NHS news review
- Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Backers of NHS shake-up turn against Andrew Lansley’s plans
Leading doctors voice concerns that reforms will suffocate GPs and jeopardise promised freedom to commission care
Two prominent backers of the coalition’s NHS shake-up have joined the growing chorus of critics by claiming that GPs will be “suffocated rather than liberated” by the planned changes.
Dr Charles Alessi and Dr Michael Dixon have helped Andrew Lansley claim credibility for his plans among doctors over the past 18 months by strongly supporting his radical restructuring. They are leading lights in the NHS Alliance and the National Association of Primary Care, two key pro-reform organisations.
But they now fear that the new consortiums of local doctors, which will start commissioning healthcare for patients in England from next year, will not have the freedom that the health secretary has repeatedly pledged. Lansley has attempted to persuade sceptics that his reorganisation will put family doctors in charge of healthcare.
NHS primary care trusts (PCTs) and strategic health authorities (SHAs) are due to be abolished next year.
But the doctors are worried that the GP-led clinical commissioning groups (CCGs), which will replace PCTs, will find themselves unexpectedly under the control of another organisation, the NHA National Commissioning Board (NCB).
In July the NHS chief executive, Sir David Nicholson, said “CCGs will be the engine of the new system” and that the reformed NHS “gives pride of place to clinical leaders”. But the reality is that primary care doctors and clinical commissioners will not have the promised ability to make key decisions because the current bureaucracy is simply being replaced by another that is growing up around the NCB, the pair claim.
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MP believes Prime Minister is pushing NHS to the brink of collapse
SLOUGH MP Fiona Mactaggart has claimed the Prime Minister is pushing the NHS to the brink of collapse – with patients waiting even longer for their treatments.
The latest data shows that 44 more patients were forced to wait longer than 18 weeks for treatment in the Berkshire East PCT area, between November 2010 and November 2011.
Waiting times are also up nationally with an increase of more than a third in the number of patients waiting more than four-and-a-half months for treatment.
Ms Mactaggart said “The chaos caused by the Health Bill is starting to take its toll. By the time Labour left office, waiting times had fallen to a historic low, but this Government is throwing that legacy away.
“It is hard to get this right and we have had some particular local challenges with our hospital, but we must keep our focus on patient care, and patients who are left to wait are not being cared for.
“If the Prime Minister succeeds in allowing hospitals to fill 49% of hospital beds with private patients, this will get worse.
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Private company Circle was awarded a 10-year contract to run Hinchingbrooke Health Care Trust in November. Last week it unveiled a 16-point plan for turning round the financially troubled Cambridgeshire trust, with a major focus on nursing. The trust is in the red by around £40m.
The widely publicised plan included devoting two thirds of nurses’ time to contact with patients, a culture of “complete transparency” around patient harm, reducing rates of preventable falls and pressure sores to the lowest in the region. Staff will also be subject to “360 degree” performance reviews, with assessments from both their peers and line managers.
In addition, staff will be organised into “clinical units” each run by a nurse, a doctor and a manager. The three will have authority to take all decisions about a patient’s care and have responsibility for their own quality measures and costs.
But RCN director of policy Howard Catton warned that Circle’s “public relations strategy” was placing too much responsibility on nurses for overcoming the hospital’s huge financial challenges.
“Nursing could lead improvements, but it’s beyond nursing’s control to turn around all the cost pressures and [find] a £40m saving,” he told Nursing Times. He said: “What we’ve had this week is nursing and the workforce standing on their own at the front of this PR strategy.”
Mr Catton said the RCN wanted to see the same level of “transparency” expected of nurses placed on the work of Circle’s management team and the returns expected from the company’s shareholders.
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Terminally ill care turmoil as NHS suspends company
THE care of dozens of terminally ill people in South Yorkshire has been thrown into turmoil after NHS chiefs yesterday suspended a contract with a care firm.
More than 30 people and their families, mainly in Rotherham and Sheffield, have been affected by the decision to suspend the services of care provider Abacus.
NHS officials are carrying out an investigation following allegations over patient safety and quality of care, believed to include claims staff have failed to attend home visits or cut them short.
Patients and their families were told only yesterday that the contract was being suspended.
Margaret Kitching, nurse director for the South Yorkshire and Bassetlaw cluster of primary care trusts, said: “An investigation is currently taking place into Abacus following a number of allegations.”
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NHS reforms: the bill that will cost us dear
It is hard to think of a starker failure in domestic government since the poll tax
No one, but no one, thinks that the health and social care bill returning to parliament this week is any good. Nurses and doctors have lined up to denounce it – even GPs, whom the legislation claims to put in charge. Professional resistance can be dismissed as “producer interest”, but not so the joint editorial published by three specialist periodicals, including the Health Service Journal. The journal is generally supportive of exposing medicine to competition, yet it damns the particular market-based reforms on offer as “unnecessary, poorly conceived, badly communicated” and “a dangerous distraction”. Meanwhile, a committee dominated by coalition MPs has just concluded that the current upheaval “complicates” necessary cost-cutting, and displaces “truly effective” reforms.
Even the health secretary cannot any longer really believe in the watered-down product he is saddled with punting. The one hope for the bill which Andrew Lansley had originally articulated intelligibly was removing politics from healthcare. But, after a year of amendments and grudging stand-offs with the Liberal Democrats, he has utterly failed in this – as is underlined by the latest concession, which explicitly reaffirms that he will retain full political responsibility to parliament.
Having foolishly nodded the legislation through in the Commons, the Lib Dems blundered again by failing to kill the bill – as they could have done – when their members and peers revolted. Instead, they settled for fudge. The bill before parliament is littered with warm words such as “integrated”, which mean entirely different things to advocates of planning and cheerleaders for restructured competition. It may well fall to the courts to determine what on earth whole passages mean. And yet – carried along only by the crack of the government whip – this unloved legislation rolls towards the statute book. The strongest remaining argument for passing it is that the hard-to-manage mess of half-disbanded care trusts could descend into uncontrollable chaos if new rules and structures of some sort, however flawed, are not agreed on soon.
Mr Lansley’s great error was to allow the charged words “Tory”, “cuts”, “health” and above all “privatisation” to combine to become the story of the bill. The technocrat imagined that he could quietly impose a new healthcare market, and that England would soon bow to its logic. He not only misread opinion, but also mistook a well-founded concern to restrain medical profiteering for socialistic superstition. Last month the Guardian revealed that millions were being diverted to the likes of KPMG and McKinsey to teach “business skills” to GPs. On Friday, it emerged that a cash-strapped health department was having to stump up £1.5bn to trusts that cannot afford repayments under the PFI – the last great brainwave for getting the private sector involved. Public fear of racketeering is not boneheadedness. The medical marketplace will never be one where consumers (or, as they were once known, patients) can be sovereign – the knowledge gap with “producers” is too great.
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The NHS bill could finish the health service – and David Cameron
NHS reforms: the plans and the results so far
in other news:
Treasury Wrote Off £11bn In Unpaid Tax
Revenue and Customs wrote off almost £11bn in unpaid tax in one year, according to the first joint audit of every government department.
The Treasury was not fully aware of the figure until it appeared in the Whole of Government Accounts (WGA) for 2009 to 2010, according to the Public Accounts Committee.
The PAC said it also had “no knowledge” of whether plans were in place to cut the taxpayer’s huge £15.7bn liability for clinical negligence claims.
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PAC chair Margaret Hodge said the document also “currently falls short of giving a true and fair view of the UK’s financial position”.
“The Treasury has departed from accounting standards by leaving out of the accounts of such bodies as Network Rail and the publicly-owned banks,” the Labour MP said.
“This has led to the accounts being qualified by the Comptroller & Auditor General. We want the Government to provide the necessary information so that these accounts are comprehensive and credible.”
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war of terrorism BS