[john horscroft]

Another day, another petition.  If you think as I do that the NHS reforms are both half-arsed and likely to see the privatisation of large parts of the NHS please sign the following:

http://www.38degrees.org.uk/page/s/Protect_our_NHS_Petition#petition

 

[john horscroft]

Interesting.  I post the petition against the sale of the forests and I get an immediate and heartening response.  Try to save the NHS and    Does this say something about our priorities or:

1.  Does everyone think the NHS safe in Tory hands?

2.  You've all signed it already and the collective response was therefore 

[Teaboy]

Personally I feel more strongly about the NHS reforms than I did about the forestry. To be honest this is the issue the unions should have been concentrating on instead of the scatter gun and juvenile "No to cuts" type of crusdae they have been on. A concerted campaign against the NHS was eminently winnable and would get the backing of the country, whereas the general populous see the need for cuts so are not behind the unions other campaigns.

[slackline]

Didn't feel the need to post saying I'd already signed it (as I had done with the forests and most other petitions for 38degrees as I get mail from them directly).

[webbo]

Although I signed it.
As an NHS employee I sort have mixed feelings in that if they go ahead and it turns out to be the complete fiasco everyone expects.That might mean they need to get rid of shed loads of staff and I might get pensioned off.

[butterworthtom]

Signed it

[Falling Down]

I've not signed it.  I think the NHS needs extensive reform <dons hard hat> although Andrew Lansley is making a complete cock up of everything he touches.

[slackline]

Reforms are all very well, but there have been tons over the  past 30 years and no one has ever bothered to assess objectively whether it makes one iota of a difference to patient care/outcomes because the figures used to justify this reform by Lansley are completely misinterpreted by the fool (article on this by Ben Goldacre).

Its far easier to quantify financial savings, but I'm not aware of even these being assessed after each of the reforms and value for money is high on the agenda of pretty much all aspects of the NHS as all of the funding NIHR streams that I advise on like to see Health Economics addressed in all research.


An enlightening collection of resources British Medical Journal : NHS Reforms

Martin McKee is worth following on Twitter on this front (piece by him and colleagues in the BMJ on Twitter and the NHS Reforms).

[GCW]

I wish commissioning would fuck off.

[Teaboy]

I wish commissioning would fuck off.

I'm not sure what you mean; you don't think there's any need for any commissioning of services?

[slackline]

I wish commissioning would fuck off.

I'm not sure what you mean; you don't think there's any need for any commissioning of services?

I'd hazard a guess its unnecessary administration that rubs.

[GCW]

Of course services have to be commissioned.  However, I have no training in management/ commissioning of healthcare resources.  Neither do any of my colleagues from what I can see.  And yet we are going to be set up to take the fall of arranging all this stuff, plus on a third of the previous budget.

[john horscroft]

See?  All that was needed was  and the UKB brains trust is off and running.....

[TobyD]

Of course services have to be commissioned.  However, I have no training in management/ commissioning of healthcare resources.  Neither do any of my colleagues from what I can see.  And yet we are going to be set up to take the fall of arranging all this stuff, plus on a third of the previous budget.

...thus cunningly absolving the government of the need to implement very unpopular policy changes, such as downgrading health professionals, and admitting that there just isn't enough money for some things.  Thus they get someone else to take the cr*p, while they get on with having a rather dubious foreign policy, buying and selling arms or whatever else it is they have to do.  Nice. Well it worked with the Bank of England, didn't it.

[webbo]

The other week I was invited with the Missus to York Conservative Club quiz night.The NHS reforms came up during the general social intercourse and it would seem not many grass roots Tories are in favour of these reforms.

[DaveyDave]

Signed.

[Teaboy]

Of course services have to be commissioned.  However, I have no training in management/ commissioning of healthcare resources.  Neither do any of my colleagues from what I can see.  And yet we are going to be set up to take the fall of arranging all this stuff, plus on a third of the previous budget.

Sorry Gareth, I misunderstood where you are coming from. Are you a GP? If so what's the view of you and your colleagues on this? I must say that I thought GPs might view this as a chance to make some extra money, i.e. set up a comissioning service in the GP consortium, employ ex-comissioning stafff from the old PCTs on less money and then charge the NHS for the comissioning service at a profit. Is there a reason why this won't be possible? (I'm obviously not making any accusations here agains any GPs, some of my best friends and all that, just wondering)

[Probes]

Ive worked for a number of years in and around NHS based buildings, as a M&E engineering consultants. And, you all including some of you GPs im guessing will be absolutely gobsmacked at the amount of money that is wasted through building works/refurbs etc. Through horrific bad management, lack of foresight, and blarsey dont matter attitude of a lot of public sector workers. We've just refurbed a 4 bedroom ward... redecorated, new lights, new vent.... £350k and its no bigger than my front room. This kind of piss taking happens all the time and the painful thing is we pay for it to happen. Dont know the answer tho.

[GCW]

The problem is that there is no money to be made in commissioning of services, it's a thankless task where you are essentially going to hold the purse string- ergo, GPs will be the ones having to say you can't get your knee replacement/ expensive treatments etc etc.

The money is in providing- if you can provide a decent family planning/ diabetes/ orthopaedic etc service, you'll get the cash.  BUT, you can't commission your own services as that would be unethical.  How exactly that works is still unclear.

Other issues with this are the dissolution of the Deaneries- so who will be responsible for recruitment and training of GPs?  It used to be a Nationalised system of recruitment and assessment, but now each consortium will be responsible locally.  How exactly that works is still unclear.

Paul, I am a cynical cunt and would not be surprised by anything that goes on in the NHS.

[yorkshireman]

can someone explain to me why privatisation would be so bad for the nhs because at the moment the nhs is an underachieving and wasteful business that needs major change.at the moment the nhs has no competition therefore it can get away with underperforming

[GCW]

Because people would rather put up with a free under-performing service they can moan about than have one they have to pay for?

[slackline]

can someone explain to me why privatisation would be so bad for the nhs because at the moment the nhs is an underachieving and wasteful business that needs major change.at the moment the nhs has no competition therefore it can get away with underperforming

To start with you should define how you are quantifying performance, presumably you're looking at it from the perspective of wastefulness.

Regardless taking the standard of patient care/quality of health as the ultimate indicator of the performance of a health care system (because that is really how you measure it, value for money is something separate) under private healthcare you end up spending money on treatments that aren't needed and don't actually improve the quality of health/standard of care.  Do a search, the per capita spend in the US is ridiculous compared to the UK, and they aren't any healthier nor do they live any longer.

Wonder why healthcare is so expensive in the US and everyone needs insurance, because they run hundreds of pointless tests and prescribe loads of drugs you don't need.

[Teaboy]

can someone explain to me why privatisation would be so bad for the nhs because at the moment the nhs is an underachieving and wasteful business that needs major change.at the moment the nhs has no competition therefore it can get away with underperforming

There are many answers to this but the major one is that without the NHS many people would be unable to get treatment they need.

[yorkshireman]

Because people would rather put up with a free under-performing service they can moan about than have one they have to pay for?

but as taxpayers we all pay for the nhs,you dont get anything for free

teaboy:but if the nhs were privatised im sure that under social security term as they are now,you would get healthcare anyway.

slack line:i broke my hand just over a year ago,i waited 9 months to find out it was broken and that included 3 trips to a specialist,several cancellations(by them) and in total it cost me about £30 in fuel and a further £20 in car parking charges not to mention an average of a 45 minute wait beyond the alloted time of my appointment.i agree that patient care should be the main priority and at the moment with the nhs i dont think its the case.ovee the last 20 years ive noticed a downward trend of care quality in my local hospitals(pontefract general and pinderfields) so something needs to be done and although its not nice,money needs to be saved as we cant afford to throw money away on management and beurocracy when it could be better spent on patient care.
i will admit now that im not 100% sure what the answer is,only that there must be better ways of doing it than is currently being done

[GCW]

but as taxpayers we all pay for the nhs,you dont get anything for free

I suspect you'd still pay the same amount of tax even if the NHS became wholly private.