[yorkshireman]

damn sure your right there.its the same if we get toll roads,we will still pay the same road/fuel tax

[mrjonathanr]

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.

And the attorney general might be able to finally afford some decent flock wallpaper, so it's not all bad news, is it?

[slackline]

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

Thats an unfortunate experience, but you've no way of knowing that it wouldn't have taken that long to diagnose under private health care.

Its worth bearing in mind that whilst doctors are experts on their topics there are limits, e.g. the fracture may have been very hard to visualise on an x-ray, or someone presenting with symptoms that are hard to categorise and give a diagnosis on.  Same is true of a lot of prescribed drugs, there is a decent proportion of people who just do not respond to them (look into the promising area of pharmacogenomics if you're interested in this).

Personally I don't have enough experience of time spent in hospital over the last 20 years to be able to make a judgement as to the quality of care, but a major part will be down to the motivation of the staff employed, which isn't going to increase with the thread of cuts and more hours for less (or the same) money.

Regardless, privatising the NHS will not solve these problems, and it certainly won't improve health care.  A few numbers from here.

Country	Per capita spending on health ($)	Doctors per 10,000 pop	Nurses and midwives per 10,000 pop	Hospital beds per 10,000 pop	Life expect. at birth
United States	6719	26	94	31	78
United Kingdom	2815	23	128	39	80
Russian Federation	698	43	85	97	66
Japan	2581	21	95	140	83
Italy	2631	37	72	39	82
Germany	3465	34	80	83	80
France	3420	34	80	73	81
Cuba	674	59	74	49	78
China	216	14	10	22	74
Canada	3673	19	101	34	81

Note Cubas comparative performance for far less than other countries, and being Communist they're healthcare is state run/funded and free.
   


   

   

   

[john horscroft]

   I've spent rather too much time being sorted out by the NHS over the last few years and, on the whole, my experience has been positive.  However, I don't think that gives me a forensic insight into the inner workings and efficiency of the NHS.  Any health service can fail and as Slackers has pointed out, the NHS is cheaper than both America, a largely privately funded system and France which is more akin to our own.  We seem to have a problem of perception (as usual).  Yorkshireman confidently states that the system is too expensive and we can't afford it.  All the statistics would seem to indicate that a privatised system would be more expensive.  I'm not sure how we deal with the kind of inefficiences highlighted by other posters, but it sure as hell isn't by throwing the baby out with the bath water.  The NHS may be flawed  but show me a system that isn't......

[slackline]

Oh yes, its worth pointing out that anyone can go and take out a private health care policy if they want, so if you think you'd get better care from a private company put your money where your mouth is and fork out for one, you'll still have to pay tax and NI anyway, but you won't be using NHS resources that can be allocated to someone else, and presumably you'll find out if things are more "efficient".

[fried]

I don't get the idea that if the NHS is being mismanaged then that by privatising it, it'll somehow become well managed. These seem to be two seperate issues. British rail anyone?

[benpritch]

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.

i think you should sign it just so  andrew lansley CAN'T cock it up.  to be honest i think going against nearly every health professional's opinion i have heard is arrogance of the highest order.

[joel]

Surely this is the main point -

I don't get the idea that if the NHS is being mismanaged then that by privatising it, it'll somehow become well managed. These seem to be two seperate issues. British rail anyone?

 

I cannot believe that more private sector involvement in any major organisation like the NHS can ever be a good thing?

[john horscroft]

Surely this is the main point -

I don't get the idea that if the NHS is being mismanaged then that by privatising it, it'll somehow become well managed. These seem to be two seperate issues. British rail anyone?

 

I cannot believe that more private sector involvement in any major organisation like the NHS can ever be a good thing?

 

Well, you're obviously ignoring the brilliant record of customer satisfaction enjoyed by the train companies, telecom companies, energy companies, water companies, banks, errrrr, no hang on a minute, that's not quite right is it?   

[slackline]

Clearly the desire to privatise the NHS is so they can continue to employ more middle managers to sit on their fat arses, not having a clue what to do, but who spout bullshit management drivel about needing to incentivise the work-force to save money (i.e. work harder for less otherwise bye bye)

[benpritch]

http://www.guardian.co.uk/politics/2011/mar/22/nick-clegg-nhs-reforms

[benpritch]

http://www.bmj.com/content/342/bmj.d1695.full

this is a very informative article that gives depressing reading.

[chris05]

http://www.bmj.com/content/342/bmj.d1695.full

this is a very informative article that gives depressing reading.

Indeed:

"The government proposes a commercial system in which the NHS is reduced to the role of government payer, equivalent to Medicare and Medicaid schemes in the US. However, government belief that cost efficiency, improved quality, and greater equity flow from competition in healthcare markets22 is not supported by evidence, the Office of Fair Trading, the government’s impact assessment, or its experience of independent treatment centres and private finance initiatives."


Thanks for posting.

[LucyB]

http://falseeconomy.org.uk/campaigns/uk/all/t2/2011-04/2011-05

Turn up if you're bothered. Nothing planned for Sheffield, though.

[Obi-Wan is lost...]

Just catching up on this,

Declaring my interests;
- Had two Mini-Obis in the last four years and made good use of Sheffield Childrens Hospital, Jessops Maternity Wing, out of hours clinics etc. Cost directly to us: Zero.
- Mrs Obi works for the NHS, I used to work for the NHS.

yorkshireman, you seem to be moaning about having to spend £50 on your broken hand? Would you have preferred to spend $6050?

I completely agree there is a huge amount of inefficiency and wastage going on the the NHS, I have seen it first hand. Is GP based commissioning the answer? Absolutely not. Is this opening a massive front door to privatisation, absolutely. The big US medical companies are queuing up with massive dollar signs in their eyes just waiting to get a bite of our market.

Oh and if you think having health insurance in the US means you don't have to pay for any operations, I recommend you watch Michael Moore's Sicko, it will make you appreciate what we have in the UK.

[Obi-Wan is lost...]

sheffieldanticuts.wordpress.com/ ....blocked by Sheffield City Council, Hmmm

[LucyB]

sheffieldanticuts.wordpress.com/ ....blocked by Sheffield City Council, Hmmm

Strangely, there is nothing on this website about the All Together for the NHS demo. There doesn't seem to have been much activity on the site since the demo last weekend 

[Obi-Wan is lost...]

Great response to the BMJ article...

Study proposal: changes to the NHS

As there is no overwhelming evidence in support of the proposed changes to the NHS (1) as detailed in the governments' recent white paper, ethically the proposed changes can only take place in the form of a trial. I ask you to consider favourably the following study proposal which I submit without permission on behalf of the UK government.

Title: Reorganisation of the NHS in England

Background: The National Health Service in is its 63rd year. It is suffering the same demographic and technological challenges as all high income countries, specifically ageing of the population and increasingly expensive new technologies. These are major problems that we seek to address.

We also have concerns about outcomes in the NHS when compared with other countries. France spends more on healthcare than the UK, has fewer deaths from heart attacks than the UK, and will shortly be overtaken by the UK in this mortality measure. We determine from this observation that the UK healthcare system is not delivering as much as it should and must change, but not to be like France in funding or structure, and hopefully not in the trend in heart attack deaths. We do not consider this to be an ecological fallacy, and we do not consider any other differences between the populations of France and England. (2)

Study design: Immediate full scale roll out without control or comparison group.

What this study adds to the current evidence: We offer no global, systematic appraisal of current evidence, and take no account of quality of evidence. As lawmakers evidence in the legal sense is our primary concern: oral and written statements from individuals and organisations, and we do not distinguish this from higher quality evidence. (3) We are confident that this study will accrue a substantial body of similar (grade 5) non-evidence with which to inform future reorganisations.

Study population: The entire population of England, of all ages, is served by the NHS, with the exception of the most wealthy, who will be exempt.

Interventions: 1. A market based healthcare system; open to all willing providers. 2. GP based commissioning and the closure of primary care trusts. 3. Transfer of public health to local authorities. 4. Providers that cannot generate enough profit will close, whereas those making the largest profits will succeed, irrespective of the clinical performance. Taxpayer funding will continue, allowing successful firms to become a conduit of money from the many to the few.

Comparison group: None

Outcomes: No a priory health outcomes are specified, although multiple testing, case studies and post hoc analyses are planned by all political parties for election purposes and generation of low grade evidence.

Ethical considerations: No ethical approval has been sought. We acknowledge the risk associated with changing the health service, and are aware that small changes in important health outcomes can cause or prevent thousands of deaths. (3) As we are certain that our approach is correct, we have no stopping criteria.

Consent: Population level consent sought and an election almost won on the basis of: "No top down reorganisation of the NHS". No consent sought on the specific interventions.

Costing: Estimated ?1Bn to ?3Bn, with potential future savings. Taxpayers are the sole funders.

Potential conflicts of interest: None declared although newspapers report the secretary of state for health has received ?21,000 from the chairman of Care UK to fund his personal office. (4)

Thank you for consideration of our proposal.

josephlee@doctors.org.uk

1 Pollock A and Price D BMJ 2011 342:d1695; doi:10.1136/bmj.d1695 2 Appleby J BMJ 2011; 2011; 342:d566 3 Letter from health minister Paul Burstow MP http://www.guardian.co.uk/society/2011/feb/08/deconstruction-of-the-nhs- bill?INTCMP=SRCH 4 http://www.telegraph.co.uk/news/newstopics/mps-expenses/6989408/Andrew- Lansley-bankrolled-by-private-healthcare-provider.html

Competing interests: JJL is both an NHS patient and an NHS employee.

from
http://www.bmj.com/content/342/bmj.d1695.full/reply#bmj_el_254057

[slackline]

 

[slackline]

This is very pertinent and could be a saving grace.

It invokes the Salisbury Convention because neither the Tories nor Lib Dem had these reforms as part of their election manifesto and recognises that there has been zero analysis of the true benefits the changes are said to make. 

[Jaspersharpe]

http://www.38degrees.org.uk/page/speakout/NHS-email-MP

[webbo]

Do you think it might be a cause for disciplinary action if I were to email my MP about the NHS cuts from an NHS computor.

[Jaspersharpe]

http://www.guardian.co.uk/society/2011/apr/04/cameron-as-much-to-blame-as-lansley

 

[slackline]

Its just not right at all 

[corniceman]

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

its not just an issue of privatisation but more one of fragmentation. I think to say that the NHS is underacheiving and wasteful is a bit disingenuous and a a perspective heralded in The Tory media. of course there is waste and unecessary burearocracy but most of that is created by government and the system within which we work. commissioning processes just add to that and the government reforms will do nothing to reduce the overall levels of burearocracy at all they are an industry in their own right. returning to the commissioning issue and opening up the market. A reason that it doesnt create efficency and enhance quality of service is that the complexity of delivering health and social care depends on inter dependencies between different providers of care, eg different hospitals and community services, different departments within hospitals etc that all need to work together in designing care pathways for the patients/public. now that all services within the NHS family are being tenderd out on a 3 yearly basis we have experienced a dramatic lowereing of co-operation between different NHS organisations. we have all become rivals or potential rivals/competitors and nobody wants to give away commercially sensitive information/innovations that a rival might use in their bid to win a tender from you. hence in Nottingham City as will be the case elsewhere we are finding fragmentation of services, less joined up thinking and rivalry. This in turn is leading to cost cutting, organisations winning tenders and syphoning off some of the money to sub other services and what you get is a cheaper but far less quality version of the services you once had.
To compare the workings of NHS with a private healthcare company or even any other organisation in the private sector is an unfair. But what we do know is that in any private organisation the desire is always for profit and cutting back. this might be with the aim of reducing waste but it certainly doesnt improve the services you will recieve.