Monday, July 25, 2011

NHS: Reform by stealth

Why wait for Parliament or the Lords:




The government will open up more than £1bn of NHS services to competition from private companies and charities, the health secretary announced on Tuesday, raising fears it will lead to the privatisation of the health service.
In the first wave, beginning in April, eight NHS areas – including musculoskeletal services for back pain, adult hearing services in the community, wheelchair services for children, and primary care psychological therapies for adults – will be open for "competition on quality not price". If successful, the "any qualified provider" policy would from 2013 see non-NHS bodies allowed to deliver more complicated clinical services in maternity and "home chemotherapy".
Andrew Lansley – admitting that the government's initial plans for competition in the NHS were too ambitious, and stung by criticism from Steve Field, the senior doctor called in by David Cameron to review the reforms, that the proposals were "unworkable" – has slowed down the rollout of competition. The health secretary said his plans would now "enable patients to choose [providers] … where this will lead to better care".


The Telegraph did not mince its words:



You might think that historians will record last Tuesday as the day the Murdoch empire was brought to book by MPs. Yet I suspect that in years to come, they will realise the significance of that day, not for the phone-hacking scandal but for the health service.

While the nation’s attention was focused on the most powerful man in the media attempting to dodge questions and cream pies, this was a good day to bury bad news. And the Department of Health duly obliged.

Andrew Lansley explained that from April next year, eight NHS services worth £1billion, including musculoskeletal services for back pain, wheelchair services for children and adult community psychological therapies, will be opened up to competitive bids from the private sector.

This means that in these areas, the NHS will no longer exist. Sure, the logo will still be there, but the NHS will no longer be national, any more than British Telecom is.

There is no doubt that this signals the first wave of privatising the NHS. Yet MPs of all persuasions continue to be deluded.

From:

Saturday, June 25, 2011


NHS Reform & Listening: Really!

Some of us might have been lured into thinking that they have listened. Do we have to wait for the Lords?


                                                                                                                            © Am Ang Zhang 2011


Not all of us though:



It has become very clear that on close inspection of the Government’s response to the NHS Future Forum report, the key changes that the BMA and other organisations like the RCGP have asked for have not been met:

1. That the Secretary of State should retain responsibility for ensuring provision of a comprehensive health service.

2. That Monitor’s primary role to promote competition should be removed.

3. Reducing the role of ‘Any Willing/Qualified Provider’

Thus, it is clear that the NHS will be subjected to increasing market competition and private provision and commissioning of services, which will undermine the founding principles of the NHS and drive it towards a mixed system of funding. 

Assets Stripping
In addition, the work of Lucy Reynolds from the London School of Hygiene and Tropical Medicine published in the BMJ last week also described how the bill could allow private companies to strip NHS assets “leading to more a expensive system that will deliver worse quality of care”. 

We therefore totally reject the repeated claims of the Coalition leaders that their reforms will deliver greater NHS efficiency and that there will be “no NHS privatisation”.


In conclusion, the simple fact is that the Government’s proposed changes to the bill are mainly cosmetic in nature. There are no ‘significant’ policy changes that will alter the general direction of travel of the reforms and we believe the proposals will actually create even more problems for the NHS by increasing the tiers of bureaucracy. It is at this point that we would remind Mr Clegg that “no bill is better than a bad bill”. He would also do well to listen to views of his fellow liberal Democrat colleague, Dr Evan Harris, who dismissed the NHS Future Forum’s paper on Choice and Competition as “clich√©-ridden, trite nonsense” at the Social Liberal Forum last weekend.

Integration indeed!!!

It must be hard to believe that with the numbers of highly paid management consultants working for the government that any apparent oversight is due to cock-up rather than conspiracy. Yet reading through the Select Committee reports one begins to wonder.

Could it be that for too long, accountants dominated the NHS reforms and somehow nobody took any notice of what the doctors are saying anymore?

On the other hand, could the need to pass health care provision to private providers before anybody could raise enough objections be the reason or was it simply a means to contain cost and let the patients blame their GPs?


The Internal Market:
There is no better illustration to the wasteful exercise then in all of this internal market and cross charging during recent years and one must be forgiven for concluding that the purpose was to allow private involvement in our National Health Service.

We must be forgiven for not believing that all these AWPs are not great philanthropists and are all there not for the profit but for the common good.

So even if those politicians in power today are not planning on moving into Private Health Care soon enough, the citizens do have a right to know why. In a strange way, it is easier to understand it if it were a conspiracy.


For us, it is our money, our health and our right too.

Until, now Consultants are to be excluded from the consortia. Most are not making too much noise for a very good reason.

There just are not enough of us Consultants and the reform is really COVERT rationing by any other name.

How else could the government continue to claim that competition will improve standard and bring down cost.

Private or NHS, they are the same Surgeons, Anesthetists and  Physicians. Yes, the same consultants. Only in Private Hospitals you may get free cappuccinos.
It is so simple: Private Providers need to make a profit so there is going to be less money for patient care, not more.            


Mark Porter: Chairman of the British Medical Association's consultants committee.



NHS services in some parts of England could be "destabilised" by private firms taking advantage ……….to win contracts for patients with easy-to-treat conditions. This could lead to some hospitals no longer offering a full range of services and ultimately having to close.

The worst-hit patients would include those with chronic diseases such as obesity, diabetes and heart failure, Porter added. They would have to travel longer distances for treatment.

The government is taking unnecessary risks by imposing market measures on the NHS, as competitive healthcare cannot deliver high quality treatment to everyone.

The NHS could become "a provider of last resort" for patients whose illnesses are of no interest to private firms, added Porter. Once independent providers have signed contracts with the consortiums of GPs they could deny care to patients who would be costly to treat, Porter warned.


Lord Owen:

Health is not just a commodity to be bought and sold in the market. It is not a utility in which everyone should be treated as if they are commodity managers. We must understand that and the fundamental issues which are being challenged by this Bill. 

NHS-Kaiser Permanente: Integration?



NHS: The Way We Were! Free!
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Email: cockroachcatcher (at) gmail (dot) com.

2 comments:

HyperCRYPTICal said...

Very worrying stuff Am Ang - yet not a surprise.

What to do?

Cockroach Catcher said...

Looks like the fastest way to derail is by the Lib Dems. But would they do it? There is no half measure and the BMA's latest approach may well be too late. The lure of more money for individual doctors is just too much.

Thanks for the mention on Twitter.