NHS reforms

It is some time since I added anything to this but I have just signed and
donated, with 38 degrees, to help set up an opposing conference against
creeping privatisation. Apparently there is shortly to be a conference
held in London for GP's and other involved parties hosted by two private
health insurance companies. This is not the first hint I have heard of
pressure being put on GP's and I do think we have to fight this hard if
we want to keep the NHS. I have lived in the USA and witnessed their
insidious health care for the poor, unemployed and disadvantaged; I would
hate to see this here. Very uncivilized.

www.guardian.co.uk/society/2012/mar/15/devon-nhs-childrens-services-privatisation

If this article puts the wind up you, please sign the petition I've put on the e-petitions thread.

Having spent the weekend with my daughter- in- law who is a GP, I am feeling very depressed as her feeling is that we cannot continue as we are, it is far to expensive. She is very comitted to the service but feels that many of us take advantage by demanding to see consultants when it is not needed, failing to attend appointments, which I also find appalling, and generally expecting far too much. I am desperate not to see the poor and underprivileged being deprived of treatment; I regard myself as so fortunate to live in a country where I do not have to worry about becoming ill and needing treatment that I cannot afford. To me it is a sign of a civilized country when we can take care of all our citizens. If it means higher taxes, so be it or if we need a system more like the French then, so be it but please let us keep it universal and free at the point of use!

Just realised that the link didn't appear above!
http://epetitions.direct.gov.uk/petitions/4403

I feel dreadful reading these posts as I have not seen a petition to save the NHS anywhere! Am I the only one? If someone could let me have the link I would be grateful and pass it on as well for others.

While on the subject of petitions would you all PLEASE visit the link below and add your signature to an e-petition to save coastguard stations around the UK coastline! There is a real threat to a vital emergency service which could affect any of us. Thanks! (See URGENT message in the Health Forum list)

I do take issue with the need to learn from other countries. Our NHS is one of the cheapest and one of the best. The US' is one of the dearest and one of the worst (at least in the developed world). France seems to have a well-developed system, but it has grown that way. It would not work in the same way in the UK.

The NHS needs constant vigilance and careful monitoring. It does not need radical change.

I'm sure they do run out of money, but why should we believe that PCT mark 2 run by GPs is no going to do the same. I can't see any way in which it will improve things and fear they will be a lot worse. What I meant is that NICE set nation wide standards about what NHS will pay for at the moment and that is going to be replaced by a free for all. If you are a hospital dealing with several consortia all of whom are willing to pay for different combinations of drugs, is that not going to increase bureaucracy? The poor hospital doctors are going to be tearing their hair out asking patients which consortium area they are in before they can make a clinical decision on what to prescribe.
Or have I got this all wrong...

It is not true to say that all PCTs work in the same way. I know that the two round here duplicated systems and staff but interpreted things in entirely different ways causing great confusion among the healthcare professionals and, as I said before, then they run out of money to provide patients, particularly the elderly, with fairly basic help. That can't be a good system.

I suspect that PM declared that they were going to be a reforming government and that all ministries had to come up with some form of "reform" however hair brained.
kittylester I know there are lots of wonderful, dedicated professionals in the NHS. many of them are doctors and some choose to work in deprived areas.
Equally there are some lazy, uncaring so-and-sos who are only in it for the money. If we are to believe the Daily Mail today, some are even defrauding the NHS.
Some of the dedicated professionals are even managers. I think the reforms will just re-create bureacracy (the GPs are going to have to employ managers to run the consortia, so all the PCT staff will probably end up with new jobs) - in the hospitals they will probably need more managers and administrative staff, because they will not be working in a single system any more, with all PCTs working in the same way.
I don't think that saying, basically, "doctor knows best" is a very convincing argument to reassure people that it will all come right in the end. There is going to be a huge outcry about postcode lotteries in 2-3 years time and in about five or six years time some government is going to be spending time and money on unpicking it. Or trying to.
A truly reforming government in my book would put a freeze on legislation and spend a while just concentrating on the management functions of government. The money spent on implementing new laws (in terms of civil servant salaries) is astronomical.

You are right JessM that polititians don't have the know how to make these decisions. One can only hope that they are consulting thoroughly with all those in the know in the NHS because this is where, a failure to do this results, in deep set dissatisfaction amongs the workforce - consultation is the name of the game!!
To be honest, I think that a few people like ourselves, involved in the shake up, could come up with some good ideas - simply because we are looking in from the outside and aren't hindered by politics or other inside forces!!

Being a food professional and after a stay in my local hospital I volunteered to go along and suggest what was going wrong with the catering. As with most things, guided by a little commom sense, problems were easily ironed out and at no extra expense.

I seem to recall that before the election the Conservative party said that it had no plans for major changes to the NHS. Once in government, Andrew Lansley announced his fully formed plans but has never explained truthfully why the NHS needs reforming as opposed to improving and what those reforms are supposed to achieve. Introducing a market economy into something that is fundamentally a service has failed in the past and there is no reason to believe it will succeed now. I am convinced that this is privitisation by the back door.

Hattie64 I don't personally know my MP but, if she does have private health care, that is surely her choice.

JessM there are more 'managers' in the NHS than just those in hospitals -PCTs are overrun with them in various guises.

Ask your MP if he has private healthcare???

kittylester - can you explain how the current "reforms" are going to decrease the numbers of hospital managers?

Gangy - what qualifies the MPs to make these decisions?

Sorry to hear about your MiL's experience, Jess, but maybe things would have been different if a consortium had been in existence. Lots of the best healthcare professionals choose to work in the worst areas to do the most amount of good. As gangy said, most people don't have anything but outside experience and something has got to happen to stop all the money wasted paying high wages to "managers" but making nurses redundant and then running out of money to pay for essential treatments.

The majority of us are on the outside looking in and the odd medical experience doesn't qualify us to vote on the currently proposed reforms. The NHS is such an unweildy organisation and it will take grit and determination to reform successfully.
Some way back on this thread somebody suggested France's sysyem to be a good model. There must be somewhere in the world that can show us how to do it!
This current period of dithering must be very demoralising for all involved in attempting to deliver a quality service - and I would like to add that this is the one desire of the majority working within the NHS.
All of my family, up until now, have everything to be grateful for from their experiences with the NHS. My sincere wish is that thorough reorganisation results in good clinical results with a necessary economy which is not damaging.

I am not sure what the reforms are supposed to achieve, but I do not think it is more equal health care.

I do not trust individuals to exercise their judgement on my behalf, even if they know better than I do. If they could be relied upon to use their powers for my good, it would be different. But one reason for having democracy is the sheer weight of evidence that shows that power is inevitably abused sooner or later, and that "experts" can abuse it as enthusiastically as the talentless.

If we must have the situation where the Secretary of State (him/herself not directly elected anyway) can shed the responsibility of providing adequate health care free at the point of use to all UK citizens, then at the least we should be allowed to elect directly the person/people who take on that responsibility.

GP consortia do not exactly meet that requirement.

I dont doubt future sec of states will come under pressure re health. But maybe the job won't exist... You can see the effect with the railways and the privatised utilities - they are not supposed to be under govt control but they keep on trying to get involved and coming under pressure re railways, fuel prices etc.

You have obviously had good experience of GPs. MY MIL lives in a relatively deprived area of the midlands and she has had terrible service from hers over the years. She has been living with my SIL in a much more affluent area for the last 9 months and the GPs are so much better there, you would not believe. It is, literally, like going to a different country. (But why wouldn't the best GPs choose to live and work in the nicest areas... ) Under the new system I think the better off areas will get an even better service.
Under the new model, nobody will take those tough decisions that have to be taken if you are to have a modern cost-effective health system. I used to live somewhere that had two hospitals and two A and E departments. Against opposition, one of them was, effectively, closed. As you an I know if you are to give a 21st century service and recruit the right quality consultants, someone has to make those choices. Who will do it under the new system? No-one will have the power. Takes a long time for "market forces" to close down a third rate department or hospital however you structure the market.
And post-code lottery-ism is going to go crazy with all the consortia setting their own priorities.
I cant see how the "reforms" are going to get rid of your excess managers either - maybe it will increase the admin/management load in hospitals even. Wouldn't surprise me.

Hi Jess - I doubt that there will ever come a time when the NHS is completely removed from any accountability - genies don't readily go back in bottles! As I said, I think we should respect and trust the GPs and if consultants etc are included in the consortia maybe they will understand the real needs of the community rather than have their working practices dictated to them by people who have absolutely no hands on experience! I have heard patients referred to, by managers, as "units". These are people not blinking units!

expatmaggie Well-off and even fairly okay pensioners pay tax here and general taxation is the source of NHS funding. National Insurance is a spurious tax (not ring-fenced but just goes into the general coffers) that is supposed to cover pensions, unemployment pay and other so-called benefits and pensioners don't pay that.

Well, I might trust my own GP, but I am not sure I should trust all of the others too. Anyway the BMA is against the reforms.

HI kittylester. Do you think it is right though that the NHS should be completely removed from any democratic control or accountability? Which seems to be the plan. Just cut it loose and let the devil take the hindmost - those who live in areas with less competent consortia.

The bit of the NHS I know about has, over the period the last government was in power, added layer upon layer of self serving "managers" while not having enough money left to pay for treatment for patients who are actually in need. My GP is in favour of reform and I know him to be a really "professional" person so, while not really having a fantastic grip on what the proposals mean, trust in his judgment. We, or at least the PCTs, seem to have lost sight of the fact that most people who work in health care are genuine, caring people trying to do a good job.

The potentially disastrous health bill is being debated. It is going to remove all democratic accountability for the provision of healthcare, including that which rests with the government.
It will also introduce a postcode lottery, of nightmare proportions.
For legal opinion follow the link.

www.38degrees.org.uk/

I have just sent this link and brief comments to my MP via the website WriteToThem - it only takes 5 minutes. Come on gransnetters lets lobby.