The disappearance of the NHS

The NHS has been slowly charging for services for years - do you remember free prescriptions, free dentistry, free glasses - we accept these as normal now- I fully expect other charges to come in and I fully expect there to be private services tendering for NHS work. All governments have been clear about the need to introduce competition as a way of driving down cost. It does not mean these services will necessarily be charged directly to patients but rather to bodies such as the CCGs

GPs don't refer every case to the CCG- only those that are not already contracted for by that group on behalf of and agreed by the GPs against previously agreed clinical criteria - the CCG is a bunch of GPs that's all- they just oversee the collective budget. I'm sure your friends procedure will go ahead its only occasional cases that are reviewed for example plastic surgery that is thought to have only a cosmetic benefit, gastric bands that kind of thing.

I think we are right to be alert but also to be realistic about how we want to fund the NHS- to continue as it is may mean significant rises in taxes and no-one wants that.

Good post Teetime

Not got back to this until now. Are you health workers teetime and kittylester or otherwise involved, because I'd really like to know more.

I didn't for instance know that the secretary of state no longer has a duty to see healthcare is available for everyone in England since 2012 (Wales and Scotland having kept that duty). Although I understand a private members bill which aims to change this is currently having it's second reading.

It also seemed to me from what I heard that the idea that it's all about affordability was more a political matter than reality. The NHS used to cost a tiny amount compared to other healthcare systems but now that so much is being put out to tender, the costs are rising enormously. PFI has brought debt with it and, as with so much privatization, the original organisation (in this case the NHS) cannot compete with enormous corporate bodies who are moving in and bidding. But, the latter both aim for 'efficiencies' (i.e. cutting actual treatment and drugs) while spending 30-40% on administration costs and then pull out when they cannot make a profit.

I don't want to write lots, there is clearly much to research but the hall last night was packed with senior doctors of all sorts, health care workers and GPs, including my own GP, who were very vocal in support of everything that was being said.

Doesn't sound good to me.

It's not scaremongering and links up with the TTIP thread, annie.
Do you look at the NHA party website?

www.nhap.org

My thought always is that the general public will not vote for a party that proposes too much damage to the NHS.

But Cameron and his mates promised no top down reorganisation of the NHS. Lots of people voted for them because of that, and he immediately reneged on the agreement.
This is why it is best not to believe anything they say again.

teetime Where are the examples, in essential public services, where competition has driven down costs? I'm not talking about parts of the NHS that have been hived off to private contractors - it is obviously in the interests of those contractors to keep their costs as low as possible until they have a monopoly over the whole area of acute healthcare.

Has so-called competition made the water companies, energy companies or transport companies more efficient and cheaper?

The National Health Service in Wales is run by the Labour administration. There is such a backlog in some areas they have finally started allowing patients to go to English hospitals to be treated.

I know this will not go down well amongst some Gnetters, but quite honestly I do think that pensioners whose income is over a certain level should still pay National Insurance at a reduced rate to be spent exclusively on the National Health Service.

Thanks durhamjen didn't mean to repeat discussions that have already been had. I do agree with what you say, TTIP came up at the meeting too. Eloethan I would completely agree about the results of allowing competition. Look what's happened to the energy market! I am so shocked at the idea of healthcare being similarly dealt with, you cannot expect private companies with shareholders to operate in the interests of the general public and when that general public are sick people, it is a scandalous way to go.

I can't quite remember the figure but I think it was said that 30 million people in the US are without access to healthcare because of the way their health industry operates. In fact, I just googled that and it is only 41 million or 8 percent of the population! Can you imagine that situation in this country after 60 years of the NHS?

Remember when NHS dentistry was 'reformed'? Have had problems since; finding an NHS dentist is a real challenge to start with where I live and the practice I go to has been put out to tender twice and changed both times so I never see the same dentist. As dentists manage the money they get the treatment you get may depend more on their budget than your needs, the most cost effective option for the dentist is an extraction and that is what you get unless you challenge, argue and are well acquainted with the terms of their contract. If they think your treatment may be unprofitable they send you to the dental hospital which is not supposed to happen for work within their competence. Has happened to me, family & friends with different dentists which is why am cynical. It is a dire warning for what may happen to general practice a few years down the line.

annan, I think that is a huge generalisation.

Most dentists are professional and treat their patients well and ethically. Dentists have no option what they charge for treatment on the NHS as there are only 3 bands (ridiculous reforms by Patricia Hewitt) For example - a one tooth denture costs £219, full upper and lower dentures cost £219! The dentist is only given sufficient funds for a certain amount of 'units of activity' and, when they are gone, they are gone. To repeat what I have said on another thread, the service is over-managed and money wasted on treating dentists as though they are con-merchants rather than using the money for patients.

Certainly round here there is hardly the option to send people to the Dental Departments in the hospital or to the Community Dental Service as their waiting lists are enormous.

Remember when Labour built all those nice new hospitals, prisons, schools etc under the PFI schemes?

That is what the NHS is still paying for.

We don't have PFI hospitals in Wales but still Labour can't run it efficiently.

Here's a link:

www.theguardian.com/politics/2012/jul/05/pfi-cost-300bn

www.telegraph.co.uk/comment/9356622/Labours-PFI-landmines-continue-to-explode-in-the-NHS.html

You're right, rosequartz, there has been a lot in the press recently about the state of the NHS in (Labour-run) Wales, but Wales doesn't seem to get much of a mention on GN.

Free prescriptions don't really make up for the lack of decent NHS services, do they? Good vote-catcher though.

And free parking!!

Which is as it should be - if you or a family member is ill and has to attend hospital or you have to visit an in-patient, you shouldn't have to be worrying about finding the money for the car park.

No - you just have to worry about finding a parking space!
(And I know of what I speak...)

The last time I saw my dentist he was raging about the new agreement that was being imposed on his patients. He is expected to assess people's teeth and if they are obviously not being looked after, then he has to send the patient away with a time limit to return showing improvement. If they return and there is none, then he must treat them but do the most basic job possible. As he said, turning him into a policeman.
He also told me that because the way his NHS work is costed, he gets paid not for instance for each filling, but for each course of treatment, so money gets clawed back each year by the DOH because he isn't doing enough work yet he regularly does a 60 hour week. An incentive for him to do less rather than more which is a great shame as he is a dedicated, talented and really nice man.
Extras like having a scale and polish have vanished too. Gosh I remember the days when one saw a hygienist after the dentist.
I just don't see or hear any evidence that health services have improved. It's all gobbledegook and subterfuge - don't get me started on the waiting list letters fiasco!

Sorry I mean the new agreement being forced on the dental profession, not on the patients - a mistyping. I can see that some might argue that it's not unreasonable to expect people to look after their teeth but not if its all stick, surely.
Oh yes and just remembered him saying he had seen 5 year olds who'd never brushed their teeth and about parents who give small children endless fruit juice and sugary drinks with resulting severe tooth decay.
Never mind, we'll all have fluoride in our drinking water soon to combat this, something I don't welcome!

www.theguardian.com/society/2014/nov/27/nhs-england-millions-pounds-private-companies

says it all!

annie I was a Consultant Nurse who after a long clinical career managed community services, worked for a time in commissioning, worked in both for profit and not for profit sectors in senior management as well as lecturing on managing care services for the OU. I try to just report the position as I know it rather than giving you any particular political stance. All governments since the NHS began have tinkered endlessly with the NHS which if you like is a victim of its own success in that the advances in clinical medicine have been enormous since its inception and we have all benefited from that in different ways. My own particular bee in the bonnet is personal responsibility to keep as well as we can, take good clinical advice about doing that, don't misuse services to ensure that they are there for our fellow man/woman when they need them. I have no objection to paying my taxes for this what I object to is the gigantic administrative costs the NHS generates through unnecessary bureaucracy. about every two years there is a massive reorganisation which cost mega bucks- the stories I could tell.!!

So what do you think about Jeremy taking his children to A&E, Teetime?
And criticising GPs at the same time for not being available?

I wouldn't comment on individual cases without knowing the full clinical details and then probably not unless I had seen the patient - that would be unprofessional.

Not asking you to comment on an individual case. Jeremy Hunt thought it okay to mention it in parliament.
Surely it's the principle that you should ring your GP or 111 first and not take your children to A&E. At least that's what he tells everyone else to do.
www.theguardian.com/politics/2014/nov/26/jeremy-hunt-jousts-with-labour-shadow-over-childrens-ae-visit