下了一个神秘的效率缺口，论文作者推论其可能原因是员工缺乏"自由决定权"。
Some of this may be temporary: the new Labour government has settled pay disputes with some NHS workers, for example. But many problems predate the pandemic. To understand more, rewind to before Mr Jones reaches the operating table.
其中一些问题可能是暂时的：例如，新工党政府已经与一些NHS工作人员解决了薪酬纠纷。但许多问题在疫情之前就存在了。要了解更多信息，请回到琼斯先生走上手术台之前的时候。
His first interaction with a doctor would have been when he went to his general practitioner (GP), complaining of weight loss and bleeding from his rectum. It may well have taken Mr Jones a while to get an appointment: Britain has almost 16% fewer fully qualified GPs per person than other rich countries.
他第一次看医生应该是去看全科医生，描述自己有体重减轻和直肠出血的症状。琼斯先生可能等了很长一段时间才预约到：英国的人均合格全科医生数量比其他富裕国家少近16%。
