The English NHS, like all healthcare systems, doesn’t procure well. Part of the problem has historically been physician preference, where hospital procurement chiefs say that they are finally seeing a sea change in attitudes among doctors.

The head of procurement at a large London university hospital tells Healthcare Europa about that change: “It used to be that the physicians would want the latest model of everything, no matter what the cost. If they had XL12 with the flashing lights, rather than XL5, they would gain kudos at the next conference they went to.”

Those days are fading fast: “We’ve moved from four suppliers of heart valves to two. We’ve done the same with hip and knee replacements.” So how does he sell this change to physicians? “I tell them that if they make this switch – and it isn’t an easy one for them – then we won’t have to axe a consultant physician.”

He also routinely uses a nurse’s annual salary (around £23,000) as his unit of currency. “I was at a meeting, and the saving was £25,000 on procurement costs this year, and £12,000 the next. All of the physicians looked pretty unimpressed, until I pointed out that we had just saved one and a half nurses.”

He says that, today, physicians in the NHS really understand that there is no alternative. Unless they can find the savings from procurement or outsourcing, staff will have to go.

These changes are pervading across the UK. We feel confident that they are also playing out in most other European healthcare systems. There are many other barriers to efficient procurement – we’d put competition between hospitals and hubs, and also the stupid EU legal tender framework, up there alongside physician preference – but the important thing is that we are seeing a real shift of hearts and minds on this one.

This will mean that, over the next few years, Europe will become a much less comfortable place for big medtech.