Foreign NHS takeovers 'discussed' ‎

[eRamber]

It's being proposed that 20 NHS hospitals have their management handed over to private international companies leaked emails have revealed.

More at the BBC and The Guardian

Enough is enough

[eicosapentaenoic]

?BMA council resolves to oppose the Health Bill? BMA - 21st July 2011 1:58 pm www.hospitaldr.co.uk/blogs/bma

For sure, the NHS budget will not be divided up according to clinical need. Successful and aggressive business will attract the money (as in child orthodontics now).

With a rare version of chronic paediatric eye inflammation, my DD is entirely overlooked by current NHS ophthalmology targets, and uninsurable for private treatment. No local or county service will treat her now, and it is a day's travel to tertiary referral; school attendance is 'unacceptable' and I have had to give up work to take her.

The NHS/private hospital she attends now is expanding private business and the senior consultants who would normally manage and teach are leaving the NHS units for the private sector.

I don't see how a profit-making health service provider would accommodate children like her. She is not a quick-fix, and there is no NHS funding.

Our county private ophthalmology triage business servicing the NHS has no paediatric licence, and does not want one because there is no NHS budget.

An overseas business would feel no moral obligation at all to treat unprofitable patients who were not NHS funding targets or insurable.

[eicosapentaenoic]

And yes, I have had to use the private practices of these same consultants for appointments when NHS follow-up with them is not available.

Because chronic illness is uninsurable, I have cashed in my pension to pay for emergency treatment.

Welcome to the future.

[CogitoErgoSometimes]

Excellent. Why should we have to limit ourselves to companies within UK borders? Why not a company from overseas if they're the best? We don't think twice about using goods and services from outside the UK in any other walk of life... The NHS could be so much better than it is if only we'd stop being so stuck in the past.

[eicosapentaenoic]

cogito - you need to make sure you are not relying on the NHS if you have an uninsurable condition in your old age, as do we all.

[edam]

And what do you say to eico, cogito? Should her daughter be left without the healthcare she needs?

The Tories want to carve up the NHS so multi-national corporations can make mega-bucks out of it, and sod any patient who is 'unprofitable'. More than that, a big chunk of the Conservative party have always hated the NHS because it is a social good, a public service that has transformed the lives of ordinary people and is held in considerable affection by the people. They can't stand the idea that something that doesn't make a profit, and isn't designed to make a profit, can be so successful. Similar to their visceral hatred of the BBC, only there it's also because BBC journalists dare to question the government of the day, whatever colour it is.

[edam]

McKinsey, who are at the heart of this, were originally brought in by the last government, paid millions to do management consultancy bollocks on the NHS. McKinsey didn't understand the NHS - far too complex, far too much about people rather than widgets - so they proposed it should be broken up into units that McKinsey's was capable of understanding. It's all a con trick, driven by ideology rather than what works, or what the people, the public, patients and carers want.

(Last government was bad enough, chasing the idea that the market would somehow make the NHS more efficient - but at least they didn't dare propose wholescale privatisation.)

[dikkertjedap]

Privatisation through the backdoor. Assets and pensions stay with the NHS, brilliant given that most assets have to be leased back anyway as they are locked in long-term contracts. Pensions are a loser. So, losses stay with NHS and profit making parts will be up for grabs. I am sure there will be a lot of interest of foreign (and UK) private providers and I am equally sure that they will make a nice profit out of it. Has happened in many other sectors so far. Look at the rail reforms. Most rolling stock is now owned and operated by private companies, who make a nice profit. We have the highest train fares in Europe plus poor service on top. Great.

[edam]

Oh, and an important point - private healthcare or private providers will be exempt from the Freedom of Information Act. So us mere citizens and taxpayers will be unable to find out what they are up to.

[eicosapentaenoic]

To put this in perspective, I am potentially an international doctor-shopper now I have freed up some money. I choose the UK NHS for compassion, integrity, teamwork, 24/7 emergency cover, research base.

I am not finding any of these commitments in the UK private sector, where the service is entirely limited to cost/benefit and the individual doc's ability. Also some prefer private service because they feel 'unconstrained' by NHS regulation. A few good lawsuits will sort this out, American-style. Meanwhile, let the buyer beware.

[eicosapentaenoic]

If you think specialisms don't communicate well now in the NHS, try the UK private sector and see how they shift the blame.

[CogitoErgoSometimes]

Unlike all the experienced management experts on this message board, I have no idea how to successfully run a health service. :) I just want the best healthcare available for myself and my family. The NHS is fine in principle - free at the point of need - but I have posted before about how badly it has let me, family and friends down in the past, usually because of the terrible inconsistencies within it, not least from some truly appalling GPs. Ecosapentenoic's daughter is being badly let down by the NHS by the sound of it. It's wrong.... something has to change. And yet any proposal for change is howled down immediately because, for some bizarre reason, we're content to let it keep happening.

Friends in places like NZ, France, Holland and Belgium seem to get a good service. So I'm not bothered at all what nationality the drugs or the equipment or the specialist are. 'British' doesn't necessarily mean 'best'.

[eicosapentaenoic]

Absolutely, cogito. Truly sorry to hear about your family experience.

DD's blinding eye condition was brought about by a drug reaction from GP prescription (steroid), compounded by 14m misdiagnosis and lack of further referral by NHS consultants.

While a publicly-funded NHS supports their 'mistakes' with further treatment we are inclined to support them. If not, especially mistakes made by a private provider, UK patients will take recourse to ambulance-chasing medico-legal firms to pay for corrective or life-long treatment. Goodwill will be lost.

[edam]

eico - oh, the government's sorting that one out. They are pushing through a legal aid reform bill that will remove legal aid for clinical negligence. So children who are harmed by medical mistakes will just have to put up with it. They are also removing legal aid for victims of domestic violence - they claim they aren't but are drawing the criteria so tightly that almost no-one will get help. And victims certainly won't get help with anything beyond the direct 'I need to get away from this violent man' stuff - contact with children, housing, everything else.

Cogito, I don't think the funding mechanism protects you against medical failures. All healthcare systems make mistakes. At least no-one is profiting from mistakes made in the UK. And FWIW I know several people who have been injured by private healthcare, including one woman left permanently disabled.

Btw, France spends far, far more on healthcare than the UK. So comparisons with France are comparisons with a much more expensive system. Comparisons with the US are also with a vastly more expensive system, but one that has far worse outcomes for pretty much everything. Personally I'd rather not live in a system like the US where the leading cause of bankruptcy is medical bills.

[BagdadCafe]

'We believe there continues to be an inappropriate and misguided reliance on ?market forces? to shape services.' BMA position on Health & Social Care bill www.bma.org.uk/lobbying_campaigning/bmapositionhealthandsocialcarebill.jsp

NHS reform - Online Day of Action, 5 September
The Health and Social Care Bill will be debated in the House of Commons on the 6 and 7 September. This is the last chance to lobby MPs on the Bill before it moves to the House of Lords. www.bma.org.uk/healthcare_policy/nhs_white_paper/nhsreformsocialmediaday.jsp

[VeryLittleGravitas]

More info on this at 38 degrees

[BagdadCafe]

Thank you VLG

[BagdadCafe]

Debating on Health & Social Care Bill now live in parliament www.bbc.co.uk/iplayer/tv/bbc_parliament/watchlive

[BagdadCafe]

I'm loving Frank Dobson, he's addressing all my points above

[edam]

Frank is a former health secretary.

Even the Dept of Health had to admit hospitals may well indeed be flogged off to the private sector. A 'myth buster' they've sent out includes this gem:

"MYTH: NHS hospitals will be managed by foreign companies

Even if independent sector management is used, NHS assets will continue to be wholly owned by the NHS. And there would be rigorous checks to ensure that any such independent provider is reputable and fit for purpose." So that'd be a truth, not a myth, then... (The bit about assets is a fat fib too, what the DH appears to have been saying to the companies is that the NHS will keep the liabilities - the pension funds, the buildings - while private sector foreign companies get the assets i.e. the funding for operations and other patient care.)

[Solopower]

I am so worried by this. To me it is as simple as this: once the profit motive is involved it takes over, and decisions will be made which are in the interests of the shareholders rather than the patients. I understand that the health care providers will want to create a good reputation for themselves - otherwise they would go out of business - so that should at least protect the vast majority of patients. What worries me more than anything is that it is the people with long-term costly ('unprofitable')conditions who will suffer, and as we all know, they are the least likely to be able to fight for their rights. With no transparency and no legal aid, they will be completely helpless.

And I am so sorry for your daughter, Eico. But it does seem to me that if anyone can look after her interests, you can, because you appear to be very clued up about it all.

And Edam, I almost can't read your posts they are so scary ... You have taught me so much - thank you.

[eicosapentaenoic]

Thanks for your kind thoughts Solo, and Gravitas for the info about 38 Degrees - public concern brought about many amendments to the Bill.

Scary though it is, I think it's actually going OK due to the amendment process adjusting immoral, flaky, dangerous policy suggestions, and some major U-turns (see Edam above).

As a mum, I do feel they are messing with life and death decisions and there's not enough medical practice reality being discussed. We're not just privatising the railways because no provision means suffering or dying.

Some policy-makers would be more careful if they didn't have private health insurance. What they forget is, insurance will not cover everything and their families will have recourse to the NHS for long-term illness or really difficult stuff and Any Qualified Provider is unlikely to cover that or train their doctors.

Some Qualifed Providers round by us servicing the NHS do a fantastic job with top-speed service, happy docs, and the latest equipment. There will certainly be new attractive medical jobs available.

Re service gaps: when my daughter is 16, our troubles are over. She can:

• personally claim all travel expenses if she wants to continue with the NHS paediatric tertiary service
  
• be seen in the evenings or weekends NHS by our local adult ophthalmology private provider for either monitoring, triage or treatment, enabling me to go back to work
  
• qualify for any NHS adult glaucoma or macular degeneration frequent monitoring service (a current target) instead of risking it with long follow-ups
  

Same for me, Solo. What will happen in the NHS if:

• there's limited local provision for what you've got, or no help finding it
  
• there's no subsidised travel and accommodation
  
• different providers compete instead of cooperating, don't share notes
  
• AQPs don't honour or make subsequent provision for mistakes or failures (which they won't)
  
• cherrypickers hoover up the funds, teaching hospitals and their outreach clinics are left short of bread-and-butter income
  
• AQPs are not interested in training, accreditation, formal and informal mentoring
  
• different providers do not cooperate on complex disorders
  
• different providers deny knowledge of or liability for shared medical errors
  
• AQPs deny obligation to treat in difficult cases
  
• AQP patient notes are no longer shared by medics and accessible to patients by law
  
• competitive providers cut costs by using sub-standard equipment
  
• AQP does not refer undiagnosed or tricky cases on to NHS hospital in order to retain income
  
• AQP only provides part-service for condition and local comprehensive clinic has been withdrawn due to AQP cover
  
• AQPs servicing NHS have more lax attitude to qualified staff (which I've seen in the private sector)
  

I really want the NHS pot back in the hands of docs, those who've taken the Hypocratic Oath. A kind, skilled doc with integrity is a beautiful thing and I want them cherished, content and liberated to do their job and follow their professional interests. Not confused, exhausted, overloaded, disillusioned, like now. If they enjoy running their own departments, improving efficiency, keeping their staff happy, as well as treating patients, my joy will be unbounded. Put a compulsory management, staff and systems year in the med training - it's inescapable now.

I also want 24/7 NHS treatment, so this may be forthcoming under the new regime.

Maybe the boom in private health and AQP business will help subsidise NHS services, free up lists, happier staff, pay for equipment, let's hope.

There is a big buyer beware component in private practice, no cooperation between disciplines. Maybe this will transfer to AQP business. It's like seeing a quack at the county fair - gone in the morning, NHS picks up the mess.

At the moment DD and I are the poor relations - due to no NHS pot for paediatric eye service, beggars cannot be choosers.

I just felt I had to put this out there because it's interesting who reads MN! Any comments?

[eicosapentaenoic]

Oops ~ Hippocratic Oath ~ less of the hypocrisy (good one, sorry Pendants)