Showing posts with label Bevan. Show all posts
Showing posts with label Bevan. Show all posts

Friday, January 9, 2015

Bells toll for Greece or Circle?


Detailing examples of “poor care provided to patients”, it said patients who lacked the capacity to consent had been sedated on medical wards, despite no “best interest decision” about their treatment having been taken. “The use of sedation without best interest decisions in place can be classified as restraint or a deprivation of liberty safeguarding concern,” said the letter sent to the hospital chief executive, Hisham Abdel-Rahman.
Inspectors who visited between 15 and 18 September also encountered examples of staff caring for patients in an “undignified and emotionally abusive manner”.
Standards of handwashing among staff in the A&E department and some wards were “very variable”, the letter said. It cited “an incident whereby staff failed to follow handwashing guidance after seeing to a patient isolated for C difficile”.
Blatant?                                                                      Guardian


Hunt is likely to face pressure in parliament next week after the damning CQC report. It said that some children arriving at A&E were left “potentially unsafe” at times because of a lack of specially-trained paediatric nurses both there and in some operating theatres, while patients told inspectors of a poor response from nurses if they rang their bells, especially at night. Drinks were found to have been left out of reach of patients, even after inspectors had pointed that out.
“Our inspection at Hinchingbrooke Health Care NHS Trust highlighted a number of serious concerns, surrounding staffing and risks to patient safety, particularly in the A&E department and medical care. There were substantial and frequent staff shortages in the A&E department”, said Prof Sir Mike Richards, the CQC’s chief inspector of hospitals. Other failings related to the way the trust was run and led, he added. For example, “both the Circle management team and the trust board told us that the other was responsible for holding the trust’s executive team to account”, the CQC said.

Bribery?

: Exclusive: Hinchingbrooke backtracks on controversial £50 referrals offer
Hinchingbrooke hospital will be placed into special measures after a report by the Care Quality Commission (CQC) revealed a catalogue of serious failings at the privately run hospital, including in its A&E unit, which put patients in danger and delayed their pain relief.
Circle, the private company in charge of Hinchingbrooke, told the London Stock Exchange earlier that the CQC’s report was one of the reasons it was pulling out of running the hospital.
The CQC was scathing about the hospital, rating it as “inadequate” overall, and specifically for patient safety, displaying caring towards patients, and leadership.                                             


Are the bells tolling for Greece or the NHS?©2011 Am An Zhang

Most of us do not realise how brilliant those people that have worked at Goldman Sachs are: 
Antigone managed to help Greece "relocate" their debt before they entered the EU. In the business world, Antigone or Addy was highly regarded:


"A defiant Goldman Sachs says it did nothing wrong by concocting a deal that temporarily masked Greece's bloated government debt, an arrangement that has sparked outrage across Europe."

Now Ali Parsa is from the same Goldman Sachs stock and he is either altruistic or very smart & has done the unthinkable of "buying" a failing NHS hospital. "Buying" is perhaps wrong as he is smart and will not do anything like that. There were little if any detail about the deal but knowing someone with a Goldman background, the government would not be a match at all as far as the contract goes. But then the government was not that good with ISTC or PFIs. 

For Hinchingbrooks to succeed it must do more cases and yet CCGs are suppose to cut referrals to hospitals. Ali Parsa must know that and my assumption is that it will not happen with Hinchinbrooks. Being private means we the public cannot access the details of the deal.

Another smart move then.

But perhaps they too were smart as it is one means for the ruling class to secure their future and ration health care at the same time. Sorry---getting GPs to ration Health Care

After all Greece still has more Porsche per capita if you must know and most of their rulers' money are safe in Switzerland.


To say the Circle is the John Lewis of Health Care is indeed a blatant insult to that much loved high street store. John Lewis had no Cayman connection and Circle is not fully 100% employee co-owned.



But Circle is really a first step by our government to COVERTLY ration HEALTH CARE. Canada is doing it using waiting time and so are many western and indeed eastern countries. 

The distraction of the current NHS Reform is to allow the debate to be focused on Primary Care.

That has now changed thanks to Circle. 

Please everybody it is about Consultants & Secondary CARE!!!

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 the NHS 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.

According to the NAO:

In 2009 the total value of the market for PH(Private Healthcare) in the UK was estimated at just over £5.8 billion. Private hospitals and clinics account for the largest part of the overall PH market, generating an estimated £3.75 billion in revenue during 2009. Fees to surgeons, anaesthetists and physicians generated an estimated £1.6 billion in 2009.


The total number of UK citizens with Private Insurance is estimated to be around 90,000. It is not difficult to work out what good value the NHS has always been.


The NHS was not perfect, far from it and yet successive attempts at fixing it has produce the opposite effect: it needs more fixing.


If you read that line again from the NAO report, it was clear where the problem was: fees to surgeons, anaesthetists and physicians!!!


Yes, that was the main recipient of Private Health income.


To become a Consultant in the NHS used to be prestigious and even those aiming to doing mainly private work will have to wait till they achieve Consultant status in the NHS.


The NHS for all its sins tried to keep every consultant as close to the MAYO ideal by insisting on the same pay-scale.


Several levels of Distinction Awards were used to keep some professors and top consultants happy. Later the name of the Awards was changed and yet it was still the same soup.

If Consultants were prepared to give up one session of pay, then there is no limit as to the private work they can take on. It was a safe way to start your private work and you keep the rather nice NHS pension.

                                                         

What is generally not talked about is that you keep one foot in your NHS hospital and one in your private one.


So far so good and yet this is where the problem starts.


It does not need a genius to work out that people worry about their health and do not want to wait for a suspicious lump to stay in their body too long. They will pay. We need not even mention the manipulation of waiting lists, etc. Then big companies realise that they can attract staff by offering Health Insurance and the rest is as they say history.


Then the rules changed and every consultant can do a maximum of 10% of their NHS pay in private work without having to give up anything. Some hospitals even allow you to use their facilities for a small fee.


Why not, more private patient means less expenditure for the NHS.


Private Insurers discovered that too and they started offering a small fee if you can wait for your operation at your free NHS hospital.


There has never been any control of Health Insurers and I suspect if was not even because they have a strong lobby: just the feeling that the NHS was for everybody so no one could be excluded.


But Health Insurers are cleverer, they exclude chronic conditions, many psychiatric ones belong to that group and often they will exclude after a while.


So, indeed it was a clever move by the present government to simply hand over a portion of money to the GPs and say: get on with it, the best price or better still, why not treat them yourself. You are all doctors, forgetting one of their own just had neurosurgery done at Queen Square.


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.




"Like blood, health care is too precious, 

intimate and corruptible to entrust 

to the market"







NHS & Market Forces: Fund Holding & Medical Ethics

Tuesday, July 15, 2014

NHS & Bevan's Curse: What about Andrew?


“But what about McKinsey & Company, now that it has provoked the ghost of Nye, founder of the NHS and the swashbuckling Churchill of the left?

I envisage an outbreak of hospital-inquired infection sweeping through its 94 offices in 52 countries, a mysterious fire gutting its London HQ in Jermyn Street, its senior executives caught in compromising positions with choirboys and bankers.”

The Jobbing DoctorIt's begun.......

The ultimate corporate firm McKinsey (for whom the Foreign Secretary used to work) is now getting its management teeth into the NHS.

The curse extends to anyone that has worked at McKinsey too!

Really?

Wow! William Hague then!
Nah, no way, this is the 21st Century.

But hang on:

It took care of Daniel Hannan  & Sarah Palin.

Looks like one of their most famous sons is now in trouble:


On Wednesday, a federal grand jury in Manhattan charged Mr. Gupta, 62, with one count of conspiracy to commit securities fraud and five counts of securities fraud. He is accused of sharing corporate secrets about Goldman and Procter & Gamble with Raj Rajaratnam, the co-founder of the Galleon Group who was sentenced to 11 years in prison earlier this month for insider trading.

…….The government has taken aggressive action against insider trading. In the last two years, the government has charged 56 people with swapping illegal tips, including Mr. Gupta; of those, 51 have pleaded guilty or have been convicted.

With Mr. Gupta, the campaign has moved beyond financial professionals. As the head of McKinsey & Company, the prominent consulting firm, Mr. Gupta advised some of the world’s most influential people, rubbing elbows with the chief executive of General Electric, Jeffrey R. Immelt, and the former President Bill Clinton.




"The NHS will last as long as there are folk left with the faith to fight for it"
Aneurin Bevan



What about Andrew?


Former health secretary Andrew Lansley has been removed from Government in the Coalition reshuffle, with William Hague moving into his position as leader of the House of Commons.
During his term as health secretary Lansley was responsible for the Health and Social Care Act, which abolished PCTs and replaced them with GP-led clinical commissioning groups.
In June 2012 the BMA voted for Mr Lansley to resign, and he was replaced as health secretary by Jeremy Hunt soon after and moved to be leader of the Commons.
The South Cambridgeshire MP’s new role had not been confirmed at time of publication

First published January 11, 2012.

Get in close© 2009 Am Ang Zhang
“Up close and personal” those words of my first guru still ring true when he told me that to understand my patients or their parents it was what I needed to do.

It would seem to be politically incorrect in many ways but as we need to understand our politicians, my guru may well be right.

It looks as if the genius is way on its way to achieve what Bevan has closely protected with his curse for years: Our NHS or was it his NHS.

GPs will be given a sum of money and the rest will be up to them.

Hospitals may or may not fail, but it no longer matter as 49% will be ‘doing’ private patients. For all that matter, it could become wholly private or partly private. Hospital Consultants will be happy with the better income from private patients.

But why is he doing this? This is when we get “up close and personal”!

The Observer: Andrew Lansley
The answer, or at least a large part of it, can be traced back 19 years to the summer of 1992. Lansley, then head of the Conservative Research Department (where a very young David Cameron worked under him) was playing cricket in Rochester. They had both helped John Major win a fourth consecutive general election for the Tories. Lansley went to pick up the ball, stood up again and found his balance had gone. "I tried to stabilise myself on the pitch, but I had lost my balance," he recalled in an interview with the Spectator. "I walked down to the pavilion and sat down, but it got progressively worse." He collapsed and was taken to hospital, where he was told he had an ear infection.
But his then wife, a doctor, saw no symptoms of the supposed ear infection. The couple fought the system to get a second opinion and the necessary tests. "Now it was true, and continues to be true, that if you have somebody who knows their way about, you can argue your way through the system without being dismissed by the authorities," Lansley recalled in 2006. "We badgered the GP so much that he eventually sent me off to have an MRI scan."
He was referred to a private hospital where tests were conducted using the most up-to-date equipment. "[The staff] were all chatting away merrily as the results came in, then they suddenly all went a bit quiet," Lansley remembered. At the age of 36, he'd had a stroke. In the years that followed, Lansley, now fully recovered, took up the cause of other stroke victims, highlighting how delays in their treatment caused paralysis and how the NHS compared poorly with health systems in other countries.
He had been born into an NHS family and had known the medical world from a young age. His father worked in a pathology laboratory and was chair of an institute of medical laboratory scientists. His first marriage to a doctor meant he remained steeped in medicine at home as he began his professional life. But friends and colleagues believe the real seeds of his interest, and determination to change the NHS for the better, were sown in that personal experience which could have cost him his life.
Langsley divorced his doctor wife in 2001    BMJ

Now could such a curse be working through something medical: like PIP Breast Implants.
The Lancet
The events of the past month show why this policy is so misguided. When something goes wrong in the NHS the entire organisation can be mobilised to address the problem coherently, transparently, equitably, and to the very highest of standards. In the case of PIP implants, over 95% of which were done by private providers, what have we seen? Mr Lansley has had to castigate private cosmetic clinics for failing to gather and provide high-quality data on their procedures. The best he could do was ask that they “take similar action” to the NHS; he could not require such action. Bruce Keogh went further: “we can place no reliance upon [their] figures”. Yet this is the future for the NHS. A system of health care that cannot be held accountable by government, one that has no obligation to collect or supply accurate information about what it is doing, one that fiercely resists its duty of care to patients, and one that is more concerned with cost than it is with quality. The evidence is before us: it’s time to kill this Bill.

Looks as though Bevan’s Curse has hit at the most crucial of the Langsley reform: the regulation of Private Providers. Those of us who has not got his superior intelligence can understand it. Its emotive and yet it is an aspect of health care that is at its best on the fringe of medical care, until problems arose.
Regulation does not work as we are still struggling with RBS & Lloyds.
Private companies could easily go bankrupt and set up in the same place again and again. Government run NHS will always be around.

Lets see how Bevan fare against the genius.

Out!

Out!