NHS Reforms

Not to mention the reduction in privatisation.

The biggest con of all. How can there not be more privatisation when, as growstuff points out, It would appear that "cutting bureaucracy" means that contracts will no longer need to go out to tender.?

It won't just mean contracts for equipment and supplies, it will mean contracts for the supply of services. Privatisation, in other words. I'm sure there are some US companies licking their lips in anticipation right this minute... And absolutely no way to hold the Minister to account...

The original Health and Social Care Act was marketed as being all about choice and putting GPs and patients centre stage. Competition between providers was supposed to drive up standards. We all know it didn't work out like that and GPs and patients have been big losers.

The only think the new bill will stop of the hated previous reforms is that now everything will be centralised and the Secretary of State will have more control.

This is from the government's press release:

"The NHS and local government to come together legally as part of integrated care systems to plan health and care services around their patients’ needs, and quickly implement innovative solutions to problems which would normally take years to fix, including moving services out of hospitals and into the community, focusing on preventative healthcare."

This is an attempt to stop so-called bed blocking in acute hospitals and will enable hospitals to move patients to care homes. Some years ago, responsibility for people with severe special needs needing residential care was moved from the NHS to local authorities, who promptly outsourced the services. The same thing will happen with frail and elderly people in hospitals.

I agree suzie and I find it really sad.

Wow isn't this being marketed well though! Shots of Cameron and Lamesly on TV one of the most hated men, mention of the last reorganisation (hated by almost everyone) being abolished, talk about health and social care being integrated and the Minister for Health having more authority, Not to mention the reduction in privatisation. Even I was sucked in and had to remind myself-"These are the Tories they don't like the NHS. So thanks GNers for enlightening me. Just one question where's the opposition to this? Have they all been paid off?

grow the deeper we dig, the more we access the detail, the more we only have confirmed that this latest change will be nothing whatsoever to do with improving health care in all its manifestations and everything to do with enriching the private sector. I really am going to waste no more time on following these proposals. Whatever they are, the nodding donkeys and lobby fodder will enable their legislation so long as it’s in their interests.

I have seen so many reorganisations of the Health Service in the past 40 years that you will pardon me for being sceptical on this one. They all seem to involve spending more money on reorganisation than is saved by it, and the administration is worse not better.

No more privatisation. Look at the most recent event. A rubbish Track and Trace making loads of dosh for a small group of people.

Our wonderful doctors, nurses and local health authorities have organised a great vaccine delivery programme on top of caring for all those who are extremely sick.
I say yes to reducing privatisation. Instead a Public Health Service as proposed by by Bevan.

www.bbc.co.uk/bitesize/guides/z27nqhv/revision/5

For anyone who doesn’t know what was proposed.

I've been trying to dig a bit deeper into what the new bill actually says.

It would appear that "cutting bureaucracy" means that contracts will no longer need to go out to tender. In other words, they can just be handed out with very little accountability - much as the Covid contracts have been handed out.

Katie59

Maisie I wouldn’t disagree with your logic, it sound much like the system we have now, the reality is that demand for health services has exceeded cash targets for many years. A more income or wealth related payment system would provide more resources like the Medicare system in the US

The health service is not like a factory because demand is unpredictable on a day to day basis, a lot of resources are going to be wasted however good the management is.

The UK spends around 1/3 per person compared to the US and much less than other developed economies, for the UK any more tax income is going to have to come from premium services that cost extra. But if the same level of service is available on the NHS few will pay .

The amount spent on health services in different countries and the link between that and indicators of efficiency, efficacy and equity is incredibly complex. You seem to be seeing a simplistic correlation between the amount spent and the quality of the system. You seem to have a particularly rose tinted spectacles view of the US health care ‘system’ even after Obamacare

Katie59

Maisie I wouldn’t disagree with your logic, it sound much like the system we have now, the reality is that demand for health services has exceeded cash targets for many years. A more income or wealth related payment system would provide more resources like the Medicare system in the US

The health service is not like a factory because demand is unpredictable on a day to day basis, a lot of resources are going to be wasted however good the management is.

The UK spends around 1/3 per person compared to the US and much less than other developed economies, for the UK any more tax income is going to have to come from premium services that cost extra. But if the same level of service is available on the NHS few will pay .

I'm sorry, but I don't think you've understood the point I was making in my post about financing the NHS.

There is no practical constraint on the amount that government can spend on the NHS or any public service. Cash targets are political and ideological constructs based on the myth that a state with a sovereign currency can 'run out of money'. It can't do that because it doesn't have a fixed amount in the state bank! If it needs more money it just creates it.

Taxation doesn't fund spending. It has a purpose, but it's nothing to do with getting enough money to spend.

If we were to go to war state money would be poured into the war effort with no 'cash targets' in sight...

Maisie I wouldn’t disagree with your logic, it sound much like the system we have now, the reality is that demand for health services has exceeded cash targets for many years. A more income or wealth related payment system would provide more resources like the Medicare system in the US

The health service is not like a factory because demand is unpredictable on a day to day basis, a lot of resources are going to be wasted however good the management is.

The UK spends around 1/3 per person compared to the US and much less than other developed economies, for the UK any more tax income is going to have to come from premium services that cost extra. But if the same level of service is available on the NHS few will pay .

growstuff

The more I read about it and understand some of the details, the worse it gets. The public is being treated like mugs.

Well, why shouldn't it be treated like mugs, growstuff? The government have proved that the public can be treatedlike mugs with absolute impunity.

It persuaded them to vote for Brexit
It has destroyed the public's voice in Parliament, and Parliamentary supremacy by using Brexit and covid to give itself power to bypass parliamentary scrutiny and make whatever laws it likes (this is known as dictatorship in other countries):-)
It has presided over the carnage of over 100,000 unnecessary covid deaths caused by its appalling inability to act on expert advice and late decision making.
It lies so continually that the odd grain of truth is a shock..
It has passed £billions to its cronies and tory party donors for unusable PPE and inneffective test & trace.
The only thing it's managed to get right this year, the only gamble that has paid off, is the vaccination procurement and distribution and putting the NHS in charge of the vaccination programme.

Now they're planning further chaos in the NHS and more privatisation to boot, yet half the population thinks the sun shines out of their bottoms and are panting for more death and the destruction of democracy.

I don't understand it..

The more I read about it and understand some of the details, the worse it gets. The public is being treated like mugs.

or more money, which means higher taxes.

While this is the line which we have been fed, Katie59, it is completely untrue. But people need to understand that taxes don't fund spending. Government spends first, to put money into the economy and the money spent on state funded services comes back to it in a number of ways.
Firstly, it is mostly spent in the private sector for the provision of everything that the NHS needs; equipment, pharmaceuticals, so it supports private enterprises, big and small which return taxes to the treasury. Then it pays wages, in both the private and state sectors, which are spent into the economy; once again supporting private enterprise, and there is income tax on wages which returns to the treasury. So, one way or another, the government gets back the money it has 'spent'. The only money it doesn't get back reasonably quickly is money that people save. Or the profits made by private enterprises that are squirreled off abroad to avoid taxation.

Government spending grows an economy.

Once this is understood we could be much more wary of pleadings of state poverty. And resistant to 'austerity measures'.

The government is getting credit in the media for ‘taking back control’ of our NHS. In reality, Health Secretary Matt Hancock’s new plans would mean more American-style privatisation, not less! (1)

Dear Boris Johnson and Matt Hancock, don’t give private companies a bigger role in our NHS.

We call on you to get private companies out of our health service so the NHS can get on with the job of caring for people in this pandemic.

Enter email to sign *
weownit.org.uk/act-now/stop-matt-hancocks-private-takeover-nhs

The idea of 'competition' and running the 'service' like a business was supposed to make it more efficient. Just an extension of the Thatcherite belief that 'business' methods were more efficient than unbusinesslike state provision. And it made it easier for private providers to offer services.

The biggest dilemma as far as I’m concerned is ‘does the NHS provide a service or is it running a business?’

I don’t think the two are compatible.

Hospital Trusts compete for ‘clients’ and the money flows accordingly.

It's difficult to imagine the Tories giving up the idea of outsourcing to private companies being abolished. I also read some time ago that American providers were already operating in the UK advising healthcare trusts.

In some ways the French system, which is different to the English system works more efficiently (even after the debacle over covid vaccinations). We have a "carte vitale" which we hand over when we go to for a consultation or treatment, or to collect our medicines. We have to pay health insurance the premiums for which depend upon age.
In effect the state pays 70% of health costs and the insurers 30%.

When we first arrived here we debated whether to take out health insurance and came to the conclusion that we wouldn't. We would just pay for treatment as we went along because we knew that the govt refunded 100% of costs if you have a long term illness. Then a friend told us that you have to pay for all the treatments you in order to find out what's wrong. eg blood tests and x-rays and those costs can mount up so we decided to go ahead with the insurance.

If I need an x-ray or a mammogram I have a choice of 4 or 5 clinics where I can make appointment, usually usually within a week.

As we have got older and get more things wrong, we have found the french to be beneficial.At one time we felt a bit like health tourists as we got more things wrong with us.

Katie59

Less beaurocracy forget it, only one of 2 things will improve the NHS, either less services which is politically impossible or more money, which means higher taxes.

Because the health service is “open ended” demand is always going to exceed supply, you can revamp regional authorities providing for local requirements but then you have a post code lottery

Yes, we will end up with a worse postcode lottery than there is now.

Knittynatter

@growstuff
‘Clinical commissioning groups haven’t existed for some time’
I think you are a little ahead of yourself there - the one I work for will exist until April 2022!!

The names still exist, but decisions are being made at a higher level. I'm on the patient panel for my local CCG, but it's actually just a branch of a bigger organisation. It's the minor partner in the "partnership" and sometimes seems to be forgotten when organisational changes and funding decisions are made.

Less beaurocracy forget it, only one of 2 things will improve the NHS, either less services which is politically impossible or more money, which means higher taxes.

Because the health service is “open ended” demand is always going to exceed supply, you can revamp regional authorities providing for local requirements but then you have a post code lottery

It's all smoke and mirrors Maizie. I'm keeping a close eye on it, but it's already evident that the spin doesn't match reality.

I think what B9exchange means is explained in the BMJ article. The NHS and local authorities currently work with different lists of people, which causes big problems where I live because we don't tend to use the NHS services situated in our county area. Co-ordination between hospitals and councils has caused problems for maternity services, the frail and elderly and disabled, etc. There is nothing in the new proposals to overcome these difficulties.

@growstuff
‘Clinical commissioning groups haven’t existed for some time’
I think you are a little ahead of yourself there - the one I work for will exist until April 2022!!

Bringing it all within the purview of the Minister is a bit of a worry, too. Especially one that has overseen this sort of debacle.

£billions of PPE ordered, don't know where it all is and whether or not it's useable...

www.theguardian.com/world/2021/feb/11/uk-government-not-sure-where-billions-of-pounds-worth-of-ppe-is?CMP=Share_AndroidApp_Other