The Plot Against the NHS #2
Selected excerpts from ‘The Plot Against the NHS’ by Colin Leys and Stewart Player. Chapter One is available here. I highly recommend this book available from Merlin Press for £10.
p.148~154 References in the original.
Within the BMA a strong challenge emerged to the leadership’s position of ‘critical engagement’ with the government’s plans, and a demand for outright opposition. The development of serious opposition from a large part of the medical profession, and especially from GPs , was significant, because Lansley constantly claimed to have their support.
The false case for the Health and Social Care Bill
The government’s claim that the NHS was in urgent need of further fundamental reform was also becoming more and more obviously false. During the previous ten years, while the NHS was being covertly marketized, the Labour government had raised NHS funding rapidly towards the average level of spending of the other major countries of Western Europe. Spending on the NHS still remained significantly below that of the richer EU nations, and a significant portion of the new funding was absorbed by the cost of market creation. But the extra cash also produced some important improvements. Staff levels were improved, waiting times for elective care were sharply reduced, facilities were renovated or replaced.
This was reflected in the high marks given to the NHS in the Commonwealth Fund report cited in chapter 1. And by 2010 the particular charge constantly made by the marketizers, that England lagged behing European countries in the survival rates for major killer illnesses, was ceasing to be true. Lansley repeatedly declared that a wholesale restructuring of the NHS was ‘a necessity, not an option’, and David Cameron asserted that ‘pretending that there is some “easy option” of sticking with the status quo… is a complete fiction’. But in January 2011, coinciding with the publication of the Health and Social Care Bill, a paper by the King’s Fund economist John Appleby, published in the BMJ, showed tha t the marketizers’ charge was unfounded. It turned out to rest partly on the use of European data that were not comparable with the English data (and in some cases highly unreliable), and partly on selecting static data instead of trends over time. For several of the conditions usually cited English survival rates have in fact been improving so fast over the last 30 years that if the trends continue they will overtake
European rates by 2012.
The real choice
The choice is not between change and no change. It is between handing over a public service to be developed by private enterprise in the interests of shareholders, and ensuring that it develops in the interests of the public – and as the public sees those interests, not as politicians declare them to be. To maintain that there is no capacity for improvement within public provision is empty rhetoric. What evidence is there that public servcies are incapable of change and improvement (provided they are not undermined by financial starvation or market-driven disorganization)?
Around the world there are various examples of excellent public and publicly-provided health services, and all of them need to be studied for ways to improve the NHS in England – and beginning with an examination of those that are developing within the UK itself. The national media largely ignore what occurs across our nearest borders, but what is happening there, and especially in Scotland and Wales, raise crucially important questions about the future now being charted for the NHS in England.
Looking at Scotland
Even before devolution health ministers in Westminster had been too aware of Scottish sentiment to risk pushing the internal market very far there, and the Labour-Liberal Democrat coalition governments that held office in Scotland after devolution, from 1999 to 2007, recognised that voters would not support them if they followed England’s path to a healthcare market. Scotland’s Area Health Boards remained in place, foundation trust status was not introduced, nor was payment by results. The PFI was used for three Scottish hospital-building schemes, and one Independent Sector Treatment Centre was opened at Strathco in Angus. But these measures provoked intense controversy and in 2003, responding to pressure from both doctors and the public, the coalition government ended the purchaser-provider split, restoring direct administration to the NHS in Scotland and decisively closing off the market option. Also in response to public opinion, in 2002 the Scottish Labour-Lib Dem coalition made personal care for the elderly free, instead of means-tested as in England.
The 2007 elections, however, led to the formation of a minority SNP government, and yet further departures from the market-driven policy that was being pursued in England. In 2008 hospital car parking charges – a significant deterrant for families – were abolished, except at PFI hospitals, where legal reasons prevented it; and in 2010 plans were announced to abolish prescription charges from 2011. No further PFI schemes have been undertaken. Glasgow’s biggest acute hospital is being built with public funds, the ISTC at Stracathro was taken into public ownership, and plans to outsource the management of a health centre in Lanarkshire to a private company were dropped. Out-of-hours care is publicly provided.
Perhaps most significant of all for the future, in 2009 elections were introduced for the majority of the members of Scotland’s Health Boards, beginning with two pilot schemes to be evaluated after four years. This means that in addition to professional medical judgement democratic representation, rather than individual ‘patient choice’, could become a significant element in determining the direction of future change.
In face of all this the marketizers inevitably portrey Scotland’s NHS as a failure, with the usual misuse of statistics to support their claim. For example they routinely state that Scotland’s waiting times are worse than England’s, because no element of competition has been introduced into Scotland’s. In fact an analysis of newly-consolidated data concludes that since 2005 waiting times have fallen faster in Scotland than in England. In each year since then Scotland has actually had either the second shortest or (more often) the shortest waiting times of the four nations in the UK. And over the ten years from 1999 to 2008 Scotland’s mortality rates for all causes of death declined almost exactly as fast as England’s. As Dr Matthew Dunnigan, the author of the waiting times analysis, says, the objective comparison of English health statistics with those for the three devolved nations is now a very important task.
Looking at Wales
The story in Wales has many similarities to Scotland’s. For the first eight years following devolution a Labour minority government was in office, only giving way to a Labour-Plaid Cymru coalition in 2007. But as in Scotland, even the initial Labour-led Welsh Assembly Government did not dare follow the English path. The purchaser-provider split remained, but Wales did not adopt foundation trusts or payment by results. Development remained based on collaboration and planning, rather than on a market system with legally enforcable contracts and all the tensions and extra administrative costs involved.
And after 2007, under the Labour-Plaid coalition, the purchaser-provider split was dropped. In 2009 a major reform resulted in the formation of just seven integrated Local Health Boards to plan and operate the NHS in Wales. These are very like the Area Health Boards in Scotland, but also have overall responsibility for all aspects of health, including public health, with a strong emphasis on linking health and social care.
The Local Health Boards in Wales are not elected but they must have members representing local primary care, community care, public health, local government and voluntary organizations, as well as lay members. In one Local Health Board (Powys) the purchaser-provider split was abolished earlier and the Board was integrated with primary care and community health service providers. Other Boards are set to follow suit – exactly the opposite direction of change from that taken in England, where even community health services have been forced into the marketplace.
Wales also declined to use the PFI for hospital-building, led the way (in 2007) in abolishing prescription charges, abolished hospital parking charges, and dealt with the vexed issue of means-tested personal care for the elderly by widening the definition of what is considered nursing care (and therefore free), and by setting a flat-rate contribution to the cost of personal care throughout the whole country.
Considerations for England
We need to ask ourselves why Scotland and Wales opted to keep the NHS as a public service, and even extend the principle of free acess. Longstanding Scottish and Welsh cultural traditions are certainly important, especially a deeply-embedded commitment to social democracy in public life, and in the medical profession, which politicians of all parties have to respect. But another key reason is cost. Next to education health is by far the most important and expensive devolved publis service. Even before the financial crisis politicians of all parties in Scotland and Wales realised that if they followed the English route, and allowed the costs of operating a market to start soaking up ten per cent or more of the health budget, health services would be liable to deteriorate, with dire political consequences for themselves.
They know that the public spending cuts imposed by the government in Westminster will hit Scottish and Welsh health services. But they also know that the effects will be smaller that they would have been had they opted for a market, and that whatever they have to do will have a legitimate foundation in public opinion, which remains at the base of decison-making about the NHS in both countries. And when the crisis has passed they will still have a public health service, not a three-tiered healthcare market and a low-risk playground for healthcare corporations and ‘doctorpreneurs’.
Scotland and Wales don’t exhaust the alternatives for the future in England. Other good models of publically-provided health services exist and deserve study. But the successful evolution of the NHS in the rest of the UK shows that Cameron’s assertion that ‘we can’t afford not to modernise’ – meaning that we have no alternative but to accept the abolition of the NHS as a public service – is pure bluster. It has no foundation in evidence and serves no interest except that of the private health industry. In the parts of the UK that the plot against the NHS couldn’t reach, people see through it. They know that good health care for all means excluding profit-making, and have shown that with sufficient public backing that principle can prevail. We need to insist that in England too the NHS is not for selling.
NHS news review
NHS news:
Andrew Lansley’s NHS reforms are unworkable, says review chief | Society | The Guardian
Prof Steve Field, chairman of the NHS Future Forum – set up last month to undertake the coalition’s “listening exercise” – flatly rejects the health secretary’s plan to compel hospitals to compete for patients and income, which he says could “destroy key services”. The proposal, contained in Andrew Lansley’s health and social care bill, has led key medical organisations to warn that it will lead to the breakup of the NHS and betray the service’s founding principles.
It was ‘Nurse’s Day’ on Friday.
A report from the Torygraph Junk food Britain costs the NHS more than cigarettes and alcohol – Telegraph says that obesity is a huge problem to public health. Lansley consults junk-food companies on NHS policy: McDonald’s and PepsiCo to help write UK health policy | Politics | The Guardian.
There is confirmation by Mark Britnell, an advisor to Cameron that the intention of the Con-Dems’ abolition of the NHS bill is to abolish the NHS and create a health care system based on the US insurance model. He said that the NHS “will be shown no mercy” by the Coalition.
Shameless liar Nick Clegg lies shamelessly by stating that there will be no “privatisation by the back door”. The theme is picked up by the Morning Star.
Shameless liar David Cameron lies shamelessly by claiming “… it’s because I love the NHS so much that I want to change it.”
These shameless liars raise an issue of democracy. Shameless liars deliberately decieving the electorate should be held accountable for their actions. There have been similar recent incidents in UK political history with Blair, Campbell & Co and it appears that Cameron and Clegg are following that example e.g. Clegg’s “I believe” formulation.
Cameron is expected to make a speech full of shameless lies today e.g. “this Government will never, ever take risks with the NHS”.
The BMA warns on training.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
Andrew Lansley’s NHS reforms are unworkable, says review chief | Society | The Guardian
The senior doctor called in by David Cameron to review the government’s health reforms has dismissed them as unworkable and “destabilising” in provisional conclusions that could fatally undermine the plans.
Prof Steve Field, chairman of the NHS Future Forum – set up last month to undertake the coalition’s “listening exercise” – flatly rejects the health secretary’s plan to compel hospitals to compete for patients and income, which he says could “destroy key services”. The proposal, contained in Andrew Lansley’s health and social care bill, has led key medical organisations to warn that it will lead to the breakup of the NHS and betray the service’s founding principles.
In an interview with the Guardian, Field says Lansley’s plan to make the NHS regulator Monitor’s primary duty to enforce competition between healthcare providers should be scrapped. Instead it should be obliged to do the opposite, by promoting co-operation and collaboration and the integration of health services.
“If you had a free market, that would destroy essential services in very big hospitals but also might destroy the services that need to be provided in small hospitals,” says Field.
“The risk in going forward [with the bill] as it is, is [of] destabilising the NHS at a local level. It would lead to some hospitals not being able to continue as they are. If you were to say ‘we’re going to go out to competition for vascular surgery services’, University Hospital Birmingham wouldn’t be able to run their own trauma centre, for example, because you wouldn’t have the staff and the skills on site to do things and the volume of procedures needed to ensure clinical standards remain high.”
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Nurses “Holding The NHS Together” – Carter, UK
The Royal College of Nursing (RCN) today praised the vital work of nurses as they marked International Nurses’ Day. Dr Peter Carter, RCN Chief Executive & General Secretary, spoke out to highlight the work nurses carry out above and beyond the call of duty, and called for their achievements to be recognised.
Nurses’ Day was also marked by The Prime Minister, David Cameron, and key figures from across the political spectrum, including Deputy Prime Minister Nick Clegg and Leader of the opposition Ed Miliband, as well as Health Secretary Andrew Lansley. The political leaders all recorded video messages pledging their support for nursing and thanking nurses for their work. Many thousands of people have also signed a pledge in support of nurses on the RCN Nurses’ Day website.
Dr Peter Carter, RCN Chief Executive & General Secretary said: “Nurses’ Day is an opportunity for all of us, whether we are patients, nurses or politicians, to reflect on the value of a profession whose worth is clearer than ever as we deal with an aging population who increasingly need care. Medical advances are helping people to live longer, but it is nursing which can help them to live well and make those extra years worth having. I am very pleased that in spite of all that is going on in the NHS at the moment, political leaders and MPs of all persuasions have made time to recognise the value of nursing.”
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Junk food Britain costs the NHS more than cigarettes and alcohol – Telegraph
A rising tide of diseases caused by poor diet and couch potato lifestyles are costing the health service around £12bn a year – almost twice the £6.6bn spent on ill health linked to smoking and alcohol, according to research by experts from Oxford University and the World Health Organisation.
The paper, published in the Journal of Public Health, says obesity and poor diet now place “the largest economic burden” on the NHS of all lifestyle choices.
Experts said that while the individual health risks of smoking and excess drinking are high, resulting in billions spent treating liver disease and lung cancer, the far higher numbers of people eating a poor diet had a bigger overall impact on NHS costs.
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David Cameron’s health adviser has warned the NHS “will be shown no mercy” by the Coalition.
Mark Britnell, who has been advising the PM on reforms, revealed that the NHS could turn into a US-style insurance system.
The former Department of Health bureaucrat said he believed the NHS would leave operations and other procedures to the private sector, with the taxpayer picking up the bill. Unions were outraged at the remarks and they will also anger Lib Dems who have demanded big changes to Health Secretary Andrew Lansley’s reforms.
Last month, the PM ordered a pause in the plans after Lib Dem activists voted against them at their party’s conference. Mr Britnell, head of health at accountants KPMG, visited Downing Street last week to advise on NHS policy. Speaking to bosses of private health firms, Mr Britnell said: “In future, the NHS will be a state insurance provider, not a deliverer.”
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NHS reforms will provide private firms the opportunity to make big profits, one of David Cameron’s advisers has said.
Mark Britnell said the healthcare system will be transformed by the Government’s controversial reforms to become a ‘state insurance provider, not a state deliverer’ of care.
His unguarded comments to a conference of executives came as there were calls for Health Minister Andrew Lansley to water down reforms which will give the private sector a far greater role in patient care.
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Clegg in vow to listen to medics – Health – The Star
DEPUTY PM Nick Clegg told doctors and nurses in Sheffield unpopular plans to reform the NHS would be “significantly and substantially” altered after a public backlash, writes Ben Spencer.
The Hallam MP, quizzed by staff at Sheffield Children’s Hospital, pledged there would be no “privatisation by the back door”.
The Lib Dem leader hopes to reassert his party’s independence within the Coalition Government after their disastrous performance at last week’s council elections.
He told staff: “No Government has the right to change the NHS without greater consent from people within the NHS.
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A chance to move ahead / Comment / Home – Morning Star
Health professionals and patients fear NHS reforms will “destroy essential services,” senior doctor Professor Steve Field warned at the weekend.
Deputy Prime Minister Nick Clegg has vowed to veto the legislation but that’s merely as part of efforts to demonstrate a greater influence by his party following disastrous results at the ballot box last week.
It gives some perspective on his lack of understanding when he commented on a Bill that is designed to allow the backdoor privatisation of the NHS that there would be no “backdoor privatisation” of the NHS.
Health Secretary Andrew Lansley’s plans would scrap primary care trusts and strategic health authorities and give GPs control of £80 billion of NHS spending, with a remit to commission treatment and services from “any willing provider” – including private companies.
It also places a duty on watchdog Monitor to promote competition in the provision of health services and, ostensibly incidentally, removes the duty to provide a free health service from the Health Secretary’s mandate.
The clear impression is that the government is seeking to privatise the NHS. Of that there is no doubt and Prof Field made it quite clear in his comments.
“If you had a free market, that would destroy essential services in very big hospitals and also the services in small hospitals,” he said unequivocally.
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David Cameron: ‘It’s because I love the NHS so much that I want to change it’ | News
David Cameron will signal his determination to press ahead with “deep change” in the NHS, warning it faces a fundamental crisis in the future if reforms are blocked.
The Prime Minister will use a keynote speech to detail some of the reworking being done of the Government’s health service shake-up to meet widespread political and professional hostility.
But he will make clear that the controversial package drawn up by Health Secretary Andrew Lansley will not be abandoned as Labour seeks to exploit tensions within the Tory-Lib Dem coalition over the plans.
Speaking at a London hospital today, the premier is expected to say: “We save the NHS by changing it. We risk its long-term future by resisting change now.
“I know that some people still have concerns. They might be listening to this and thinking: ‘OK, but if you love the NHS so much, if you don’t want to take any risks with it, why do you want to change it?
“But this is the point: it’s because I love the NHS so much that I want to change it. It needs to change to make it work better today and it needs to change to avoid a crisis tomorrow.”
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Cameron to promise ‘no risks’ in NHS reform – UK Politics, UK – The Independent
David Cameron will today attempt to breathe life back into the Coalition’s faltering plans for the NHS.
In his first major speech on health since the controversial plans were put on hold, he will set out the case for radical reform while insisting that “this Government will never, ever take risks with the NHS”.
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BBC News – Cameron set to stand firm on need for NHS changes
David Cameron will try to rally support for planned changes to the NHS in England, in a speech to health staff.
The prime minister is expected to focus on a need for “deep change”, warning of a “crisis” if proposals are blocked.
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Medical training reforms threaten patient care | GP online
In a speech to the BMA’s Annual Conference of Junior Doctors, Dr Shree Datta, who co-chairs the BMA’s Junior Doctors Committee, said proposals laid out in Liberating the NHS: developing the healthcare workforce ‘threaten the future provision of high quality patient care as anything in the Health Bill itself’.
‘They propose to invent a new system to commission, deliver, and quality-manage training through large-scale, untested, changes to the current system,’ she said.
Dr Datta expressed concerns over the pace in which medical training reforms would be implemented. ‘I am sure many of you remember MTAS,’ she said. ‘Are we really expected to believe that, with an entirely new structure in place, the recruitment process will run smoothly in a year’s time?’
Reforms could spell the end of deaneries, leaving Health Education England in charge of training funds, Dr Datta warned. Employer-led ‘skills networks’ are beginning to appear but ‘no one knows what they are going to do,’ Dr Datta said.
‘Are employers really going to focus on investing in the long term training of doctors when they are being asked to deliver £20bn in efficiency savings?,’ she added
27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.
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dizzy
NHS news review
Only a few NHS news items so far today. Lansley has admitted that all London hospitals will have to transform into foundation trusts. This appears to be counter to Tory “no top-down reorganisation” ‘commitments’. Later 13/5/11 edit: Yes, hardly noteworthy compared to the bill to abolish the NHS being a top-down reorganisation, of course.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
UNISON Calls On Lansley To Hear The Criticism And Drop The Bill, UK
Health Minister Andrew Lansley must do more than listen – he must hear and act on the barrage of criticism and opposition to the Health and Social Care Bill. This is the message from UNISON, the UK’s largest union, representing more than 450,000 health workers, in its response to the NHS ‘Listening Exercise’.
Christina McAnea, UNISON’s Head of Health, said:
“Andrew Lansley seems incapable of actually hearing the outcry from patients, public, staff, health experts, charities, health economists and even from within the coalition government.
“The public do not want a health service where people can buy their way to the top of the NHS queue, or where healthcare is rationed to make profits for private companies and their shareholders. We know that three quarters of bankruptcies in America are because of the high cost of health bills – no one wants the NHS to be dragged in that direction.
“The Government’s plans are riddled with conflicts of interest and undermine the accountability of the NHS to patients and the public. Patients will soon be priced out of care and see services, wards and hospitals lost without any arrangement to continue treatment.
“We believe the bill is too fatally flawed to be amended and should be dropped completely. ”
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BBC News – Andrew Lansley: NHS services in London will change
The government has admitted for the first time that health services on the ground in London will have to change because of NHS reorganisation.
The coalition is turning every hospital in London into a foundation trust, with more control over its own spending.
Health Secretary Andrew Lansley has told BBC London this will inevitably mean changes to the way services are delivered.
A series of hospital mergers is already planned in the city.
Foundation trusts are still within the NHS – but have more freedom to make their own decisions and more freedom over how they spend their money.
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Doctors’ chief uncompromising over NHS reform – politics.co.uk
The government’s promise to pause its bill on NHS reforms for a listening exercise is a mere “political device”, a medical boss has said.
Speaking to politics.co.uk, Hamish Meldrum, chairman of the British Medical Association’s (BMA) council, said David Cameron should withdraw the health and social care bill completely rather than amend the legislation.
“At the risk of using a very abused phrase, I agree with Nick [Clegg] that ‘no bill is better than a bad bill’,” he said. His comments underline the difficulties faced by ministers as they seek to identify areas of compromise.
Extensive negotiations with health secretary Andrew Lansley and senior government officials have seen the BMA united with other health organisations in opposing the bulk of the legislation.
NHS news review
Lansley claims that he is not creating a market despite the private health industry expecting exactly that with healthcare bought privately or through health insurance, staff cuts affecting the standard of service, Lib-Dems demand that Monitor should not only promote competition – note that they are not demanding that it should not promote competition – Baroness Young on difficulties the bill will face in the Lords, UNISON calls for the bill to be dropped due to huge opposition and Dave Gilmour pays for Gary McKinnon’s treatment.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
Coalition ‘is weakening effective government’ – UK Politics, UK – The Independent
The British public’s brief flirtation with coalition government is over. A year after the Liberal Democrat-Conservative administration was formed, voters think it has made government weaker, less decisive, less responsive and more confused.
A study by a Whitehall think tank contains very bad news for Nick Clegg. It suggests he has failed in his mission to convince people that coalitions are a good thing. Even current Liberal Democrat supporters are not persuaded.
Mr Clegg’s fightback after last week’s double defeat at the ballot box suffered a setback last night when David Cameron said the Government’s rethink over its NHS reforms was his idea, not Mr Clegg’s. The Prime Minister told the 1922 Committee of Tory MPs that his party must not “allow the Liberal Democrats to pose as a moderating influence” on it. Mr Cameron said the partnership would put his party in a position where it could go for an outright majority at the next general election.
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Almost three in five people (58 per cent) believe the Liberal Democrats have abandoned their principles by joining the Coalition. Some 61 per cent of people who voted for Mr Clegg’s party last year now support another one. The only crumb of comfort for Mr Clegg is that the public still think his party was right to join forces with the Tories – by a margin of 52 to 43 per cent.
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Pulse – Lansley insists: ‘I have no private sector target’
Health secretary Andrew Lansley has insisted he has no objective to increase private sector involvement in the NHS, as he moved to counter claims that his NHS reforms will pave the way for the privatisation of the health service.
Speaking at the NAPC’s GP-led commissioning conference in London yesterday, a defiant Mr Lansley hit back at the growing army of critics to his health bill by insisting that competition was ‘a means to an end but not an end in itself’.
The beleaguered health secretary has faced a fresh storm of criticism this week from opposition MPs and the profession, with RCGP chair Clare Gerada claiming that implementing it as it stands will cause ‘irreparable damage’ to the core values of the NHS.
In a clear attempt to re-shift the emphasis of the debate away from privatisation, the health secretary argued that competition was a vehicle for improving patient choice, but insisted he had no ideological wish to see more private sector providers.
He said: ‘What is important is for patients to be able to exercise choice. But then they say, “if we have choice, we also have competition, which, if conducted in the wrong way, could fragment those pathways of care that we’re looking for”.’
‘From my point of view, that is never the intention. Competition, [and] the tariff, are means to an end not an end in itself.’
Responding to a question from Nottingham GP Dr Chris Udenze, who asked if Mr Lansley could think of any public health services that haven’t ended up in the hands of multi-national corporations following marketisation, the health secretary insisted he was not creating a market, and had no quota for how much private involvement there should be in the NHS.
Mr Lansley said: ‘I know what a market is, and we are not creating a market. We are creating a public service, where we are using the benefits of competition to deliver that public service.’
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Response: Lansley claims that he is not creating a market. Strange then that private health vultures believe that is exactly what he’s doing and anticipate a huge market for privatised health provision and health insurance on the US model.
HealthInvestor: Top health CEOs reveal fears for short-term
The NHS reforms will lead to “short-term pain” but huge long-term opportunities for independent healthcare providers, according to a survey of 20 leading chief executives in the sector.
Consultants The Parthenon Group interviewed 20 CEOs from the UK’s biggest healthcare companies including Nuffield Health, Barchester, Four Seasons, BMI and HCA.
Around 8/10 of respondents remain positive about NHS reform in the long term, with the government’s Any Qualified Provider (AQP) policy still likely to open up much of the NHS market.
Alistair Stranack, partner at The Parthenon Group’s healthcare practice, said he expects around 50% of the NHS’s £120bn funding will be up for grabs via AQP when the reforms are finally passed.
But continued bias against the private sector and worsening bureaucracy means the value of contracts actually awarded to the sector is unlikely to rise above 5-10% over the next five years, he said.
One CEO, responding to the survey, said “the bureaucratic burdeon of AQP is likely to slow down private sector participation and may prove more cumbersome than existing systems of choice like Choose and Book.”
There would be “some hiatus in the short term” but there was “no doubt we will see growth in the longer term as new areas are opened up to AQP,” another company leader commented.
Speaking at a Parthenon event in London, Nick Bosanquet, health economist at Imperial College, predicted that the current crisis in the NHS’s finances would lead to up to 25% of all healthcare in the UK being self-funded or insurance-based by 2018.
Patient care ‘hit by staff cuts’ – National – Lancaster Guardian
Patient care is suffering due to mounting workloads and staff cuts, according to a poll of nurses and midwives.
Two-thirds have thought of leaving the profession and 75% say the number of patients they are treating has increased in the last year.
Overall, 88% said their workload had gone up in the first year of the coalition Government, and 65% think the increase is undermining patient safety and care.
The poll of more than 2,000 nurses and midwives for Unison also found 61% had seen a reduction in staff numbers in their unit.
This could be through redundancy, staff not being replaced when they retire or leave, and less reliance on temporary staff.
More than 78% of those surveyed said their employer was making staff and budget cuts, with 36% reporting redundancies at their workplace.
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NHS bosses told ‘hands-off’ over heart surgery – Main Section – Yorkshire Post
Parents, patients and surgeons yesterday gave NHS bosses an unequivocal message not to end children’s heart surgery in Leeds.
There was a determined mood, which at times turned combative, as hundreds of people demonstrated their opposition to plans which could see children’s heart surgery axed in Yorkshire.
Families brought toddlers along to the Royal Armouries in Leeds for a protest and two consultation meetings which attracted about 300 people.
Campaigners fear changes to services could spell the end of heart surgery at Leeds Children’s Hospital.
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NHS chiefs pledged the decision over the future of children’s heart surgery is “not a done deal”.
During a stormy public meeting parents angrily accused experts of talking “waffle” as they quizzed them about why the Leeds unit only features in one of out of four possible future set-ups, while Newcastle is in three.
A total of 500 people attended two consultation meetings yesterday at the Royal Armouries where NHS heads involved in the review of children’s heart surgery were questioned.
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NHS reform: Lib Dems demand Monitor climbdown – politics.co.uk
Liberal Democrats fighting the government’s NHS reforms are demanding ministers back down over plans to make the health regulator promote competition.
The controversial health and social care bill places a statutory obligation on Monitor to encourage competition, to the frustration of senior Lib Dems.
politics.co.uk understands Nick Clegg has been presented with the party’s latest demands, as the “pause” over the legislation continues.
At the top of the list is a requirement that Monitor should promote coordination and collaboration among health agencies, as well as competition.
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NHS Direct nurses fight plans to make them work more weekends | News | Nursing Times
Nurses working for NHS Direct have lodged a collective grievance after being told they will have to work more weekends in a bid to improve the organisation’s performance.
About 80, mostly band 6, nurses who work for the triage service on a part time basis are affected by the rota changes, Nursing Times understands.
They will require part time staff to work five weekends out of eight, the same number as full time staff. Currently the number of weekends worked by part time staff is worked out on a pro rata basis.
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Baroness Young: Health Bill will stall in Lords | GP online
The Bill is part of primary legislation, but the government is expected to define much of the detail of consortia roles in supplementary regulations and guidelines. Regulations form part of secondary legislation and are subject to less parliamentary scrutiny. Guidelines are advisory and do not have legal force.
Many peers were unhappy that much of the detail on consortia would not be in the Health Bill as primary legislation, Baroness Young said.
‘Parliament gets quite antsy if the secondary stuff is not available, at least in draft form, before they have to pass the primary stuff, because you are buying a pig in a poke,’ she said. ‘We have to get work started on clarifying exactly what the role of the NHS Commissioning Board will be in holding consortia accountable.’
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UNISON Press | Press Releases Front Page
Health Minister Andrew Lansley must do more than listen – he must hear and act on the barrage of criticism and opposition to the Health and Social Care Bill. This is the message from UNISON, the UK’s largest union, representing more than 450,000 health workers, in its response to the NHS ‘Listening Exercise’.
Christina McAnea, UNISON’s Head of Health, said:
“Andrew Lansley seems incapable of actually hearing the outcry from patients, public, staff, health experts, charities, health economists and even from within the coalition government.
“The public do not want a health service where people can buy their way to the top of the NHS queue, or where healthcare is rationed to make profits for private companies and their shareholders. We know that three quarters of bankruptcies in America are because of the high cost of health bills – no one wants the NHS to be dragged in that direction.
“The Government’s plans are riddled with conflicts of interest and undermine the accountability of the NHS to patients and the public. Patients will soon be priced out of care and see services, wards and hospitals lost without any arrangement to continue treatment.
“We believe the bill is too fatally flawed to be amended and should be dropped completely. “
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Pink Floyd star to pay Gary McKinnon’s medical bills – Telegraph
Mr McKinnon has had regular therapy at a London hospital to deal with his depression and suicidal feelings linked to his fight against extradition to the US.
In February, Haringey Primary Care Trust stopped paying the £240 a month cost of Mr McKinnon’s sessions at a hospital in south London.
David Gilmour, Pink Floyd’s lead guitarist, stepped in and agreed to pick up the bills through royalties from record sales.
Janis Sharp, Mr McKinnon’s mother, who was in London yesterday for a march by disability groups against welfare benefit cuts, said: “David Gilmour has been amazing. He stepped in at a time of crisis when we did not know where to turn.”
No one from Haringey Teaching Primary Care Trust was available to comment last night.
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