NHS & Spring: A New Game!

Hospital Avoidance

Only the view of flowers will be free!  Or at least of my photos:

©2012 Am Ang Zhang

©2012 Am Ang Zhang

©2012Am Ang Zhang 

A new game will start: Hospital Avoidance!!!

In a few days rationing of health care will start. 

The part of Health Care  delivered by Hospital Consultants will be severely rationed. Many so called Foundation Trust Hospitals would be in severe financial difficulties as the new CCGs will be rationing Hospital based work from A & E to Stent procedures so that the FT Hospitals will be forced to make money from private work and mainly from overseas as most citizens are still paying for the collapse of the likes of RBS, Northern Rock & HBOS.


Just look at A & E, Urgent Care Centres are set up by the new CCGs to avoid paying hospitals and if you use OOH or A & E too often, you might by removed from their list. There will be other life style excuses to exclude even Type 2 Diabetes.


Waiting time may once again be used as an excuse for rationing and this may be because of the 49% private work load. Who knows, would many consultant still be with the State side of NHS? My dentist went totally private years ago and never looked back. Do we really have such short memories?


If you do not believe the plot, the tactics are already in place to separate Primary and Secondary Health Care: 


Care pathways
Case management
Demand management
Productivity
Clinical and financial alignment
Risk stratification
Inappropriate referrals
Referral protocols 
Rules-based medicine
Referral management systems 
Admission avoidance

Doctors will not be involved to avoid problems with the GMC!!!

Insulting terms, like "frequent flyers", are being used to describe people who are sick and need our care and attention. The problem now is that they may have to keep flying as there is no where to land.

I have written about this earlier:

Is it really that difficult to grasp!

Most people in well paid jobs (including those at the GMC) have health insurance. GPs have traditionally been gatekeepers and asked for specialist help when needed. If we are honest about private insurance it is not about Primary Care, that most of us have quick access to; it is about Specialist Care, from IVF to Caesarian Section ( and there are no Nurse Specialists doing that yet), from Appendectomy to Colonic Cancer treatment (and Bare Foot doctors in the Mao era cannot do the latter either), from keyhole knee work for Cricketers to full hip-replacements, from Stents to Heart Transplants, from Anorexia Nervosa to Schizophrenia, from Trigeminal Neuralgia to Multifocal Glioma, from prostate cancer to kidney transplant and I could go on and on. China realised in 1986 you need well trained Specialists to do those. We do not seem to learn from the mistakes of others.

When there are not enough specialists to go round in any country money is used to ration care.

So we are going to but in a peculiar manner as NHS hospitals used to be state run and free. Reform is needed!!! Enter GP commissioning. If it is your GP doing the rationing it is no longer the State's problem.

Some very clever people indeed are working for the government. 

It is becoming clear that with your right to choose your GP, GPs have the right to reject you. You may find that if you have a condition that requires expensive care and medication, some excuse will be found to reject you. 

Culling will be the new game especially CCGs run on the advice of the likes of major management consultants including McKinsey.

Business will be business and the doctors will be protected. 
Is it Conspiracy or Cockup? You decide.

But strangely they thought there is still money to be made.

                                                                               This Post first appeared last Spring.