Stop the sell-off of 49 NHS GP practices to American health insurance giant.

Please sign This is now the thin edge if the wedge You can't trust the Tories with our precious NHS

To: House of Commons
Privatisation of York Hospital’s Emergency Department
www.megaphone.org.uk/petitions/privatisation-of-york-hospital-s-emergency-department?fbclid=IwAR38e3rKadhDewLMYJQOE8N0UvlaLNVrXAD107XlON78rdavbdGgbIWTrNU

Dinahmo

Interesting news today - Prince Phillip has been moved from King Edward's (private) to Barts (state)

When it comes to intensive and emergency care there is no good alternative, the NHS is it. Poor old PP.

Interesting news today - Prince Phillip has been moved from King Edward's (private) to Barts (state)

MaizieD

I have to apologise, NellG. I misread your post. I assumed that the 'this was entirely under a Labour Government' was referring to the the whole scope of privatisation of NHS ancillary services; not to the situation in your particular unit.

No worries, and no offence was taken. These are massive topics so it's really hard to peg down exact meaning in a post, especially when it's an emotive subject, and it still is for me even all these years down the line. I haven't been a clinician for years but I still care about good patient care. I haven't been a manager for years either - way too 'passionate' for that too! ?

Whingingmom GPs aren’t accountable just to themselves and the Medical Protection Society.
They’re accountable to the General Medical Council, the CQC, and any Royal Colleges they might be a member of.
But most importantly they are accountable to their patients.
I may sound naive but I firmly believe that for the vast majority of GPs acting in the best interests of their patients is their overriding concern.
If they do that, everything else should fall into place.

Unfortunately whenever a third-party provider is involved, whether it’s the NHS or an American health insurance company, other considerations come into play. Rules have to be adhered to, targets have to be met and these don’t always coincide with the patient’s best interests.

Adding another layer of bureaucracy (a private company providing services under the auspices of NHS services) may or may not be good for patients’ well-being.

They may have more efficient time-management systems (eg not sending out appointments after the appointment date) so that less time is wasted and more patients can be seen, resulting in shorter waiting times.
They may provide continuing professional development opportunities that the staff appreciate & which motivates them.

They may set unrealistic targets (on top of NHS ones) that result in staff becoming demoralised.
They may negotiate unrealistic prices for carrying out NHS procedures & find it impossible to break even without compromising patient care.

I just don’t know.

Playing devils advocate here - perhaps private ownership will make GPs more accountable to people other than themselves and protective professional organisation. The service might improve.

Totally agree Growstuff. There are an awful lot of people making money for themselves out of the NHS. Needs a radical overhaul and more transparency and accountability.

Whingingmom

“We” don’t own GP practices. They are independent businesses who contract their services to the NHS and always have been. They can sell their business to whoever they choose, just like opticians, dentists etc who are owned and run by healthcare companies.

Yes, they are and the only way to ensure that they continue to provide a decent level of care is for the government to be absolutely scrupulous about what they will pay for. If they're not providing that, with minimum standards, they shouldn't be paid. Unfortunately, there's an art involved with manipulating targets, so the government and inspection services (or whatever they're called) need to be pro-active. I've witnessed myself how an excellent, caring practice can go downhill when it's taken over by partners who just don't seem to care (and they're not a US corporate - just a bunch of people who really don't seem to have their heart in it).

I have no doubt that the GP service will remain free, but it will offer such a skeleton service that people feel obliged to pay for private care.

And it’s not done nearly so well as when it was in-house Whingingmom

And most of the NHS work is contracted out to big companies too - laundry, catering, cleaning, engineering and maintenance of buildings, grounds snd equipment, staff training and education etc etc.

“We” don’t own GP practices. They are independent businesses who contract their services to the NHS and always have been. They can sell their business to whoever they choose, just like opticians, dentists etc who are owned and run by healthcare companies.

I have to apologise, NellG. I misread your post. I assumed that the 'this was entirely under a Labour Government' was referring to the the whole scope of privatisation of NHS ancillary services; not to the situation in your particular unit.

MaizieD

^There was a mention of Thatcher and privatisation, just for clarity this was entirely under a Labour government. The in house catering was shut down because of a Labour govt directive - all they were interested in was statistics, not good patient care. Looking good because they 'got the numbers up'.^

Hospital ancillary services were privatised by Thatcher from the mid 1980s.

References to it here:

www.sochealth.co.uk/2021/01/08/the-marketisation-and-privatisation-of-the-nhs/

and here:

navigator.health.org.uk/theme/encouragement-privatisation-ancillary-services

I'm not disputing that it lead from those changes, what I'm saying is that they weren't implemented as well as they could have been and Labour didn't make it any better.

Take my bed sheet example - before the large 'Asylum' was shut down as a result of Thatchers hatchet job, all the laundry was done on site, in a huge facility - they took in private laundry for hotels etc for income, and did everything from the 'Royal' too.( sorry for being vague, trying not to give identifying info). The workforce were the patients - happy to go into the morality of that elsewhere if needed.
That facility went with the care in the community changes so, the powers that be cobbled together expensive contracts to replace and replicate that service - only it wasn't cost effective and didn't save money, because it wasn't staffed for free and it didn't draw income.

So I'm not blaming Labour, I'm saying that neither party has helped the NHS improve, in short, my opinion is not politically motivated and in my experience regardless of the intentions of a government for the NHS, the way they will ultimately be enacted is filtered and corrupted by the employees and managers who implement them. The mention of politics at all was solely in response to the hint that it's 'all Thatchers doing'.

On the ground floor what this meant was under the Tories care in the community - so case loads of over 100 for a single CPN who was supposed to spend time with all of those people. Then, under Labour, that CPN then having to spend half his/her time doing paperwork to generate 'good' statistics, instead of nursing her 100 patients during her 40 hour week with no paid overtime... because ALL governments are more concerned with appearing to have a done a good job than actually doing one regardless of party politics.

I hope that clarifies my point, even though I realise it may well muddy the waters of the debate.

Fennel

ps one of my DiLs had moles on her back and they turned out to be harmless.

I've always had loads of moles. They're genetic - my mother had them, so do my sister and my son.

I know that most of them harmless most of the time but this one has grown quite rapidly and, from what I can see, it's an uneven colour and irregular edge. I'd be irresponsible if I hadn't asked for it to be checked out.

I managed to take a reasonable photo of it today with the delay function on my laptop camera and will take more every couple of weeks from now on to compare them. It's in a really awkward place which I can only see in a mirror.

I will indeed make a nuisance of myself, but they don't even answer the phone much of the time. I've been on the verge of changing practice for some time, except people say the only other practice in town is just as bad. I do have another option for a practice, but a close friend is a GP there and I've always been a bit uncomfortable with the idea of her looking at my private bits.

I won't let it just drift. I was just so appalled by the attitude of this new GP. Maybe he's temporary - hope so!

I became aware some time ago that the best thing is to become an expert in one's own body because no other bugger seems to care much. I can't see anything improving - whoever is in charge of the practice. It's no coincidence that some MPs have shares in tele-medicine.

Growstuff The GP looked at it and said that he didn't think it was cancerous. When I responded, he said that I sounded disappointed. I was furious at this response. It's a classic mole which has grown rapidly and has uneven colour and shape.

Do please follow this up yourself if you don’t hear something within a few days. Just make a nuisance of yourself at the practice, to 111, whatever it takes.
From your description (rapidly growing, uneven edges) that is something that, if it were me, I’d be demanding an urgent referral under the two-week rule.

ps one of my DiLs had moles on her back and they turned out to be harmless.

growstuff that's awful about having to wait for thorough investigation of your mole. Back in 2014, when we were in France, I had an extending mole on my arm. I went to our GP, a family practise, and he took a cutting (painless) and sent it off for analysis. It was pre-cancerous so I was sent to the nearest cancer hospital where they cut the whole thing out, as a day patient.
All within about a month.
But even there, things have changed and they've moved to our system of health centres. There's a shortage of generalistes, for various reasons eg many middle aged GPs, like ours, wanting to retire and not enough youngsters to replace them

There was a mention of Thatcher and privatisation, just for clarity this was entirely under a Labour government. The in house catering was shut down because of a Labour govt directive - all they were interested in was statistics, not good patient care. Looking good because they 'got the numbers up'.

Hospital ancillary services were privatised by Thatcher from the mid 1980s.

References to it here:

www.sochealth.co.uk/2021/01/08/the-marketisation-and-privatisation-of-the-nhs/

and here:

navigator.health.org.uk/theme/encouragement-privatisation-ancillary-services

If I honestly thought my GP practice would improve from being sold off to some kind of corporate organisation, I would go for it. However, I really don't think it will. There will be an increasing number of phone/photo consultations, which I don't think GPs should be all about.

There will also be even less continuity of care than there is now. It's no coincidence that a number of local GPs have set up private practices, which I certainly couldn't afford.

The aim is to make GP consultations "remote". There are already some companies doing this. They leach money from GP practices, but only if you're an "easy" patient. They don't deal with chronic conditions, the elderly or maternity. Yes, you might get an appointment within minutes, but it could be a telephone call with somebody hundreds of miles away or even in a different country.

MaizieD

^Feeding say, 1000 staff and patients was/is vastly different than buying food for small, bedded rehab units where we were trying to teach people how to cook and care for themselves.^

I have to agree that that sounds ridiculous, NellG!

We had a small day unit, in a separate location, attached to our hospital. I think that we issued stuff to them from our supplies. (It's a long time ago now, though...)

As a clinician I did a stint in a rural EMI unit, 30 beds, mostly dementia, some Huntington's. So, very vulnerable people, some with specific dietary needs. So I'm happy to talk about food and the NHS.

The lovely, fully equipped catering kitchen in the unit was used for making tea and toast - the meals came from the local hospital catering dept and were what was known as 'Cook Chill' - so for those reading who don't know what that is, it's basically giant trays of pre cooked food that is reheated on site in huge ovens specifically for this purpose. Now, cooked fresh and served it was no doubt OK food - stored in metal trays, transported and reheated I would have hesitated to feed it to my dog. Any nutrition in it was gone by the time it was served. Remember school dinners, all that soggy cabbage and claggy potatoes? Yeah, that - plus they couldn't season the food because the salt would degrade the aluminium tray...

There was a mention of Thatcher and privatisation, just for clarity this was entirely under a Labour government. The in house catering was shut down because of a Labour govt directive - all they were interested in was statistics, not good patient care. Looking good because they 'got the numbers up'.
Meanwhile I was having to spoon feed people's relatives with food not fit for the pig bin.

Do I sound a little bitter?

So, if right now a private company running services efficiently and effectively with patient care at the centre of its delivery and actually improving things while still providing all that for free a the point of delivery is better than the NHS I remember, then I'm all for it. I'm sorry if this offends anyone, but looking through rose tinted glasses at the NHS never saved anyone's life.

To help with spending the budget before the end of the financial year we used to raise what we’re called Pro Forma Invoices, so goods were ordered and “paid for” in advance of receipt.

There ain’t a system that can’t be beat.

Feeding say, 1000 staff and patients was/is vastly different than buying food for small, bedded rehab units where we were trying to teach people how to cook and care for themselves.

I have to agree that that sounds ridiculous, NellG!

We had a small day unit, in a separate location, attached to our hospital. I think that we issued stuff to them from our supplies. (It's a long time ago now, though...)

25Avalon

MaisieD I worked in Area Supplies at the same time and we did most of the purchasing for our catering departments with approval from our catering officers who didn’t always buy cheapest but certainly, with arranged bulk contracts, still way cheaper than your local shop.They knew that serving decent food helped patient’s with their recovery. I lament their loss and loss it is.

Well, exactly, Avalon.

It's interesting that NellG's experience of working in the NHS is post privatisation of 'hotel services'.

I was working at the time when the NHS was reorganised from local hospital boards into the Area and District Health Authority structure. So I experienced the changeover from each hospital doing its own thing for catering supplies to Area based contracts. No, we didn't always go for the 'cheapest' because quality mattered too, but the amount of money we were allowed per patient for food cost (which varied with the type of patient) was so low (somewhere around £1.25 - £1.50 per week, if I recall rightly) that we couldn't always go for the very best. When Thatcher introduced privatised hotel services I couldn't see how they were going to maintain quality and make a profit from catering. I'd left by then...

I agree with NellG about that ridiculous rush to spend all your budget at the end of the financial year. If you were wise you had a wish list ready in anticipation of that. but it made it difficult to plan long term capital expenditure.

25Avalon

MaisieD I worked in Area Supplies at the same time and we did most of the purchasing for our catering departments with approval from our catering officers who didn’t always buy cheapest but certainly, with arranged bulk contracts, still way cheaper than your local shop.They knew that serving decent food helped patient’s with their recovery. I lament their loss and loss it is.

The difference for me years ago was that I wasn't buying enough to be able to sort my own bulk contract, and red tape meant I was stuck with NHS supply. Feeding say, 1000 staff and patients was/is vastly different than buying food for small, bedded rehab units where we were trying to teach people how to cook and care for themselves. What was I going to do with a pallet of rice? The issue was that I held the budgets but had no authority to spend them where I chose. The food thing was just an example to illustrate the problem.

The fact that three of us have vastly differing experience with how the NHS spends money is probably evidence that it needs to spend its money more wisely I think.