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NHS RIP

From Paul Clarke

Thursday, 20 January 2011

"I would rather be kept alive in the efficient if cold altruism of a large hospital than expire in a gush of warm sympathy in a small one." Nye Bevan.

Something to think today about as GPs take over running our NHS and commissioning your cancer/heart services thanks to the the Conservative led coalition backed to the hilt by the Lib Dems.

No wonder the Fibs are down at 8% in the polls.

From Sutti H

Thursday, 20 January 2011

This is a subject that really worries me, I need the NHS and the Tories have not got a good record with it in the last 30 years.

People can pick on Labour for many different things, but they did what they said they would with the NHS, they pulled it from the pits the Tories made it into and made it something we could trust and know we would be treated what ever class we came from.

If there is one thing worth fighting for this is it. Please don't ConDem it back to the 80s

From Paul Clarke

Friday, 21 January 2011

Sutti, thank you for your thoughtful comment and I posted the Nye quote to remind us which party actually created the NHS despite the opposition of the establishment.

I didn't agree with everything Labour did with the NHS when they were in power but I know within the party there is an absolute belief in the principle of free care at the point of delivery.

We need to remember that is not only the Tories who are backing these 'reforms' but their Fib Dem allies who will troop through the lobby to vote them through.

A recent poll revealed that Tory voters love Calamity Clegg because they recognise him as one of their own.

In the May local elections voters in Calder can send a very clear message to a Tory led coalition who are going far futher than Thatcher ever did and a clear message to their Fib Dem allies. I hope people will use their votes wisely.

From Chris Day

Monday, 24 January 2011

The coalition government's plans for the NHS spell disaster for our local health services. Many people are not aware that the policies represent the biggest change to the NHS since it was founded in 1948, and they will affect every patient in Calderdale. This is not a democratising process - as could have been simply done by putting GP's onto PCT boards. The government is introducing an American-style market health system, where hospitals and doctors have to compete with each other for business. (See Dismantling the NHS)

The Halifax Courier (21 Jan) has reported that our PCT will phased out in 2013 when GPs will take over, quoting Andrew Lansley "This group of selected pathfinders is welcome evidence of widespread enthusiasm for taking these ideas forward".

This is not about handing budgets over to GPs - it is about getting them into private hands. A number of health authorities have already signed up with private companies such as US multinational United Health. One Tory MP has described this process as like throwing a grenade into the NHS. Under this new regime "Any willing provider" will replace NHS organisations as "preferred providers". The new NHS market regulator, Monitor, will step in to adjudicate if any private hospital company complains that they were not given the opportunity to bid for NHS contracts. "The first of Monitor's three core functions is to promote competition." That means "enforcing competition law" and "removing anti-competitive behaviour".

For patients that will mean a continually worsening service. All our hospitals and community health services will be separated off from the NHS and made into independent businesses, meaning any of them could go bust or close a vital department like A&E to save money. Hospitals will be free to treat private paying customers first, with the rest of us having to wait our turn. Certain treatments like hernia operations could be dropped altogether, forcing people to pay.

GPs will be made to take on the role of accountants, buying services for patients, doing the job currently done by Calderdale PCT. Will patients still trust their doctor if they think he or she is putting cost cutting before their health? What will happen to the doctor patient relationship when it turns out the GP is responsible for the decision to close the local hospital? The government's plans will also bring about a huge postcode lottery where drugs and treatments will be available to patients of one GP and denied to those of another. Plus there is the prospect of GP surgeries running out of money and telling patients they will have to wait until the new financial year before they can be treated.

The cost of making such huge changes to the NHS is going to be at least £3 billion at a time when the country can least afford it, and they come alongside £20 billion of 'efficiency savings' in the NHS that will mean closures and cuts anyway.

None of these controversial policies were in the Conservative or Lib Dem manifestos at the election. We have to take a stand now to defend health services in Calderdale and join with national campaigns like the NHS Supporters to get these plans stopped.

 

From Gary Rathbone

Tuesday, 25 January 2011

Reform is vital in the NHS. Talking to friends who work within the regime, it is unsustainable. Change is always uneasy, however it must take place. The NHS is the third largest employer in the world, yes, read that again, the third largest employer in the world, after the Indian Railways and the Chinese Army. Why provide so much for so few?

From Sutti H

Tuesday, 25 January 2011

I don't think the general public realise what is happening. It will even effect the Con voters who think they have enough money to go private. The price of their care will shoot throught the roof.

It is obvious to me the ConDem government are in such a rush to reverse all the good the Labour party have done. (I know everything wasn't good, but a good majority was)

They don't seem to care what effect it will have on normal folk. I include people with 50K/60k income in the normal folk class. The problem is they don't include themselves in this class.

 

From Michael Piggott

Thursday, 27 January 2011

The government's proposals for the NHS, which will damage our health service so badly that it could be destroyed, were not put to the electorate before the general election.

This means they do not have a mandate for what they are doing - this is an illegitimate government carrying out illegal policies.

We are told that we must wait until the next election in 2015 before we can change the government. That will be far too late - think of the damage they will do by then.

I disagree that we must wait. The Con merchants and their treacherous allies have invalidated themselves and pose an unacceptable danger to the country. The ConDem government should be brought down.

The only way we can do this is by working towards a general strike and through massive demonstrations and enforcing a new election. Bring down this rotten, evil government!

 

From Chris Day

Thursday, 27 January 2011

Sutti is right to wonder why so few people are aware of the forthcoming health service crisis. Turkeys don't vote for Christmas and you would think there would be a massive wave of spontaneous resistance to all this. Gary asserts (with no details why) that There Is No Alternative (TINA) to the cuts, job losses, removal of public accountability and privatisation of the health service.

To arrive at a democratic conclusion general public undedrstanding of this detail is very important. The TINA arguments originate in powerful lobbying groups (see Keep Our NHS Public) or 'think tanks' as they sometimes prefer to call themselves. The American health lobbies have spent 1 million pounds a day to oppose the Obama health care reforms. The US multinational United Health that I have referred to spent $4.5 billion there last year and is currently at the centre of a storm of protest about overcharging, malpractice and excessive executive pay. An enormous American style health lobbying industry has crossed the Atlantic, flooding decision making institutions with its own proposals at the expense of the views of patients and health service professionals.

This huge lobbying machine has been circling above this country for many years and is overwhelming the democratic process here. Billions of pounds have been spent on lobbying for NHS privatisation and now they want their pound of flesh. They want to make huge profits at the expense of our health and wellbeing. A campaign of resistance is now developing in the social media and in a rapidly growing grass roots opposition movement. The mainstream media are also (See the Guardian article) beginning to investigate the proposals. Those of us who value our health service have a responsibility to inform ourselves and others about these developments.

 

From Gena S

Friday, 28 January 2011

I can tell you right now - this spells bad news for the NHS.

I currently work for the NHS and I am American. I worked for the Healthcare industry in the US. This is a step in the wrong direction. I, for one, would take part in any protest about this Conservative/LibDem change. I am pro-NHS and feel very passionately about it, especially having come from where I do, from a patient and employee point of view... on both sides of the pond.

I think the NHS is an exceptional system and has been very much appreciated by me as an employee and as a patient. My experiences in the US healthcare system as a patient and as an employee were much more difficult/different and I would never want to see a similar system adopted here. It is a nightmare. It fails ordinary people in so many ways. Unless you have the means for it, forget about it.

 

From Tim B

Saturday, 29 January 2011

Gary can you expand on why being the third biggest employer in the world is a reason for change? It seems a provocative statement to compare it to Indian railways and the Chinese army.

I always thought that the public sector employed many people to provide a good service while private companies skimped to provide bigger profits.

From Sutti H

Monday, 31 January 2011

I would like to agree with you Mick when you say we need strikes, demo's etc but there needs to be a very well organised demo if there is going to be one.

NHS staff and violence will not gain support, NHS and a strike will also upset the general public and not gain support. If private companies take over the services the employees usually apply for just another job, go to work for just the money. I have found many NHS staff live the NHS, they do far more than they are paid for, because they care. They need to work to rule to show how the private companies will operate. Let the public see how it could go.

The next time I see my GP I will ask him to put a message on my notes, use NHS services only, no private services or hospitals. I know I can't avoid taking tablets from private companies but I can control the services I use.

People have many ways to change things, but we seem to have become a "Can't be bovvered" society.

From Chris Day

Tuesday, 1 February 2011

Gary's quote was from a Murdoch paper headline (Times 20/3/2004) that has been widely posted around right wing chat groups and claimed that 'England ...is becoming a nation of healthcare workers'. For those people who read past the headline the article quoted then health minister John Reid praising the health service and pointing out that 'census figures exploded the myth that everyone in the NHS was a bureaucrat with 84% of NHS staff directly involved in patient care and managers only making up 3% of the workforce'.

Many people are looking beyond the Murdoch headlines with determination and courage - (see report) from a protest outside Boots in London this weekend: 'It was brilliant: it was powerful, it was togetherness - and, crucially, it was harmless - In a split-second, a cloud filled the air. It was like steam, and I remember seeing it twinkle in the light, suspended for a moment before it invaded my throat and I lost my breath. Someone must have told me it was pepper spray, because I remember knowing what had happened, even though I'd never experienced it before. It was a horrible feeling of powerlessness: I remember looking down, panicked by how slowly it had gripped my windpipe, thinking it might get worse. I had not been deterred at all. The purpose of the protest had been to highlight the correlation between tax avoidance and cuts in the NHS, so it was bitterly ironic that the NHS had cared for us where the police had failed. Paramedics arrived quickly, treated us well, and acted with complete professionalism'.

Local campaigns against the cuts are already underway throughout the country and the TUC march on March 26 seems as though it is going to be huge. Experienced politicians are already predicting that this government won't last a year. (See The Return of the Public)

From Gary Rathbone

Tuesday, 1 February 2011

Apologies, my statistics were a little out of date, the NHS is now the fourth largest employer in the world.

Quoting the NHS website 'Only the Chinese People's Liberation Army, the Wal-Mart supermarket chain and the Indian Railways directly employ more people.'

Also quoting from their website 'The NHS employs more than 1.7m people. Of those, just under half are clinically qualified...'

Here's an excellent website discussing the modernisation of health care.

 

From Chris Day

Wednesday, 2 February 2011

Thanks Gary. The NHS page you quoted from has some informative statistics:

'Since its launch in 1948, the NHS has grown to become the world's largest publicly funded health service. It is also one of the most efficient, most egalitarian and most comprehensive'.

'On average, it deals with 1m patients every 36 hours. That's 463 people a minute or almost eight a second. Each week, 700,000 people will visit an NHS dentist, while a further 3,000 will have a heart operation. Each GP in the nation's 10,000-plus practices sees an average of 140 patients a week.'

'The money to pay for the NHS comes directly from taxation. According to independent bodies such as the King's Fund, this remains the "cheapest and fairest" way of funding health care when compared with other systems'.

From Andrew Hall

Wednesday, 2 February 2011

I've come to the conclusion that there's no point trying to use statistics to justify your position on this issue. A brief look at the NHS website shows that in October 2010, the NHS employed 1,216,235 people of whom 630,863 (52%) were professionally qualified clinical staff (ie doctors, nurses, and other scientific, therapeutic and technical staff). The remaining 48% were clinical support staff (ie secretaries, lab assistants etc) and infrastructure support (eg property, management, senior management, central admin). You could argue that it is only the last group which have no direct contact with patient care, but with a headcount of 232,808, even this represents 19% of all staff - somewhat different from John Reid's 3% figure. There are lies, damned lies... and statistics!

But I have another issue. Many contributors here show their true colours by using terms such as ConDems, Fibs, Calamity Clegg etc etc. - all very emotive, clever and witty I'm sure, but does it contribute to the debate? I think such language actually gets in the way of serious (or any other) discussion. And the future of the NHS is certainly one of the most serious issues that has ever appeared on Hebweb.

Before anyone accuses me of being a right-wing reactionary, I have to say I'm opposed to many aspects of what the Conservative Liberal coalition are trying to do with our health service. I happen to believe that, just as teachers should be standing in front of students, doctors should be treating patients, not managing huge budgets and justifying their own existence through endless paperwork. Most doctors seem to agree.

I have no particular political axe to grind regarding the NHS and private healthcare. Unlike most here, I'm really not too bothered about the means; I'm more concerned with the end. But there are two provisos about that end which should be written in stone. Firstly and absolutely fundamentally, whatever service we have must be free at the point of delivery (without having to take out any sort of private insurance). Second, it must be the best that available money can buy (and yes, sadly we must be realistic about the fact that every day, this country is becoming millions of pounds deeper in debt, as it has for years). Any government of whatever political hue that can deliver such a service would have my support.

All very simplistic and naive stuff, I know, but something that I'm sure the vast majority of the population would agree with.

 

From Gary Rathbone

Wednesday, 2 February 2011

Indeed Chris, very impressive statistics. Also, we can compared ourselves with our European neighbours here, with the UK coming 14th and the Netherlands top.

I'm not knocking the NHS, only suggesting that reform is urgently required.

When the National Health Service began in 1948, the UK population was 49.4 million, its now about 61.1m.

In 1948 average life expectancy for men was 66, and for women 70. It is now 78 for men and 82 for women, and increasing.

The elderly are the heaviest users of the health care system, along with children.

The NHS is funded through taxation. This means there are less people paying in compared to more people taking out. As technology develops, treatments are becoming more expensive. The NHS provides a lower quality of service compared to those of our European neighbours.

The model is no longer sustainable and will continue to become even more unsustainable. Gordon Browns previous solution of throwing more money at the problem just hasn't worked.

The answer?, i don't know. Lets look at other European models, see how they work.

Anyone who acts against NHS reform is consigning the organisation to a slow, painful lingering death. Then it will be NHS RIP! Act now and save our health service!

 

From Graham Barker

Saturday, 5 February 2011

What concerns me about the reform proposals is that they probably won't touch one of the ugliest aspects of the NHS - its tendency to behave like the worst kind of dictatorship. We regularly get reports about neglect of the elderly, stonewalling of complainants, victimisation of whistle-blowers, cover-ups of various kinds, and litigation nightmares for patients who dare to sue.

Then there is Stafford Hospital - an atrocity that in terms of fatalities eclipses Shipman, yet all those responsible have got off scot free. David Nicholson, the regional NHS head on whose watch it all happened, became the boss of the entire NHS. And Stafford Hospital seems to have learned few lessons, as this recent article indicates.

An enquiry is now looking at the failure of regulation at Stafford. It ought to look at the failure of the BMA and the unions too, as they could have used their clout to blow the whistle much earlier. Stafford is extreme, but similar failings keep cropping up in other hospitals. Why do they happen? One reason is that the NHS can't be prosecuted for neglect or manslaughter. Another is that career always seems to rank higher than care.

The NHS does need reform to cut costs, and we could help by reforming ourselves so that we live less unhealthy lives. Whether the coalition proposals will do any good, I have no idea. What I do know is that neither Labour nor Tory governments have ever given us an NHS that stops bad people and bad practices in their tracks. Until we get that, reassigning control of the cash won't make much difference.

From Chris Day

Sunday, 6 February 2011

You are in for an unpleasant surprise, Graham. (See Guardian article).

"All those Tory MPs dutifully reciting their pre-scripted support for the NHS bill in the Commons this week are as clueless as the voters about the bill's meaning. Just wait until they panic at the life-threatening effect on the NHS in their patch. Crash trolleys will be dashing down Westminster corridors soon enough."

Here's why. Andrew Lansley's Health and Social Care Bill encourages "any willing provider" to cherry pick profitable slices of NHS services. Existing NHS services will be left with reduced budgets, so many will be forced to close. This proposal will cost billions to implement, and will save little if any money, as existing public sector managers will be replaced by costly private sector consultancies.

GP consortia need to generate £20 billion of "efficiency savings" and will become no more than local rationing bodies, restricting access to hospital care, and drawing up ever-longer waiting lists.

In reality most GPs will not do any of the commissioning themselves. The consortia will hand the reins over to managers re-employed from Primary Care Trusts, or to private management consultants, such as United Health - brought in to cut a consortium's spending by "managing" (reducing) GP referrals of patients for hospital care ? making a nonsense of 'patient choice'.

The Bill means that patients and the public will be even less informed than ever. GP consortia will function in secret sessions and the national NHS Commissioning Board will be remote. Local people will only be provided with PR spin. There is no statutory right to know what is being discussed, to provide hard information or to explain the financial situation to local communities. Health care services are to be privatised, with EU competition laws forcing GPs to put any service out to tender initially to non-profit social enterprises and then, using market forces, for-profit companies. This will require them to close down any of their services which do not make a surplus. With NHS budgets frozen for four years, and £20bn of 'efficiency savings' forcing down the price hospitals are paid by the NHS for each item of treatment, many hospital managers will be forced to prioritise attracting wealthy private patients. Price competition will trigger a disastrous race to the bottom, undermining the quality of care in just the same way as competitive tendering of hospital cleaning services wrecked hygiene standards in the 1980s and unleashed a wave of MRSA-style infections. (See Health Emergency)

From Rosey G

Sunday, 6 February 2011

I feel very concerned about the Governments Health & Social Care Bill. I recently wrote to our local MP regarding the modernisation of the NHS. I personally think we have one of the best NHS's in the world and think we are the envy of a lot of countries. I agree we can look at ways of cutting costs and ways of looking at more healthy living styles but I believe it is the biggest mistake in History if we are passing the book of responsibility for finances to our GP's. GP's are trained to look after patients not be financial wizz kids, how does anyone expect GP's to fulfil their obligation to patients and manage the financial budget.

I recently wrote to our MP Craig Whittaker with my concerns, Re-modernising the NHS and also my concerns that he had voted for the amendment on the smoking ban.

Re - smoking ban. Craig Whittaker agrees he voted for an amendment to the smoking ban, surely this is one of the points in living a healthier life style.(He also states in his letter that he doesn't agree with smokers congregating outside pubs and building etc. and thinks the no smoking ban is a contribution to the closure of pubs etc) I would strongley disagree, I think more people are going to eat in pubs etc since a no smoking ban came into force. I believe that the price of beer and the pubs rents are the reason for closure, not anti smoking.(But that is another debate).

Re - update of NHS. Craig Whittaker states in his letter that - First the bill will give responsibility for the NHS budget to frontline family doctors - instead of remote Primary Care Trusts. (Do the family doctors want this?)
Second the bill will ensure there is much greater local democratic involvement in health services, by giving local councils a crucial new role in helping frontline doctors take their decisions in the best interest of local communities.(There again is this wanted)

Finally, the bill will allow anyone who requires treatment on the NHS to choose to be treated anywhere which meets the NHS standards - whether this is at a charitable organisation, in private sector or in the NHS itself.

He also states by modernising the NHS the government will be able to save £5 billion on unnecessary administration costs in the NHS. But he does state that the savings would be reinvested in treating patients.
I think pigs might fly!

I believe that if the government goes ahead with modernising the NHS as planned we are going back to the dark ages.

Our ancesters have fought for years to get a good NHS to provide for ALL. Everyone is entitled to good treatment 'the poor and the wealthy' I think we are going into 'if you can't pay you won't get'.

From Alan McDonald

Wednesday, 9 February 2011

I'm not a supporter of the Labour Party, I'm a Green, but I think any impartial observer will admire the tremendous extra investment that Labour made in the NHS in 13 years of government.

I know this from personal experience. In the mid-90's I had a heart attack, and waited 17 months for treatment. 17 months. I was terrified, day after day. People with my condition died waiting. Now I would only have to wait, at most, 8 weeks for the treatment I received, and many get it the day after their heart attack.

'Top-down targets', to my mind, together with extra money, combined to make this tremendous improvement possible for thousands of people. So others will undersand how nervous I feel for fellow-sufferers after the abolition of these targets in favour of rather vague 'reporting on outcomes'.

I am very nervous, too, about a top-down health service administrative reform costing £3billion, in the midst of major cuts in public finances, a reform unannounced in anyone's manifesto, which seems to be promoting privatisation by stealth and a managerial upheaval that so few people, even inside the Health Service, seem to want. Why the heck are they moving these deck-chairs around all over again? Whence comes this fanatical desire among the political classes for a continual whirligig of 'reform'?