Saving the NHS!

[LodshipLang]

So, sorry to come along like a n00b with a political agenda but I do genuinely live in East Dulwich and read the forum fairly reguarly! And this is so important that I really feel I have to shout about it to anyone who'll listen. If you don't know, the Health and Social care Bill is set to be passed through government next Tuesday the 20th of March, and it'll be VERY detrimental to the NHS, opening up possibilities for competition and for private companies to have a hand in what goes on, prioritising private patients and money over patient care. I'd tell you all to write to you MPs but happily Tessa Jowell is thoroughly against this, so it'd be great if you could shout at everyone you know out of the are about this! There are some great resources and ideas on this site for other actions you can take http://www.unison.org.uk/ournhs/news_view.asp?did=13310 .

And if you want to read more about it, this is great- Nick Cleggs letter defending his choices, fact checked http://abetternhs.wordpress.com/2012/03/10/ldconf/ In case you've read of reasons that it 'won't be that bad' they are unlikely to be very true. Cos it'll be awful and WILL effect us all eventually, so doing nothing about it just seems ridiculous to me, really. I hope you can all be stirred into action in some way, I appreciate it's diffcicult to get really riled up about politics these days and just feels a little pointless at times, but I think this is a time when you can say it's definitely 'worth a try'. Because this going through is to awful to contemplate, and if absolutely everyone in England did their best then we can definitely only blame the governetment for this! PLEASE do smething and spread the word!

[Marmora Man]

Dear LL,

You're rather out of touch if you truly a genuine regular reader of EDF. This subject has been debated here already and your union inspired "cut n paste" is simply scaremongering and incorrect.

My position - posted elsewhere

I know from personal experience that the NHS is a massive bureaucratic and sclerotic, inefficient organisation that is barely fir for purpose today - let alone for the future and inevitable increased demand. If you strip out much of the rhetoric the essence of the reforms are just three:

a. Get rid of a layer of management - a good thing.

b. Replace manager led Primary Care Trusts with clinically led Care Commissioning Groups - a good thing

c. Make it easier for non state run organisations to provide care - free at the point of delivery - at NHS tariff rates. Another good thing as it will encourage change and competition (NOT for clarity commercial competition necessarily but competition to do better and provide the best, competition to innovate).

Innovation is desperately needed in the NHS, identifying how to achieve more with less. How to provide the care in the most appropriate and least costly setting.

The current NHS management structures are biased toward maintaining large white elephant hospitals, hospitals which are beloved of the public who would, ideally, have one on every street corner. However, they are not the best place to provide much of the care that our ageing population needs - but while most clinicians in hospitals can see the changes that are required the self perpetuating managerial class that run the PCTs and Hospital Trusts have been incredibly slow to initiate change.

Again from personal experience of working in a Healthcare Charity I have seen a contract for care removed from the charity and passed to the local Trust because - and I quote "If we didn't support the Trust it would have to lay off staff and might become bankrupt". Yet the charity was providing care with no elective waiting time whatsoever, had no MRSA or other hospital acquired infections, a lower return to theatre, a lower revision rate and higher quality KPIs in every area.

[LodshipLang]

Hi, I'm very sorry this has already been discussed, I did a quick search for 'nhs' that bought up nothing, did think it was rather odd.

I don't have time to reply to this fully at the minute, but that WASN'T cut and pasted from anywhere, and I am in no way claiming the NHS in it's current form is completely perfect, but the changes that need to be made can be made without this bill, which will be a costly upheaval that doesn't, in my opinion, address the changes that do need to be made.

[Loz]

LodshipLang Wrote:

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> ... opening up possibilities for competition ...

That's a bad thing?

[Marmora Man]

Competition is exactly what is required. Offer lots of organisations the option of winning major, fixed price, contracts for provision of healthcare devices. Set, as part of the contract, outcome quality measures.

Result - organisations designing systems and processes to optimise the quality of care and outcomes against a fixed price. At present the NHS mindset doesn't, generally, work this way and is too schlerotic to make effective change quickly - competition will stimulate change.

[StraferJack]

question to supporters of the bill:

leaving aside any proposals and politics - but as things stand, do you think the US has a better health service than the UK?

[ontheedge]

StraferJack Wrote:

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> question to supporters of the bill:

>

> leaving aside any proposals and politics - but as

> things stand, do you think the US has a better

> health service than the UK?

In short absolutely not unless you can afford some type of private insurance and your circumstances do not change. The NHS is pretty amazing warts an all.

Needs to sort out layers of management and my belief is train people in management rather than clinicians rising through the ranks to become managers. A good clinician does not a good manager make!

[taper]

'question to supporters of the bill:

leaving aside any proposals and politics - but as things stand, do you think the US has a better health service than the UK?'

What's that got to do with the Bill?

[StraferJack]

Is the road we are starting on. Opening up to competition. No?

[NaiHM]

I completely agree with you LodshipLang. Have just signed the petition and will encourage everyone I know to do the same.

[Marmora Man]

StraferJack Wrote:

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> Is the road we are starting on. Opening up to

> competition. No?

No - it is not the road the bill is embarking on. This "privatisation" cry is a red herring. Nowhere in the Bill is there even a hint of a suggestion that patients will have to pay for NHS services. In the USA everyone needs to medical insurance or be eligible for Medicare / Medicaid. In UK privat, charitable and social enterprise organisations can compete to deliver care to NHS patients in return for the NHS tariff price (which has an inbuilt deflator to encourage efficiency).

[StraferJack]

Erosion MM. Erosion

I'm happy to be wrong. But let's meet in 5 years time

But NOONE has explained to me why anyone would compete to care for (wildly variable and costly) patients. Where do they get the profit? What if fixed contract price is wildly exceeded?

In short, I can see why a nationalised service would want to care for ill people. I cannot see why anyone who needs to make money would want to

[Loz]

StraferJack Wrote:

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> Is the road we are starting on. Opening up to competition. No?

A bit of an extrapolation, and also some of the FUD employed by some opponents to the bill. The US is a markedly different system. A better idea would be to look at Australia, which has a much more interesting balance between public and private. People are encouraged to get private insurance and use the private facilities, but the public system is still at least as good (if not better) than the UK.

The Guardian did a examination of Australian, Canadian, Irish and US healthcare systems. Quite interesting.

[StraferJack]

And yet the Australian system costs about 9% of GDP versus <7% in uk, but expects users to pay more and choose from

More complex systems

Not a selling point to me

[ultraburner]

Most (all?)of those actually in the NHS (from top to bottom) are opposing this bill.

That means quite a lot to me, as they are the ones delivering the service. If they think the plans are unworkable and will lead to a breakdown of what we have, then its worth taking note. I dont think you can apply starbucks type management goals to something as unique and perhaps delicate as the NHS, imho.

[Undisputedtruth]

I want to know how much money Marmora Man will make once the NHS bill goes through. ;-)

[nashoi]

StraferJack Wrote:

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> And yet the Australian system costs about 9% of

> GDP versus more and choose from

> More complex systems

>

> Not a selling point to me

According to the OECD, in 2009

Australians spent an average of $3445 adjusted for ppp, equivalent to 8.7% of GDP.

UK spent $3487, 9.8% of GDP.

France spent $3978, 11.8% of GDP.

USA spent $7960, 17.8% of GDP.

The French are usually reckoned to have the best health service in the world, why don't we copy them? Why do people always bring up the USA whose health service is both hideously expensive and leaves a huge number of people without cover?

Eta noone has a private healthcare system, the majority of funding is always by the taxpayer, it's a question of degree and how it's organised.

[Chippy Minton]

LodshipLang - MM is right, it's been done a couple of times on here already http://www.eastdulwichforum.co.uk/forum/read.php?20,840902,page=1 and http://www.eastdulwichforum.co.uk/forum/read.php?27,816423,page=1

Obviously he is not correct about the scaremongering ;-)

[Marmora Man]

Undisputedtruth Wrote:

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> I want to know how much money Marmora Man will make once the NHS bill goes through. ;-)

I don't know if that was meant as a "tiongue in cheek" comment but I confirm that I have no financial interest in the outcome of the bill. I have a professional interest and desire to see the NHS improve and become more efficient and effective.

[gamerr]

.

[Marmora Man]

Gamer - that misleading, erroneous and scurrilous blog has already been aired in an earlier thread about the NHS and rejected by all but the most naive.

[steveo]

I've supported a few Avaaz petitions but not its 'Last chance to save the NHS -- 24 hours left' campaign. It's a complex issue and Avaaz petitions are better suited to simples like saving whales.

The word is 'slacktivism'

[Chippy Minton]

MM - "rejected by all" - what, you mean by 3 of the 17 people that contributed to that thread?

gamerr - the blog is based also entirely on investigations and reports by the Mirror newspaper. The connections and figures are all factually correct. It is obviously not clear if/how much those listed could gain if the Bill is passed.

[Huguenot]

Exactly - not only is 'not clear' what influence might be wafting around, but the balance of probabilities is next to nothing (given that the quality of the association is about as strong as '...once knew a bloke whose neighbour's dog...' etc.).

So really what this, the Mirror, yourself and all the other people who trot this out are trying to do is to make these people guilty by association.

It's a campaign of persecution, defamation and smear based on snide insinuation.

It's despicable, shallow and borderline criminal.

What the hell, another dirty union tactic slung around by semi-evolved bullies. If only these energies could be put to something constructive, instead of trying to bring everything down to their own pigsty level.

[Undisputedtruth]

Hugo, you need to get over your union phobia.

Chippy is absolutely right in what he is saying. Not much support for the NHS Bill apart from Marmora Man and the Tories.