NHS - Cameron plays a blinder

[CogitoErgoSometimes]

Seems like the listening period has resulted in amendments that health professionals are buying into. Bit of a slower introduction but you know what they say...' Aim for the stars, settle for the moon'... great politics.

[newwave]

If your saying Cameron is a lying deceitful scumbag you are correct.

"No top down changes to the NHS" "The NHS is safe in Tory hands"

Same old Tories same old lies

[jackstarb]

Cognito - I'm not so sure it was planned.

I'm currently reading Tim Harford's excellent new book - Adapt. According to him - the secret of good leadership seems to be flexibility, listening and a willingness to adapt strategies to changes in circumstances. I've heard a rumour that top Tories have been seen with the book.....

[CogitoErgoSometimes]

Whatever book he might have been reading and whether it was planned or not, the Opposition don't seem to have found a way to criticise on this occasion.

[breadandbutterfly]

See my thread on the NHS from a Daily Mash perspective - spot on. And hilarious.

[socialhandgrenade]

that anyone believes DC'

The amendments are pretty superficial IMO, and as someone working for the NHS I don't buy any of it.
One of the big amendments is that a nurse and hospital doctor to be part of the GP consortia. Well thats just dandy. What about the allied health professionals: the speech and language therapists, the OTs, the Physios, where is their voice? In our hospital already, the therapists who used to work in the Emergency Department to assess the elderly fallers have been replaced by nurses. These nurses have the same role to i.e to try and discharge the patient without admitting them to the main hospital. But these nurses are more expensive, higher band nurses who can't prescribe equipment or adaptations to make the another fall less likely. Tell me where the efficiency and competitiveness is helping the patient. All the changes are doing is making each profession (who all work for different organisations now) more tribal and want to look after their own.

[Gillg57]

Cameron plays a blinder?? That is a joke heading , isn't it????

[CogitoErgoSometimes]

Not a joke heading at all. I know that Cameron-bashing is a popular sport on MN and that any scintilla of changes to the sacred 'gawd bless it' cow that is the NHS is knee-jerk unpopular in the same community.... but I think the coalition are fundamentally right to change the way it runs. I also think that the PM has demonstrated a certain political savvy in the way he's gone about it.

[jackstarb]

I offer up this very thought provoking Alan Milburn article in a non-partisan way. This-NHS-debacle-sets-us-back-a-generation. Read it with an open mind - there's a lot in there.

"Just as Labour found it hard to reform the military because we enjoyed less public trust on defence policy than the Right, so the Conservatives are finding the reverse is true in spades in education, welfare and health. As this episode proves, reform of the public services in Britain won?t be achieved from the Right: it has to come from the Left."

[jackstarb]

I profoundly hope he is wrong - but I have nagging feeling he might be right....

[CogitoErgoSometimes]

I don't think he's right at all. 'The Left' had their chance for the last 13 years and did bugger-all as far as I could see. Paying the NHS more and more money without reforming the fundamentals of the way it ran was throwing good money after bad. I am a fan of the NHS in principle - free healthcare at the point of need - but think it seriously lets far too many people down in practice, many within my own circle of family and friends. They have no competition so they get away with, literally, murder.

[ttosca]

I don't disagree with the sentiment behind the hypothesis that change has to come from the 'left'. Nobody trusts Tories with the health service, nor should they.

Your mistake, Cogito, is assuming that 'change' has to be in the form of privitisation. If we call New Labour 'left' (which they weren't, but anyway...), they did indeed throw a lot of money at the NHS. It may not have improved efficiency, but patient satisfaction with the NHS was at an all time high.

Having worked for the NHS, I agree that the NHS could be more efficient, but this doesn't necessarily mean privitising and competition. Reducing the number and pay of middle-management and consultants, along with better handling of IT infrastructure would go along way.

So it's a straw man to say that if you don't support privitisation and competition, you're 'for' inefficiency; no, we just don't want privitsation and competition in the health service. It doesn't belong there.

[jackstarb]

ttosca - IMO, 'we' (humanity) haven't really come up with a better alternative to the 'free market'.

It's not just about incentives (the profit motive) but about, flexibility, autonomy and independance. With bad ideas being able to fail and good ideas quickly copied and improved on.

You can attempt to achieve this with targets, processes and monitoring - but it's hard.

That's why New Labour were prepared to try introducing elements of the private sector into health and education.

But please outline the alternative as you see it .

[ttosca]

Yeah, the 'free market' is so great that we have periodic crises every 20 years due to overproduction, we throw away tens of tonnes of food every day even though millions go starving, we have thousands of empty homes and yet many people can't afford to buy a house, and we have pollution from industries causing cancer and diseases and potentially catastrophic climate change.

Great system there.

But I digress... this isn't a discussion about how shit Capitalism is, but whether it is possible to reform the NHS without privitisation and competition - and clearly it is. And I have already provided a few general principles for impovement.

[jackstarb]

ttosca - sorry but reducing a few management layers will not really have any major impact on the NHS. Even if it saves money - how does that improve efficiency, promote best practice and ensure that the needs and preferences of patients are taken into account.

Anyone can look at a system and decide what they would do to improve it - but that's not going to actually make it happen. And who says you are right (you may be but that's not the point). Why should you or other individual (or group of people) be trusted to make all the decisions? And who judges if they are right? And that's before you've considered how to motivate people to follow orders from some remote central planner.

[HHLimbo]

'Cameron plays a blinder' in the reverse foxtrot competition.

Great post ttosca. The 'free-market' is a woefully inefficient model on which to base something as essential as the NHS.

Cant see how allowing private companies to suck out funds (or 'profit') from the NHS would help anything.

[queenbathsheba]

Well said ttosca.

Seems that competition from the private sector is the kiss of death to standards and the red light for privateers to line their pockets.

Just look at the situation with Southern Cross care homes and the situation with domicilliary care services.

Article in the mail today about how care in the community is failing to meet the basic needs of the elderly. Old frail people being left dirty and hungry. Problem here is that the so called experts commissioned to research this disgraceful situation say " more thorough training is needed" when the reality is a "little less profit" would do much to improve standards of care. The agencies are paid by the hour, the staff are paid by the hour except the staff have three half hour calls to make in an hour and get paid for just that and the agency overlooks the difference and no one asks Mrs smith how she feels!

I worked in adult care services for the LA and oversaw agency commissioning and I swear the last Tory government did much to condemn the elderly.

Now they are up for selling our health to the fat american capitalists.