Saturday, April 3, 2010

New Zealand, Wales & England: NHS

“Do not adjust your TV, there is a fault in the broadcast” was an approach my Guru taught me about some of the symptoms psychiatric patients think they might have. Just as Dr House thought in one of the recent episodes that he might be hearing voices. (Yes, The Cockroach Catcher watches House M.D., the best antidote to top heavy management).

In Hooray for the Health Committee, Dr Grumble was worried:

“At times it seems that nobody else is aware of these home truths about our health service to the extent that, just occasionally, Dr Grumble begins to just wonder if it might be him that is mad and not the rest of the world.”

©2010 Am Ang Zhang

Following his suggestion I read: House of Commons Health Committee Fourth Report of Session 2009–10:

“The most radical option would be to abolish the purchaser-provider split, as Wales and New Zealand have. The BMA argued that the split between purchaser and provider had been expensive, inhibited clinician involvement in planning services, and fostered a system which is dominated by cost containment by PCTs and income generation by providers.”

New Zealand? Where is it? Was it part of the original NHS?
Should I like Dr House check into an asylum?

On Darzi:

However, the Committee received evidence of concerns. Professors Bloor and Maynard have argued that it is not yet clear whether incentive schemes will result in improved patient outcomes and justify the cost of implementing them. Evidence for US incentive schemes is weak and the impact of the new scheme in the English NHS is not predictable:

Experience from the US suggests that a balance needs to be struck between the motivational effects of potential penalties and the possible costs of destabilizing organisations. In addition, if penalties are a real possibility and are on occasion levied, their motivational effects are likely to be short lived.

Is Pavlov still alive? Who are these MPs?

                                                               3  Key issues

Current provision of healthcare is the responsibility of 14 geographically-based local NHS Boards and a number of National Special Health Boards. In April 2004 the NHS became an integrated service under the management of NHS Boards.

NHS Wales
  • Abolishing the internal market in Wales by providing funding from the Welsh Assembly Government or an NHS Board for Wales directly to NHS Trusts and Local Health Boards (LHBs);
  • Three options for establishing a Board for Wales - a Special Health Authority, a Civil Service Board, or an Advisory Board supporting an Assembly Government NHS Chief Executive; and,
  • LHBs reduced from 22 to eight, including Powys LHB. Health of Wales NHS Reconfiguration
FT: they know about money!
Having a purchaser-provider split, rather than more integration between health authorities and hospitals, involved a degree of tension between commissioners and providers, the committee said. But at present the NHS in England might “have the disadvantages of an adversarial system without as yet seeing many benefits”.

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