NHS fragmentation

whitewave Bless her, and well done to her for caring (from conversations I've had with people, many don't - they may later regret their previous lack of interest).

Yes, Eloethan, it is depressing how few people realise what's happening. I feel like shaking some I know.

Not upset, its OK. I was thinking out loud i.e. it might be someone else that is trying to make the health budget balance in Scotland. Not AS.
Just after the last election I was expressing the opinion that the NHS, which had been steadily improving, had got as good as it was going to get and we were going to see a decline in it. This despite Cameron insisting it was "safe in his hands". I wish Labour were giving them a harder time - but of course it was bloody Blair that started the privatisation by outsourcing batches of operations to private sector. etc
I would save money on the NHS by having a dedicated drinks and toilet monitor on all the wards with elderly patients. A kind soul who would spend his/her days going from bed to bed, saying "Are you OK love? would you like to go to the toilet?" and "Would you like me to help you have a drink of water?" and "Do you fancy cuppa love?". I keep hearing about elderly people who spend a long time in hospital because they are lacking these basics, get dehydrated, go on drips and catheters and then lose their mobility. Oh and then end up staying in hospital longer and incurring a lot more expense. DH's aunt has just spent a whole week in hospital in order to have a colonoscopy. And she ended up on a drip because she wasn't drinking enough (embarrassed to ring bell to go to loo probably).

Sounds like as good idea Jess.

We had them - they were called nursing auxiliaries; then we professionalised them out of existence. And they were valued and respected members of the NHS team.

Those providing food and drink now come from an outside organisation and they fly in and fly out - job done!

Usually part of the PFI agreement, Mishap.
Have you heard today's news that Cameron is going to ask all the government departments to become more family friendly from October.
He really does think we all have the memory of a gnat, doesn't he? I think the DWP is not going to make it in the family friendly stakes.
Even though Blair started the destruction of the NHS, he did not get power by promising no more top down reorganisation, then bringing in a health and care bill.

JessM years ago I was one of those at Groote Schuur Hospital in Cape Town - not a nursing auxiliary but a volunteer - and I spent a lot of time washing elderly patients' hair and even putting curlers in for the women.

You have also made me think about my rant in the office (I retired from that job at the beginning of July) - which was basically "Whatever happened to the office junior?" This was because in the office where I worked (and where everybody was supposed to look after themselves) - the stationery cupboard was in a mess, the printer paper refill system consisted of people ripping open a ream of paper, taking only enough for whatever it was they needed to print (in other words not filling the printer tray) and leaving the rest of the pile of paper all askew and bent and therefore in readiness to jam the printer! That's just the tip of my rant iceberg. And the reason I was ranting was because we had an office junior (apprentice) - who sat on the flipping computer all day looking at websites! No one had thought to train him or even put it in his job description that included with ordering stationery was also keeping the cupboard tidy - as it is all part of knowing what stock you have! (rant over).

Back to the NHS - why does this (see link below) make me feel so disconcerted?

consultations.dh.gov.uk/nhs-policy-and-strategy/daltonreview

durham re your post of yesterday and the GP practices closing, ours seem to have got it right - all the GP practices in my locality have joined and are all located in fantastic brand new health centre, consultants from the local hospitals come there for outpatient appointments (which is brilliant), blood tests and other minor testing is done there and then, there is an open all hours pharmacy on site, exercise classes, ante-natal classes etc etc.

And since I've discovered that I can log on and view all the GP appointment slots online and pick and choose not only time but who I want to see - I've got no complaints.

Grannyknot during your time at the hospital, did you come accroos a Dr Alan Ponting?

Durhamjen

We have to speak as we find and I get annoyed at the view taken the NHS has been 'destroyed' by the Tories.

I wish the marches you speak of occurred when patients were left to a pretty miserable end of life under Andy Burnham and Labour, they were very quiet then and there was proof of what was going on, not supposition. It wasn't fantasy it was happening, sorry I won't forgive Labour either. Is it right to bring politics into it, questionable but as it is all about the politics for some then so be it.

What about Labour run NHS services in Wales for example. Poor Labour MP Anne Clwyd was derided in parliament not by the government benches but small minded, party must come first MP,s on the Labour benches. They didn't give a stuff about her heartbreak all they want to do is make as much mayhem and cause as much trouble as they can to frighten the public, Anne Clwyd didn't fit the bill.

Labour started privatisation, Labour took out PFI schemes on a scale that makes your eyes water with their ridiculous contracts, money was no expense to Labour and hence the crap we find ourselves in a decade later. Labour were in charge at the time of the North Staffordshire Hospital debacle and other hospital trusts, Burnham never has taken responsibility yet he is still in his job.

As for my NHS area things have greatly improved at our hospital and we have no issues with our doctors or dentists. Lucky, maybe, but that is what is happening in my area so I wanted to say so.

I went to Nuneaton on Saturday shopping and the Labour Party were asking for signatures to 'stop the Tory government from privatising the NHS, 'COMPLETELY '. I think they did well, you would given the subliminal text and the fact is out to scare the public. I also stood and listened to some who told them that the local hospital was better now than ever.

Politics is politics but I really abhor the hypocrisy of Labour and I know this post will grate with the usual posters who think differently but at least I've said my piece as I see the NHS in my life. I am not frightened by privatisation but I am frightened by hospitals and staff who should have no control over the publics health whether they be private or NHS run.

I'm not really interested in blaming one party or another, but just in sorting out the mess that things are in. I was working in a job that straddled NHS and SSD when all these changes started and you could watch the standards going down day by day in the hospital where I worked- and then in SSD when LAs farmed everything out to the private sector.

A service like the NHS does not lend itself well to outsourcing, private enterprise and competition. It simply does not work.

I cannot help wondering whether all that was needed were better systems of accountability within the NHS as it was.

galen if I did, my memory sadly now won't retrieve it! I was very happy doing that volunteering work, loved working there.

POGS Sadly PFI started under the Tories, and multiplied vastly under Beloved TB's reign and GB's lust for money

pulsetoday.msgfocus.com/c/15aHpVD22aANQ8uCES8ZDdM

Today's privatisation news.

Was going to respond to you Pogs, but I cannot be bothered.
When the tories have destroyed the NHS, you will be happy.

Grannyknot, my GP surgery is moving at the end of the month to a new allpurpose building. I was wondering where they got the money from. It turns out it's not theirs. The centre will be owned by Assura Group, which is an offshoot of Virgincare. So the NHS will be paying the GPs to rent the premises. The directors of Assura include a chairman from Balfour Beatty, another from PWC and another from Serco and Worldhotels. Not exactly well known in NHS circles. The profit will probably be going offshore.
In order to build this centre, they knocked down a care home. There are no council run care homes in the whole of County Durham.
I had to ring to make an appointment with my GP, and the receptionist was trying to make me see one I did not want to see. My GP can give me a telephone consultation in two weeks time, then that will be the last one as she is retiring. I have looked on the website, and there is no other GP apart from locums in this practice. The GP who is retiring is at least ten years younger than me. She is also the chair of the CCG, so that will be a problem, too.
About the open all hours pharmacy on site, some company - cannot remember which but possibly BootsAlliance - has complained about GPs recommending pharmacies, and will take CCGs to court if that happens. It's all in the Health and Social Care Act, to do with competition.

Oh dear.

Link about pharmacies.
www.pulsetoday.co.uk/commissioning/commissioning-topics/prescribing/gp-practices-face-legal-threat-for-working-closely-with-pharmacies/20007431.article

Durhamjen

I will most certainly NOT be happy to see the NHS destroyed.

POGS It was Mrs Thatcher’s government, in the 1990 NHS and Community Care Act, that introduced the “internal market”. Contracting-out followed – leading to increased fragmentation of services and greater bureaucracy. Under John Major, administration costs rose from 3% to the current 15%.

Cleaners, maintenance, catering, etc., etc. are now contracted out – with costs cut to the bone and staff pay and pensions reduced. There was a huge increase in hospital infections during 1993 and 1997.

The private equity firms that own these healthcare companies don’t really care what they invest in – security, arms, prisons - you name it they’ll invest in it – so long as there’s a tidy profit involved – and if that profit diminishes or they think they can get a better yield elsewhere they’ll just sell up and go. Then the whole bidding process – and the costs involved – has to start all over again. There is great difficulty in obtaining data regarding costs, contractual terms or performance because private companies can refuse to give information on the grounds of “commercial confidentiality”.

Three Camden GP surgeries (4,500 patients) were awarded to United Health, an American healthcare giant. Then United Health sold shares in the three surgeries to another provider in 2011. In 2012 one of the surgeries was closed and the other two were put out to tender in 2013.

Serco’s out-of-hours service for Cornwall introduced a new IT system to reduce costs. They replaced skilled clinicians with call handlers that had no medical training and who read from a computer-generated script, leading to a fourfold increase in ambulance call-outs.

Thousands of NHS patients did not receive vital medicines on times because of problems at Healthcare at Home (owned by Vitrivion Partners, a private equity firm), the company contracted to deliver drugs to patients in their homes. Healthcare at Home took over around 3,000 patients from Medco Health Solutions which pulled out of the UK market three years after entering it.

BMI Mount Alvernia Hospital Surrey failed 8 out of 9 care standards on inspection when “life threatening failures” were found at the hospital. These included children operated on without parental consent, nerve blocks administered on the wrong side of the body before surgery and resuscitation teams failing to respond in emergencies.

The NHS had to take over the running of a centre run by Clinicenta after three people died following routine surgery. Clinicenta was paid £53m. for termination of the contract.

Vanguard Healthcare has recently been reported as having been responsible for cataract operations that have left dozens of people with impaired eyesight. Their services were discontinued after three days.

These are just a handful of examples of the lack of accountability and continuity that increasing private provision brings. The NHS also makes mistakes but it carries out every sort of medical procedure and treatment – including dealing with emergencies and chronic conditions – private providers are doing the easier, “routine” procedures because they are more profitable.

durham our GP practice does not recommend that pharmacy (although it is one the premises so of course that does give them an advantage). We are fortunate enough to have another independently owned old fashioned community pharmacy, which is the one I support because I have come to know and trust the pharmacist.

The building of the new health centre has been on the cards for some years too, so I tend to think it was simply fortuitous that the other changes came about and the GPs then decided to all pitch in together. I think.

We're lucky that what we have works well.

Chilling reading Eleothan - can we turn the clock back? I do not think so. The move to privatising and farming out services has been a disaster. It was based on inappropriate models and theories and failed to understand the nature of a public service. Very sad - and all so predictable. Those of us working on the ground were throwing our hands up in horror - and wringing them in despair.

The whole PFI palaver defies belief. Our local hospital was funded thus and owes so much money that no-one knows whether it can survive,

You missed Simon Stevens out of your list, Eloethan, the CEO of NHS England who previously was executive vice president of United Health, the US insurance company you mention. He is still on the board of the Commonwealth Fund, which is all about the US health system. How can he do both?
It sounds like you have a file as thick as mine on the NHS.

Message withdrawn at poster's request.

https://secure.38degrees.org.uk/page/s/jeremy-hunt-don-t-close-our-gp-surgeries

For all of you who are worried about your surgeries closing, a petition to sign.
If you are not worried, think about the rest of us who are.