NHS reforms- anyone else as disbelieving as I am?

[nowwearefour]

What on earth is going on here? Privatisation by stealth? I know what- let's take the focus off the patients and the healthcare and put it on re-organising ourselves.AGAIN. how brilliant. anyone care to help me see what the benefits are of this?

Although having said that when I visited the hospital at the University of Heidelberg, for work, I was very impressed. Every patient with a brain tumour gets a second opinion and is treated in first-rate facilities with first-rate equipment and a multi-disciplinary team that pays attention to every aspect of patient care.

No idea whether that is standard across Germany, however. It's a regional centre and a very high profile hospital.

I agree that Labour played its part in this. Ms Thatcher was probably one of the first post-war politicians who dared openly to question the humane 'from each according to his ability, to each according to his need' philosophy.

But what's much more important is what to do now.

I agree I'd like to see more money put into healthcare as we are 26th in per capita spending on healthcare.

I guessed that edam, though I can't find any links to back it up.

I read somewhere (can't find it now) that the public satisfaction with the NHS had increased from around 50% to around 70% in recent years.

So it certainly seems that increased funding does indeed have a positive impact.

I'm not against change per se, but this is the wrong time to be wasting billions on these ill thought out reforms.

The fact that almost everyone involved in healthcare is concerned at the pace of change is something to take note of.

The UK spends USD2,992 per capita, 8.4% of GDP, on healthcare;
the French spend USD3601 per capita, 11% of GDP, ie 20% more per capita
(comparisons cross country comparisons).

Seems like you're arguing for increasing the health spend, Huddspur?

X-post

Our GP practice is staffed by incompetent money grabbing bstrds. When they were fund-holding no-one could get referrals to specialists or more expensive prescriptions. I asked to be fitted with a Mirena coil and the GP told me that it would cost the practice too much and I would have to have a cheaper one.

They will have the power to decide what health care we get and can pocket the difference.

They don't have to publish their accounts, comply with freedom of information or dislose any cosy arrangments with private companies.

This will however bring Cameron down. How many people in the meantime will lose out on the drugs and treatment they need.

I think, the general desire in our Trust at the moment is that GPs will employ the PCT staff members and fund the existing services so that thy continue.

That is our best-outcome scenario. We already know what works and what doesn't - successful modern NHS trusts operate like very slick businesses.

We hear complaints about too many managers - but would you run Europe's largest employer/business with no or few managers? GPs will have to find a way to manage and frankly, some don't want to, some are unable to, and others see pound signs flashing. I heard the figures recently - crap memory so can't remember the details - except that the new system will award GPs massive salaries and bonuses. Some are rubbing their hands in glee.

MrsDennisLeary I agree that wen my GP was fundholding they were more reluctant to refer. And dont get me started on NHS Dentistry - they resist treatment for so long you end up having teeth pulled because they have deteriorated so much! Both I and my OH have had this and we are not alone.

Pulling teeth is cheaper than crowns etc as they get little reimbursement and it eats into their profitsm therefore, they resist doing it at all costs.

I don't understand it! At my GP's we have to wait a week for an appt! Unless you're an emergency. How are they going to do any better than the NHS? My sister's GP is a lazy b'stard never wants to see his NHS patients, (only in the mornings) and has plenty of NHS time to see his private patients! I feel a sense of dread coming on!

P.S.It's up to us, to not allow it!

Tigereyemum. You are right when GP's hold budgets they are reluctant to refer. I can see those with the loudest voices getting the services.

Bad move on the coaltions part.

NHS on BBC news now.

The whole mess is going to screw up the system and the most vulnerable who rely on it and will have reverberations for many years if not generations to come.
As a sufferer of a chronic condition that I will probably have for life - this scares the hell out of me
I know of other RA sufferers around the world and currently I wouldn't be anywhere else - the NHS isn't perfect and does have its inefficiencies but it doesn't need an extremely expensive overhaul which will plunge it into chaos (which always costs money ) to sort it out.

It is back door privatisation (which has worked so well for this country so many times before ..... rail, utilities (the infrastructure of the system is in a shambles), PFI and cost us billions of pounds of wasted money) which is going to 'save money' in name alone and is actually going to cost us all dearly

GPs don't even want it which has got to say how wrong it all is. Some GPs are great but some are complete numpties (i've had both) and all are overstretched so how does this actually work without stretching this even more.

Rushing through these huge controversial plans is bloody awful news and saddens and upsets me and makes me truly worried about the future.

The sad thing is services are already beginning to fragment which leads to a poorer patient journey.

Fragmentation is also a big worry for children's health services in respect to child protection. Remember public services have to be interlinked to ensure the most vunerable are protected.

There are these people

who campaign to keep the NHS public

I work in the NHS and every day I speak to patients who say their GP doesn't listen to them. They want to be referred for things like a bone scan/autism/counselling etc and GP doesn't know how or if he can. This is where the PCT comes in, they have the commissioning managers with all that knowledge of how and where to refer.

My concern is that the GP Consortia which are being set up will want to change what is already set up (along with the monitoring and quality audits) and make decisions based on price alone without a thought to locality or quality. Also how well with these decisions be communicated to every GP practice in the consortia (average size 50 surgeries).

When you next see your GP ask him questions about how he sees this working for his patients. Will these services be easily accessible to you and your family? Will he be able to recommend them? etc.

Cameron in the Commons, saying he wants to make sure we get 'value for money' for the money we put into it.

As a healthcare professional and a patient, I would say we get outstanding value for money. It could be better - with more money and consistent standards. Not fragmentation and the application of 'market forces'.

... and can you imagine the flack GPs will be getting when patients don't get the referrals they want, at the time they want them? And who will handle all the complaints? I used th be a Complaints Manager in the NHS and just handling the serial complainers was a job in itself. The PCTs did a lot of gatekeeping in that area.

Angel1210 - I hear this all the time as well (one woman ended up getting a stroke because of neglect). Or that the GP simply does not care. One GP is so notorious for prescribing paracetamol regardless of your condition, that he is now known as Dr Paracetamol.

Dr Paracetamol I had a GP that refused to tell me what she was prescribing, she would just scribble an illegible squiggle and the pharmacist would decipher it.

Usually it was E45 cream which costs a third of the price over the counter and I was allergic to anyway She got so many prescriptions wrong that the lady behind the counter at Boots would shake her head and tell me what to really buy as the prescription was worthless!

They used to get £10 for every script they wrote....

TigerseyeMum - I have a few friends who are Pharmacists and they constantly complain about the prescriptions. I work in Radiology and I am always astounded at the unecessary or incorrect radiological examinations that patients are sent for.I wouldn't mind so much if radiation wasn't so hazardous.

Ps - You have made excellent points in your previous posts, and I really do wish we had more people like you in NHS management.

LadyFanny thank you for your compliment, I wish I was in management too! Sadly I am merely the works donkey, and I am just finishing my work for the day - long day - started at 8.30am and off to bed to start all over again in the morning!

At least we have jobs...for now!

I welcome DC plan to reform the NHS. Currently GP pays for hospital care when people are admitted to hospital. I work in a hospital and have noticed that people with long term conditions often re admit after DC. There are many conditions that does not require hospitalisation. Therefore if Gps are given fund then They can set up services that will support pts wit longterm conditions. NHS is costly to run. We should welcome plans that will reduce its cost and invest in plans that will generate money. It should remain free for all(for those that are entitle to it).

What will happen to the GP "service" that we are supposed to receive. I suspect that all we will get is another layer of accountants and managers at GP level who will then "interface" with their counterparts at the Primary Trusts, or whatever they will now be called.

I wonder how long it will take the policy thinkers to work through the implications of this change, and the additional cost.

Amaka "NHS is costly to run. We should welcome plans that will reduce its cost and invest in plans that will generate money"

Why? We already spend less on healthcare than many equivalent nations.

Personally I'm not interested in cutting fudning to the NHS, I'd rather see an improvement in care. I'd be happy to pay more tax to see that happen.

GPs having more say? Fine. Why can't we just add GPs to the existing PCTs, saving our self billions in the process?