Monday, February 7, 2011

NHS 2011: Have the cake!


For Brutus is an honourable man;
So are they all, all honourable men—

Julius Caesar Act 3. Scene II

Regardless of what the Telegraph said about the wife of the Health Secretary, we have to; for our own sanity believe that he is honourable.

Perhaps he is honourable and smart as at one stroke he has more or less dealt with hospitals and the costly consultants in one simple act.

Let the GPs have the cake!

Private Health Care providers all knew the value of specialists. (These specialists have been known as hospital consultants in England and the rest of the U.K.).

Now that the GPs (in the form of consortia) are going to be given 80% of the total NHS budget, the government has more or less set up a NHS that has a limited liability.

NHS plc.

I was not the first to coin the term.              Here>>>>

Why are hospitals and the consultants not kicking up a fuss?

A few are, but very few.

This is where the brilliance of the Health Secretary came in useful.

Hospitals and Consultants were hardly mentioned in the White Paper.      Here>>>>

An oversight? Hardly!

Every Private Health Provider knew that secondary care is where the money is. Primary care has never featured in Health Insurance schemes. It has always been secondary care.

So why only about GP consortia.

For many doctors (I used this term to cover all doctors) we for too long have been treated like zombies, fools and worst: banana grabbing monkeys. Targets, targets and more targets.

Anything to get rid of the current management system must seem good.

So our honourable and smart Health Secretary did the clever thing.

Let them have the cake. But that is it.


How will this happen?
Trusts will need to ensure that they are in an appropriate financial position to become a Foundation Trust and that in conjunction with the Strategic Health
Authority they have established credible plans. If not, the possibility of merging or acquisition by another Foundation Trust will be considered. Legislation is to be changed to facilitate mergers and acquisitions and the Secretary of State may apply the trust administration regime introduced by the Health Act 2009 where an NHS Trust is financially unsustainable.

This is where the Private Providers are hovering around FT hospitals. They have to answer to their share holders.

Who knows, in some prime hospital sites in big cities, there may well be real estate opportunities. Remember the old mental hospitals?


The White Paper proposes a move to local negotiations on pay and terms and conditions
The Government wants local healthcare employers to take the lead on determining pay for their staff, as is currently the case in Foundation Trusts. In addition, plans are set out to place responsibility with individual employers for leading negotiations on new employment contracts.
The BMA’s Consultants Committee believes that national contracts and terms and conditions of service ensure consistency in quality across the UK and protect against poor working conditions. We will be vigorously defending these and offering greater support to LNCs and regional structures.

We advise you to make sure your Medical Staff Committee (MSC) and Local Negotiating Committee (LNC) is active and get involved yourself if you
can. Any new posts you are involved in developing should remain based upon model national contracts.

But who cares when Consultant income would go up at least 300% when private companies take over.

There could be a shift toward more private work
It is proposed that the cap on private income be abolished.

We have concerns that this may provide an incentive for Foundation Trusts to undertake a greater amount of non-NHS work at the expense of NHS provision.
We advise that you should make sure that you are aware of the regulations on conflict of interest for NHS consultants

That was why there was no need to talk about hospitals and consultants. They will no longer be the government’s problem. Not even their pension.

We need smarter GPs to see through all of these. GPs will be the gatekeeper and they will be blamed. By then it will be too late and Hospitals and their Consultants will be in private hands.

Just say “no”!

No! No! No!



From the Book by Allyson Pollock: NHS plc
The NHS is being dismantled and privatised. Very soon every part of it will have been ‘unbundled' and commodified...a new business dynamic is taking charge of the ways in which services are provided and patients are responded to. The dramatic costs involved - in terms of loss of equal access and universal standards, as well as of money - are concealed by claims of ‘commercial confidentiality' and by tearing up the once-exemplary systems of NHS accounting


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