Health and Social Care Bill - a danger?

[Peckhamnearbe]

hi all,

The attached document

explains simply and clearly what the Bill is going to do and why we

have to keep trying to stop it. Raise the questions with anyone you

can, share the information with anyone, get papers to raise the

questions or send excerpts in as letters, ask your MPs to get answers

that reassure you on these questions.

As a colleague recently reminded me, the first duty of a doctor, and by

inference a health professional or system is ?DO NO HARM? ? this could

be the most basic question of all to challenge the government with ?

can they prove beyond doubt that their intentions will do no harm in

the face of such overwhelming evidence that that is exactly what will

be the impact?

http://abetternhs.wordpress.com/faq/

[Marmora Man]

It is difficult to know where to start with piece of egregious disinformation that has clearly been drafted by someone only interested in maintaining the status quo, which leads me to believe it may be sponsored by Unison or a similar organisation.

My own political views are well known to regular readers, and most will be aware that I work predominately in the healthcare sector. Until I know something more about this new poster "Peckhamnearbe" I will refrain from detailed comment.

I would add that the criticism of Circle is the one well founded fact in the paper. Much of the rest is pure b******s.

[Otta]

Have to agree with MM. Of you want to discuss the merits of something, then give us an unbiased document that sets out exactly what the bill proposes, not some obviously one sided scare mongering.

I say that by the way,as someone with differing political views to MM

[Chippy Minton]

egregious disinformation that has clearly been drafted by someone only interested in maintaining the status quo, which leads me to believe it may be sponsored by Unison or a similar organisation.

How ironic to accuse someone of providing "egregious information" and then in the same sentence accuse Unison or similar organisation of only being interested in "maintaining the status quo."

Unison, The Royal College of Nursing and Unite (the 'big three' NHS unions) along with numerous smaller and more specialist ones, have repeatedly stated they recognise the need for the NHS to modernise and become more efficient. Indeed, the Royal College of Nursing actively encourages its members to report NHS waste and inefficiencies as part of its campaign to make the NHS more efficient.

The blog identified in OP looks to have been written by an NHS doctor - it's hardly surprising they want the Health and Social Care Bill stopped given almost three quarters of GPs share these fears and agree the Bill should be scrapped.

[Undisputedtruth]

My feeling is that the NHS is being privatised through the back door but one step away from not being a chargeable service.

The blog gave a number of interesting points.

The current cosmetic surgery controversy highlights the fact that that some private medical service providers put their financial interests before the welfare of their patients.

[Marmora Man]

UDT - you are usually one of the progressives that rail against me for my right wing and conservative stance. Progressives are supposed to be against the power of patronage, protection of the status quo, preservation of the past and for change & progress. Why do you relinquish this fervour when it comes to the NHS?

As I have often argued the NHS is a faulty, inefficient and mind bogglingly bureaucratic system that eats up money yet delivers very little discernible improvement.

[Undisputedtruth]

I'm not at all in favour in privatising the NHS but I do recognise the need for change as technology matures and changes in work practices. Part of the problem is that the organisation is a political football that does little to engage the staff. Personally, I think the NHS should adopt the John Lewis co-operative model where profits are ploughed back into the system.

Privatisation is harmful to the NHS as more private companies becomes increasingly focus on their profit margin rather than looking after the patient's interest.

[Marmora Man]

Privatisation is harmful to the NHS as more private companies becomes increasingly focus on their profit margin rather than looking after the patient's interest.

You're shifting the argument but, hey ho - that's what you usually do. On what do you base this thesis?

No business, whether it's healthcare or the making of widgets, ever becomes or remains successful without attending to it's customers interests. Profit and healthcare are not incompatible - I've worked both sides of the healthcare divide NHS & Independent and I know.

Notwithstanding the recent PIP breats prothesis problem - I would wish the NHS to be as flexible, commercial and cost aware as the independent sector. Remember, the NHS has its own scandals, one's that don't occur in independent acute healthcare - MRSA, C Diff, N. Staffs, Pembury at Tunbridge Wells - the list is very very long.

[Chippy Minton]

Most GPs think the Bill won't result in more cost-effective delivery of care and over 75% of GPs think the Bill won't reduce bureaucracy in the NHS.

[david_carnell]

Mamora Man - is it not true that the NHS was found to be vastly more efficient and effective than many other health care systems in the developed world whilst our spending on health is actually less than half that of the USA per capita?

The answer is yes by the way. Or at least so says the Commonwealth Fund.

I would suggest, that whilst politically unpalatable in this age of having to be seen to "do" something, the NHS should be left alone for an entire parliament. No new diktats. No new initiatives. No new efficiency savings. No new managerial oversight committees issuing reams of paperwork.

It is this constant tinkering or, worse, full scale attempts at overhaul that leave many health workers exasperated. No sooner has one scheme been adopted than a new one is introduced.

I would suggest that opposition from all corners of the medical establishment to the HSC Bill is not that of vested interests protecting the status quo but those who know best telling politicians and managers to leave well alone.

[Otta]

What strikes me about the Health and Social Care Bill (having read up on it today), is that it doesn't really mention Social Care very much.

[Chippy Minton]

In addition to the raising of questions etc referred to in the OP, a national demonstration against the Bill is now set to take place in London on a Wednesday afternoon sometime in early March.

[Huguenot]

Oh great.

Now we're going to have an entire day of bullshit and weeks of news coverage given to poorly informed strutting peacocks who don't have a clue about the issues mouthing off about fabricated hypotheticals as they chuck paint bombs at the Halifax.

Whoopeee do.

[Chippy Minton]

coverage given to poorly informed strutting peacocks who don't have a clue about the issues

Ah...are you organising it then?

[Huguenot]

:))

[Chippy Minton]

And it seems the poorly informed strutting peacocks in the Health Select Committee, that obviously don't have a clue, have now mouthed off as well ;-) http://www.bbc.co.uk/news/health-16690273

[Chippy Minton]

Here's an interesting graphic from the NHS Support Foundation that shows the professional opposition to the Bill.

http://www.nhscampaign.org/uploads/images/bill_opposition.png

[Huguenot]

I think it was you Chippy who stated on a discussion about Bob Crow that the primary objective of a union was to look after the salary packages and employment benefits of its members at the expense of everything else.

So the fact that the block votes on the left are predominantly unions only tell us one thing:

That the unions think their members will get more money and perks working less hard by blocking the health bill.

It tells us nothing about the advantages of the health bill to either the NHS or the general public.

[Chippy Minton]

The lobby of Parliament has now also been confirmed for 7 March.

[Marmora Man]

Chippy,

As Hugenot has already pointed out you have a bunch of trades unions arguing to perpetuate the existing flawed model, scarcely the progressive alliance they would purport to be.

The Royal College of GPs is the only Royal College to collectively (I use the term deliberately - if you're worried about privatising the NHS you needd look no further than the mighty trades union / monopoly threat that is the RCGP) to come out against the Bill. They tried, at a recent Academy of Royal Medical Colleges meeting to get all Royal Medical Colleges to sign up to oppose the bill but couldn't persuade their surgeon and anaesthetist colleagues to do so.

Noting some of the crowd that makes up the opposition tends to make me want to support the Bill. There are a number of aspects within the Bill that I do endorse but I would agree that the implementation planning looks poor and Lansley has made a sterling job of turning support for his initial plans into, almost, total opposition. He's a nice man, a deep thinker but clearly a poor Minister and manager.

[Chippy Minton]

MM,

As I've already pointed out, I don't think these organisations are trying to perpetuate a flawed model. They recognise the need for the NHS to modernise.

The graphic shows the opposition to the Bill so your statement that the RCGP is the only Royal College to come out against the Bill is wrong. The RCGP has come out and said they want the Bill scrapped, but only two weeks ago the Academy of Medical Royal Colleges - representing 21 royal medical colleges - drafted a statement that said it had ?significant concerns? and could not support the Bill in its current form. Although not released to the media, it stated ?unless the proposals are modified, the Academy believes the Bill may widen rather than lessen health inequalities and that unnecessary competition will undermine the provision of high- quality integrated care to patients." I think this demonstrates the Royal Colleges' opposition.

Also, I'm not quite sure what you mean when you say "noting the crowd that makes up the opposition tends to make me support the Bill." It's a hell of a mixed crowd - these organisations represent everyone from Doctors and GPs to hospital porters and maintenance workers. I assume you mean you want to cut your nose off to spite your face?

[Huguenot]

Well, the majority of 'that crowd' directly benefit from a monpoly market - they may simply be trying to jam closed the door on any sort of competition that may reveal their weaknesses, expose inefficiencies, or even try and prevent some GPs from collecting over a hundred thousand pounds a year in salaries whilst only taking appointments weeks in advance.

It is not reasonable to assume that 'that crowd' are only motivated by delivering the best health service, when their pay, perks, conditions, accountability and workrate are closely linked to the outcome.

[Marmora Man]

only two weeks ago the Academy of Medical Royal Colleges - representing 21 royal medical colleges - drafted a statement that said it had ?significant concerns? and could not support the Bill in its current form. Although not released to the media, it stated ?unless the proposals are modified, the Academy believes the Bill may widen rather than lessen health inequalities and that unnecessary competition will undermine the provision of high- quality integrated care to patients." I think this demonstrates the Royal Colleges' opposition

I've worked as Interim CEO of the AOMRC - it is extremely unusual for them not to reach a consensus - but on this occasion they could not and the draft statement was not ratified. Thus indicating not the Royal Colleges opposition but that the Royal Colleges could not agtree to oppose.

[david_carnell]

Huguenot Wrote:

-------------------------------------------------------

> Well, the majority of 'that crowd' directly

> benefit from a monpoly market - they may simply be

> trying to jam closed the door on any sort of

> competition that may reveal their weaknesses,

> expose inefficiencies, or even try and prevent

> some GPs from collecting over a hundred thousand

> pounds a year in salaries whilst only taking

> appointments weeks in advance.

>

> It is not reasonable to assume that 'that crowd'

> are only motivated by delivering the best health

> service, when their pay, perks, conditions,

> accountability and workrate are closely linked to

> the outcome.

But the flip side of that coin is that two of the organisations in favour of the bill are, or represent, the private sector health care providers or suppliers who would be most likely to gain financially from the bill passing. So their support isn't an indication of anything other than their own vested interests either.

It is easy to portray the BMA, the RCN and the RCM opposition to the health bill as a product of grievances on pay and pensions, as they are trade unions as well as professional bodies. But although pensions are a big issue for them, that isn't the reason for opposition to the Bill.

Last year the BMA voted to work constructively with the government, as did the Royal Colleges. Now they have moved to outright opposition. Now the Royal College of Radiologists and the Royal College of GPs have voted to oppose, after 98% of RCGP members surveyed said they wanted the Health and Social Care Bill to be withdrawn. The Faculty of Public Health is surveying it's members after an Emergency General Meeting voted against the reforms, and the Royal College of Physicians are holding an emergency meeting too. The Royal College of Surgeons have stated they have concerns, but will continue to work to improve the Bill.

These are not trade union bodies, but represent their members' views regarding health care delivery.

And for all the cries of "Reform, Reform! We need Reform!" I've yet to note dissent from my earlier post that showed that the NHS is one of the most efficient health care services in the world.

[Chippy Minton]

They haven't ratified it yet, but they haven't come out to support it either. Hardly a ringing endoresment. And now that British Medical Journal, Health Service Journal and Nursing Times have jointly warned of the flaws in the Bill describing it as "bloated and opaque" and "an unholy mess" I don't think the arguement that its a "bunch of trades unions arguing to perpetuate the existing flawed model" stacks up either.

Even the Daily Mail ran a story last week about the "poorly thought-through NHS reforms" and today's Times runs an editorial about the "botched NHS reforms" that "could destroy the Tories."

It will be interesting to see if Alan Milburn becomes the man to rescue this Bill!