NHS reforms

[Termite Man]

can anyone give me a basic outline of what the NHS reforms are , from what I can work out it would involve private companies providing the healthcare but it would be funded by the state. If thats the case then I don't see how a profit can be made by the companies unless they charge over the odds for the service they provide or priovide a lower quality of service and expect people to pay top ups for a service similar to what the NHS currently provides.

 

[weltweit]

I don't think that is right for the first statement of the reforms...

I think the first statement is that financial decision making will be moved from Primary Care Trusts to General Practitioner panels with Primary Care Trusts being closed.

 

[Santino]

can anyone give me a basic outline of what the NHS reforms are , from what I can work out it would involve private companies providing the healthcare but it would be funded by the state. If thats the case then I don't see how a profit can be made by the companies unless they charge over the odds for the service they provide or priovide a lower quality of service and expect people to pay top ups for a service similar to what the NHS currently provides.

They'll cherry-pick the profitable services and cut costs by having less staff. Then all the trickier services like mental health care and other long-term services will be run at a loss by hospitals that will face pressure to close because they're losing money.

 

[agricola]

They'll cherry-pick the profitable services and cut costs by having less staff. Then all the trickier services like mental health care and other long-term services will be run at a loss by hospitals that will face pressure to close because they're losing money.

I think we are already in that boat, tbh.

can anyone give me a basic outline of what the NHS reforms are , from what I can work out it would involve private companies providing the healthcare but it would be funded by the state. If thats the case then I don't see how a profit can be made by the companies unless they charge over the odds for the service they provide or priovide a lower quality of service and expect people to pay top ups for a service similar to what the NHS currently provides.

Basically, as weitweit states the main plank of these reforms is that GP panels will be responsible for far more of the spending than they currently are, with PCTs going, and will be able to operate in a market for healthcare services that has both public and private providers offering those services. In some ways, this might actually be a good thing - the current system sees private healthcare providers get a lot more money and better support than the NHS does, and if anyone has to lower costs then it will be private firms (who are the ones bitching about this aspect of the reforms). One also imagines also that the public hospitals best placed to succeed in that market will be those without PFI debts, which might (though the Coalition have authorized at least one new PFI hospital) eventually weed out PFI from the NHS, though some hospitals would probably go bust as a result (which again may not be that bad - in many cases the state would have to take them over, at a cost would be far less than the contract PFI cost).

However, there is a growing trend of the likes of KPMG getting in to the GP panels (for contracts, advisory services, consultancies etc), as well as private healthcare firms looking to take over the panels themselves, which would be an utter disaster for any kind of sane system - the firms would have a strong incentive to favour their own firm / allied firms when it came to awarding business, there would be very little local political oversight into what they were doing / what they were spending, and they would almost certainly essentially operate a local monopoly since none of them would sign deals if there was any chance of direct competition. There will almost certainly be problems with GP panels paying themselves above the market rate as well.

 

[Weller]

Has the Mail been invaded they certainly seem to be up in arms about the diagnose yourself via email story if not

http://www.dailymail.co.uk/news/article-1349908/Now-email-GP-Patients-told-come-surgery-instead-symptoms-online.html?ito=feeds-newsxml

 

[nino_savatte]

Coming soon. DIY keyhole surgery at home.

 

[London_Calling]

It struck me as odd that just about the entire politcal class explicitly or implicity supports these reforms while, at the same time, the NHS is still costing in GDP terms less than the EU average for health care. Yet it's "unsustainable".

I can't help but prefer to talk about how the debate is being defined first, perhaps starting with how Trident remains 'sustainable' (especially given it points at those fiendish cities in . . the 'Soviet Union').

 

[lewislewis]

These reforms have been rejected by the Welsh and Scottish Governments. They are in no way necessary or inevitable. In Wales we also abolished the internal market in the NHS and PFIs in the NHS. It is a complete lie to state that a fully publicly owned health system is "unsustainable", they are a bunch of ideologues trying to finish off what Thatcher started.

 

[ViolentPanda]

The word "reform" gets taken a step nearer to being NewSpeak.

 

[ovaltina]

can anyone give me a basic outline of what the NHS reforms are

Like railways 'reform' under Major, but with the NHS.

 

[agricola]

It struck me as odd that just about the entire politcal class explicitly or implicity supports these reforms while, at the same time, the NHS is still costing in GDP terms less than the EU average for health care. Yet it's "unsustainable".

I can't help but prefer to talk about how the debate is being defined first, perhaps starting with how Trident remains 'sustainable' (especially given it points at those fiendish cities in . . the 'Soviet Union').

I appreciate this is probably preaching to the converted here, but the majority of the political class probably supports these reforms solely because they will create (or rather sustain) a market in healthcare that of course leads on to payoffs, jobs after politics, lobbying and whatnot; all other arguments are usually just a cover for naked greed to hide behind. This is especially obvious with the NHS of course, because its most costly and most dysfunctional parts (PFI, the IT contracts, ISTC and drug procurement to name a few) are precisely those where the private sector is most involved.

edit: and as lewislewis states, you can get a further idea of how bad the reform argument is by contrasting england with wales

 

[The39thStep]

The word "reform" gets taken a step nearer to being NewSpeak.

Modernisation

 

[past caring]

Consultation.

 

[The39thStep]

Doing more with less

 

[ExtraRefined]

The Daily Mail is run by small-c conservatives, so like you they hate the idea of any change to the NHS.

 

[The39thStep]

The GP Consortiums will end up taking on some of the current PCT commsioning staff.

 

[nino_savatte]

Modernisation

...my arse.

 

[Lloyd_DepHealth]

More information on NHS modernisation

can anyone give me a basic outline of what the NHS reforms are , from what I can work out it would involve private companies providing the healthcare but it would be funded by the state. If thats the case then I don't see how a profit can be made by the companies unless they charge over the odds for the service they provide or priovide a lower quality of service and expect people to pay top ups for a service similar to what the NHS currently provides.

There is a quick guide and more information about changes to the NHS here: www.dh.gov.uk/healthandcare

 

[wake_up]

Thanks for posting this question 'Termite Man'. I was going to ask the same thing.
It seems very hard to find any concrete facts about the proposals anywhere in the media. From the Torygraph to The Grauniad there is no shortage of heated polemical rhetoric from both sides but very little in the way of explanation as to what the details of the proposed shake ups will be and on what reasoning these policies decisions are being made. All we seem to be getting from the left are apocalyptic warnings of the end of the NHS. And from the government: just a load of buzzwords and soundbites. Can anyone point us to a serious analysis and breakdown of the proposals anywhere in the media? Would be much appreciated. If only to calculate how much we all need to be shitting ourselves (or not)!

 

[Chuff]

Basically each area can form a consortium which will then be able to commission services, GP's in my area say fuck this, we will be expected to do all the fucking work of commissioners but not get paid for it and we are already overworked, areas can combine as many London boroughs are doing to form larger consortia which could actually pay people who understand commissioning to do the job, these will be the same people currently being given redundancy packages by the NHS.
on this sort of level there will also be legislation to ensure services that are specialist which GP's do not have enough experience to commission are still provided an example of this given in the government paper is children's adolescent mental health services.
finally on a national level there will be bodies who ensure very unusual services that still need to be provided are paid for by all the smaller consortia.

so we have a three tiered system with administrators at every level of varying experience which will cost a lot to set up, run poorly to start with and cause a lot of shit during the change over which very very few area's are prepared for but seem to be going ahead with.

inevitably the political types who do fuck all in terms of productivity will get the jobs under the new system and many good staff will be lost.

that said the NHS is a wasteful bureaucracy where a lot of the work is disproportionately carried by a few and many managers are incompetent and contracts are awarded to over priced companies.

same shit different people in charge

 

[wake_up]

thanks

 

[DotCommunist]

The Daily Mail is run by small-c conservatives, so like you they hate the idea of any change to the NHS.

that conservative statism that so often ends up supporting fash.

 

[ExtraRefined]

that conservative statism that so often ends up supporting fash.

The BNP are big fans of the NHS too, since you bring it up.

 

[Proper Tidy]

I saw a fash eating a twix once, ergo if you eat twixes you must be fash.

 

[frogwoman]

oh PT, how could you?

 

[Proper Tidy]

Lol! Ace.

 

[DotCommunist]

The BNP are big fans of the NHS too, since you bring it up.

statist fash supporting a statist organisation popular with the masses and any body with a brain, yes. Phone that revelation in

 

[frogwoman]

theyre hardly gonna say that they want to get rid of one of the things that makes britain british, are they. espeically when they could blame the privatisations etc on greedy "bankers"

 

[trevhagl]

The word "reform" gets taken a step nearer to being NewSpeak.

reform has for the last 10 years ago meant "makes worse"

 

[frogwoman]

On this subject I just posted the following on facebook following some very interesting books I had to sort through at work today.

Today at work several books landed on my desk which I had to sort from the 19th Century. Several of them were about the urgent need to set up the National Health Service because the combination of private companies and charities, which were scattered in limited areas throughout the country, was completely inadequate for the needs of the Population. Middle-class and many working-class people were turned away routinely from charity-run hospitals providing for "paupers" and beggars because they were too "rich"! By the 1890s the number of doctors had dropped to about 8 or 9 per every 10000 residents. One book was a passionate plea for "national medicine" and a national "register of sickness" to be set up as a matter of urgency. It was called "the Nationalisation of Health" published in 1892. Another book by a leading physician in the early 1900s, called "Politics and Disease" argued against dogmatic, reactionary religious and political views infiltrating the field of medicine and was dedicated to (im paraphrasing here) "all those who refuse to let supersistions and class-interests prevent them from working for the betterment of humanity".



I find it amazing and quite humbling that these people lived well over a hundred years ago and yet could see so clearly and had a compassion and insight way before their time and perhaps before our time too.



Wow, how things have changed ....