NHS Reforms

There has been so much criticism about the handing out of contracts to those who have failed to succeed in other spheres.
Test Track and Trace is one that would I feel have been better handled by the NHS.
It would be better if there were fewer private contracts but the devil is in the detail as some are saying.

The plans to remove the market competition for services can only be a huge improvement. However trying to join up the NHS and social care has been the aim for decades, but will always run into problems because of different funding arrangements and the lack of a common NHS number being used in social care.

AGAA4

There has been so much criticism about the handing out of contracts to those who have failed to succeed in other spheres.
Test Track and Trace is one that would I feel have been better handled by the NHS.
It would be better if there were fewer private contracts but the devil is in the detail as some are saying.

I haven't caught up with the news yet but I think the govt is bringing to an end the GP commissioning groups that were set up in about 2011 under Andrew Lansley. You know, the chap who invited McDonalds to contribute to discussions on the future of the NHS.

The devil will be in the detail - it always is. Until I know more detail, I will , as ever view with deep suspicion any thing they say about their intentions towards the NHS. ( this generally saves time later)

A new bill to reform the NHS in England: the wrong proposals at the wrong time:

blogs.bmj.com/bmj/2021/02/11/a-new-bill-to-reform-the-nhs-in-england-the-wrong-proposals-at-the-wrong-time/?utm_campaign=shareaholic&utm_medium=twitter&utm_source=socialnetwork

Private outsourcing will not be abolished, but some of the checks and balances on tendering rules will be. The government will have more direct control over the NHS. There will also be no requirement to offer minimum services.

LadyHonoriaDedlock

AGAA4

There has been so much criticism about the handing out of contracts to those who have failed to succeed in other spheres.
Test Track and Trace is one that would I feel have been better handled by the NHS.
It would be better if there were fewer private contracts but the devil is in the detail as some are saying.

I haven't caught up with the news yet but I think the govt is bringing to an end the GP commissioning groups that were set up in about 2011 under Andrew Lansley. You know, the chap who invited McDonalds to contribute to discussions on the future of the NHS.

Clinical Commissioning Groups haven't existed for some time. They have been absorbed into Sustainability and Transformation Partnerships (STPs). These will now be abolished and new area wide organisations introduced. There is a plan to centralise services even further, so it is inevitable some general hospitals and A&E hubs will be shut and people will have to travel further. There is also a plan to introduce a remote GP service, which could be run by American providers (or anybody) from anywhere.

There is a plan to centralise services even further, so it is inevitable some general hospitals and A&E hubs will be shut and people will have to travel further. There is also a plan to introduce a remote GP service, which could be run by American providers (or anybody) from anywhere.

It really doesn't sound at all promising, does it?

and the lack of a common NHS number being used in social care.

Can you clarify this, B9exchange ? What 'NHS' number are you talking about?

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

@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!!

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.

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

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.

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.

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.

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.

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 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

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

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..

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 .

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...

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

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.