Wednesday, June 1, 2011

NHS reforms live blog: The Guardian

The Guardian:

12.06pm: We've been scouting the net for the best debates on the net lurking below the radar about the NHS. Here's a selection

Over at the Jobbing Doctor, the eponymous author invites dissent:
We have the worst, most subsidised and poorest co-cordinated system of railways for any similar country. By any stretch of the imagination, Privatisation of the railways has been a disaster. A similar model is contemplated for the NHS. I wonder if my critics would care to comment?
David takes up cudgels to controversially assert
One only has to travel to Birmingham, once the hub of another failed nationalisation experiment - the motor industry - to experience the chronic road congestion in a city with totally inadequate commuter rail facilities. You would do better to compare like for like. The health systems in France, Germany and the Netherlands have never been nationalised. Unlike the USA, the service is free to those who cannot afford insurance premiums, there are no waiting lists, and according to comparative studies health outcomes are better than in the UK.
The Cockroach Catcher, who is a retired consultant child psychiatrist, asks about how doctors working in the South African private healthcare company Netcare, the owners of Britain's General Healthcare Group, fare
In theory, the buck stops with the doctor doing the cutting, but in reality, the transplant surgeons were little more than skilled mechanics dealing with bodies on an assembly line, maintained, paid for and legally underwritten by the big healthcare factory that is the Netcare Group.                                    

DrGrumble meanwhile has trawled - impressively - the current health bill before parliament and the previous one under which the NHS runs. In a post entitled "the devastating power of words" the medic says

Previously the Secretary of State had to "provide or secure the provision of services" he now only has to "promote a comprehensive health service". Please forgive Dr Grumble if he has got this wrong. Grumble has no legal training. The law is perplexing but Grumble can read and it looks very much as if Lansley is largely washing his hands of any responsibility for having to provide healthcare to us all. This is a momentous change. It is one that those of us who do not have the time to trawl through the legal gobbledegook may have missed. These words are crucial. For the NHS they are devastating.
Randeep Ramesh and Rowenna Davis Tuesday 24 May 2011

10.55am: Time for a quick recap of the blogosphere:

• Dr Jest in a long post jovially explains what lies behind the current tensions between consultants and GPs and how this might affect relations in the future. Basically primary care trusts are choosing to fund services out in the community by firms like Assura, which are owned by GPs. Is this not a conflict of interest asks the consultant? Dr Jest answers
One of the consequences of these new arrangements in our locality has been an increase speed of access to specialist opinions for patients who would otherwise have had to pay personally to see a consultant privately. Under these arrangements the PCT is paying the franchise and the patient is seen as an NHS patient. I wonder if this has some bearing on my friends' consultant's concerns over conflict of interest?
• The Cockroach Catcher, who practised NHS child psychiatry for three decades, celebrates the culture of the world renowned not-for-profit medical practice and medical research group the Mayo Clinic

You may have heard that at Mayo, doctors collaborate. But did you know that after their first five years all physicians within a single department are paid the same salary? During those first years, physicians receive "step raises" each year. After that, they top out ,and he or she is paid just the same as someone who is internationally known and has been there for thirty years    
• Alex Deane at Big Brother Watch 
with a shouty post about the state nannying people to lose weight.

Of course, doctors have never seen a cash cow they've turned down. Under this plan, they will boost their income by giving "weight management advice" to obese patients, or offer them a free place on a diet club, which the NHS (AKA you and I) would pay for. I'm not arguing that obesity is good. I'm just pointing out that it's not the state's role to nanny us about it, or to force some of us to pay for others to receive diet club memberships - or, worse, force us to pay for quacks to spout the bleeding obviuos.

10.52am: A quick tour of the blogosphere reveals
The Grim Reaper targets the Lib Dem leader's flip flopping over the reforms:
Now, Nick is trying to claim that he doesn't actually agree with many of the reforms proposed. He wants to make changes to the bill, the one he used to agree with, to make it into whatever he agrees with for the next five minutes... It appears that Nick is trying to use the same strategy as he did over the issue of tuition fees.Over this issue, he signed a white paper and was probably photographed doing it. He's now claiming the reforms aren't needed, but that something else is needed. He's going back on his word - again.
However the Jobbing Doctor is more upbeat about the deputy prime minister's intervention

So we have had Nick Clegg intervening and sending the new NHS White Paper away for reconsideration by MPs. Two cheers for this.

Am Ang Zhang, who blogs at the Cockroach Catcher after three decades of NHS child psychiatry, posts about the heady years of Tory fund holding - which GP commissioning is a descendent of:
It was an interesting time during the brief few years of Fund Holding (FH). The idea that money should play no part in who gets seen was thrown out of the window. My hospital consultant colleagues all knew that preference will be given to referrals from Fund Holding practices. It was about survival. Less urgent cases would be seen if they come from FH practices.                                                                       

Dr Zorro, a hospital consultant, says he is rather glad that GPs don't want him on their consortia boards - in defiance of the PM and the DPM.
I recently posted expressing my despair that the government had suggested that hospital consultants should be involved in the commissioning process. It looks as if I have nothing to worry about. The GP consortia don't want to play with us. I think it is just as well.

2.16pm: Here's a quick afternoon news round up:
•The Cockroach Catcher says that NHS reformers always highlight US company Kaiser Permanente as an example to emulate. Why? It's just "like the old days of Regional Health Authorities!!!"

•And on Liberal Conspiracy Sunny Hundal has another pop at the shadow health minister John Healey for not doing more on the NHS, joining Michael Meacher's criticisms referenced earlier.

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