Tuesday, March 5, 2013

Saving NHS (England): Use a Pencil!

Remove competition, ban AQPs.......

Sometimes in life the solution to a big problem could be so simple.

Remember the very old Urban Myth about NASA spending millions on developing a zero gravity pen:

The Myth did get into one episode of The West Wing: We Killed Yamamoto

      Leo: We spent millions of dollars developing a pen for the astronauts that    would work in zero gravity. Know what the Russians did?

      Toby: Used a pencil?

      Leo: They used a pencil.

Well it was not exactly true but it illustrated a very important point: solutions could sometimes be very simple and cheap.
Now most readers know that I love snorkeling and when I started my wife on it she, being a scientist, wanted to know the names of things she saw whilst snorkeling. The West Wing came to mind.

We used a polypropylene chopping board (the smaller one), drill a hole in the corner to tie a strap so that the hand could sometimes be free to operate the camera. We then use a golf pencil tied to the board with a fishing line to write.

Blue Brittle Star ©Am Ang Zhang 2010

So what about The NHS:  A pencil solution?

Just copy Scotland; that “country” north of the border.

As much of the opposition to the new Bill is to do with the simple fact that it was a back handed way to privatise a major part of the NHS, the profitable part. Ordinary citizens without insurance will be left with a much depleted hospital service and those with insurance may find that over time they too might be dumped by their Private Health Insurers.

The Herald
25 Feb 2009
Radical new legislation stopping private companies from running GP surgeries in Scotland is to be unveiled by ministers - further widening the divide between how the health service is run north and south of the border.

Explaining the purpose of the new legislation, which won near "unanimous" support from Scottish doctors during a recent consultation, Ms Sturgeon told The Herald: "We have decided to go ahead and legislate to effectively remove the possibility of commercial companies running GP practices.

"We want people providing GP services to be committed to the NHS and not to see it as a way of making a profit. I would hope that we would get considerable support for the bill from opposition MSPs."

The legislation, which ministers also expect to garner cross-party support, was sparked by concerns over a legal loophole which could allow into Scotland the kind of "creeping" privatisation of the NHS which is supported by the UK Government south of the border.

Trust in the government will return. There will not be any privatisation of primary or secondary care and that it would not go the way of the dental services.

Then those of us who could not afford private health care might be able to accept genuine and well thought out changes to the way the NHS will be run.

No more internal market, no more cherry picking and back to an integrated service.

By the way why not use the Scottish model that has now survived 10 years.

Nottingham UniversityNHS Scotland a role model for reform

After devolution the NHS in England increased its reliance on a market-based approach – now one of the various controversies surrounding its future direction.

By contrast, NHS Scotland set about developing partnership agreements at national and board level as part of a strategy to engage staff in improving services.

The result, according to a study funded by the Economic and Social Research Council, is an “incredible common agenda” among interested parties from all quarters.

Research co-author Dr Peter Samuel said: “Although partnerships are found elsewhere in the public sector, NHS Scotland’s stands out as distinct and novel. It has survived for over a decade, defying reorganisation and changes in administrations, and it can offer valuable lessons in how to improve industrial relations.

………Dr Samuel said: “The policymakers of NHS Scotland clearly concluded the only way to deliver better healthcare was to improve the way staff were engaged. This led to the establishment of various structures at national and local levels to give staff more say in decisions affecting their working lives and healthcare provision.

“NHS Scotland has even passed into law a ‘staff governance code’ that compels all its health boards to engage and involve staff and their representatives.

“This innovation in industrial relations is arguably one of the biggest examples of industrial democracy to be found anywhere in the world – and they have made it work.”

Privatisation of utilities & public transports leads to increase cost to users and high profits to privateers.

The Herald:

Cate Devine severed her left index finger last December and  after an intensive three-hour operation to re-attach it, plus several weeks of healing time, she felt compelled to talk about it non-stop.
No matter how carefully we look after our own health, the sad fact of life is that accidents will happen, violence will be visited on the innocent, and illness or disease will defy even the most rigorous diet and exercise routine. And when there's an emergency to deal with, Scotland's NHS unflinchingly steps up to the plate.

8 Hospital Departments:
My finger has required treatment at two different hospitals and has involved the emergency, orthopaedic, surgical, anaesthetic, radiographic, orthotic, outpatient and physiotherapy departments. Yet what has struck me is a tangible sense of unity and cohesion. On all levels, the practitioners I've been fortunate enough to encounter know each other by their first names and my meticulously updated case notes have always been presented on time - and my GP was fully up to speed within hours.

Now, imagine internal market and complex cross charging in the new English NHS or worst having to be referred back to your GP to be re-referred? She was lucky to be living in Scotland.
While I do agree we all need to take more responsibility for our own general health, I'd argue that achieving this is not the NHS's core remit. For all the patients who present with problems associated with conditions such as obesity, Type 2 diabetes, drug and alcohol abuse (many of whom seem to treat the their own health, and the NHS, with a perversely casual disdain), there must be as many again who find themselves forced to swallow their pride, ask for help and – even after a lifetime of payslip deductions to help fund it – are hugely grateful when it comes.

Hang on, the jury is out still on diabetes, could a pre-diabetic because of sensitivity to hypoglycaemia inadvertently ate to combat the low sugar leads to obesity? What about the 30% of Chinese that are low weight or normal weight? 

I shudder to think what might have happened were the NHS to be privatised, as critics fear will be the case in England. Health Secretary Andrew Lansley's Health and Social Care Bill, in for a bumpy ride as it goes through the report stage in the House of Lords this week, makes priorities of the promotion of market forces and competition in the English NHS. The proposals seem predicated on Tory shibboleths and, if implemented, would greatly damage the ethos of the health service.

Should we all move to Scotland?
The truly democratic nature of our NHS is what makes it truly remarkable. In our hour of need we are all equal in its eyes. And that is the mark of a dignified nation.

Some words from the heart!

07 Mar 11
The health service in Scotland remains united, sees patient care as central and rejects a market vision.

It has been said to me, and it was meant as more of an insult than as praise, that Scotland remains a basically socialist country. I take that as a compliment, as I read it as saying that we care what happens to our folk, and don’t think about money first.

……….. We need to get back to using clinically relevant measures of performance that tell us how we are doing in comparison with our peers.

This has been repeatedly shown to be one of the most potent ways of modifying GP behaviour, and we should go back to it as a way of influencing clinical practice.

Scotland has no real truck with private medicine; APMS (Alternative Provider Medical Services) is not allowed. There is no market in healthcare as health boards keep primary and secondary care working together, and we actually speak to each other. Some of my best friends are consultants.

………… that trusting us to do our job is more effective than micromanagement.

English prescription charge to go up to £7.85. (Already free in Wales and Northern Ireland.)

Scotland: Serco NOT allowed to run GP practice

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