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?

The NHS funding gap is primarly the result of increasing demand for services, not that there isn't some waste in the system, there is, but the main cause is demand rising higher than funding. Patient education about appropriate use of services is needed, there isn't enough money for everyone to have everything they want whenever they want it.

I'm also an NHS manager, I'm lucky that my role is already about working with and developing primary care so I'm probably in a better position than others, but I could still find myself out of a job, or working for a social enterprise with less favourable T&C.

We currently have to make major savings in order to keep the NHS afloat and at the same time we have to reduce staffing and handle the most significant reform of the NHS since its inception.

We've already lost key staff to a MARS scheme (mutually agreed resignation), and each week more staff leave the NHS for more stable roles elsewhere (mainly admin staff who are the backbone of back office functions).

BTW PCTs aren't going to be abolished in 2013 now, we're being merged to cover larger areas with less people, the role is currenly undefined and it's unclear where we fit in between the NHS commissioning board and GP commissioning Groups, I'm guessing a governance role not unlike the current SHA's who are being abolished in 2012.

Is that right TOS? Presumably they'll incoporate the local branch of the NHS Commissioning Board or whatever it's called?

Swedes1

I didn't book with my GP, just rang the midwives, who booked my scan etc.. The Nurse at the GP gave me a flu jab without me needing to see the GP first either. All saving the GP's time. Services can be organised better within the current framework.

ohananotherone - are you under the care of a consultant at a hospital: or are you having your baby in one of those midwifey units? I was specifically told I must go in for a GP appointment in order to be referred. He did no checks or examinations at all and asked me if I knew the rough due date. He didn't even get his little wheel out. It was totally pointless and a waste of time.

To whoever said they wanted to shove arsenic into DC's mouth, I have a sizable amount of Arsenic in my lab at work.

I saw a practice nurse for my first appointment and a midwife directly for my second. Normal pregnancies no consultant or hospital or special units.

Near beginning of this thread I read,

"DC is dismantling the NHS"

And I thought my DC's caused trouble !

Never mind, Hammer like daisies, tomorrow's another day !

Perhaps they can re-build it in meccano

I'm not just dis-believing, I'm terrified.
Where was this is either of the CON-DEMs manisfesto?

Back door privatisation for sure.

The hospitals will become Foundation Trusts which are private enterprises and will have to compete for 'business'. Hospitals that aren't making enough money will go under just like a private business would.

National tariffs (what hospitals are paid for each procedure or hospital stay) which are now set at a standard rate, will no longer be a standard rate but the maximum rate, which means if other (private) companies can provide the same service for less money then they'll get more 'business' (although of course it's totally questionable whether they will be able to provide the same quality of care for less money. And it WILL be all about attracting business not quality of care).

Commissioning boards will be set up in place of PCTs but these will be social enterprises ie. a private businesses.

GP consortias will be free to employ whoever they want to manage their commissioning duties ie. private companies or ex-pct staff.

If this all goes through there will be very few members of staff actually employed by the 'NHS'. Which is what DC wants really.

By the way DC did not mention any of this is his party manifesto - he just said the NHS would be 'safe' :(

Arsenic you say? Hmmm...

I was a bit concerned over the DC bit too - but then, even though they are 'very advanced' don't think they could go that far...

No uptake yet on the MN campaign? Do we need more hits to get that then?

DC also said 'no top down reorganisation of the NHS'. I must be imagining the abolition of PCTs, then...

Privatisation is already happening. KPMG has been given the contract to run GP commissioning in London (the system that will replace primary care trusts).

Oh, and it's very unclear how these private companies will be accountable to the public and patients if at all. The new GP commissioning groups don't have to have non-exec directors, which is the traditional way of having public input (not perfect but replacement is actually worse).

And let's not forget 20% cuts in the NHS budget and massive reorganisation are coming in at the same time as legal aid reforms that will make it impossible to sue for clinical negligence. So when the crappy outsourced bargain basement care leaves you injured or permanently disabled, tough shit.

Ahh but DC said that this is a bottom up reorganisation and he isn't back tracking on his no top down reorganisation promise . WTF?

So... if the NHS was already so fantastic, why do so many people complain about it?

Also when DC was accused of back-door privatisation in his speech yesterday, he replied "Oh grow up" - basically he has no proper answer so just has to resort to playground retorts

So what's to do? (calmer now)

An MN campaign, as Hully suggests? I think that would be a start. How do you go about it (never done one before)?

The only other thing that occurs to me, apart from demonstrating and mass sit-ins, etc, which will probably come anyway, is a sort of passive resistance.

Maybe we should take one thing at a time and think how we could combat it on an individual basis. For example, GP wants to send us to a private company for our care. Could we ask to be referred to an NHS one instead? What rights do we as patients have about who should treat us?

Another issue, under-qualified/unqualified staff at private companies (mentioned above). Do we have the right to ask about the qualifications of the nurses who will be caring for us and our kids? I'm sure we could find out via Freedom of Info Act, but that would take too long - we'd want to know on the spot.

This is just from the point of view of patients of course. I feel really sorry for the NHS workers caught up in this. What could they do to protect themselves/change the situation/register a protest - apart from joining a union and striking?

want2Be I think your OB/GYN is confusing administrative issues with clinical ability.

I second erebus' post re: accountability and patient safety, health professionals employed by the NHS have to have certain recognised qualifications and work to a professional code of conduct set by our professional bodies. If they don't work to these standards they can be disciplined and in the worst case scenario struck off the register all of which keeps people on their toes. I would be surprised if a private profit making company would be as particular about its staff

In terms of cost cutting as someone working in the NHS I'm increasingly seeing health professionals being "asked" by managers to train essentially lay people to do some of the clinical work which traditionally would have been done by graduate entry staff, including seeing and prescribing to patients. Of course they have to be supervised but increasingly as departments get busier and they don't have the money to recruit properly qualified staff more and more clinical responsibility is being given to these cheap assistants without the appropriate training or qualifications. So if you are referred to see a speech therapist, physiotherapist, dietitian or OT make sure you're seeing them rather than be fobbed off to their assistants or support workers, you'll notice the difference in the quality of the consultation and advice.
Oh by the way if the support worker/assistant gets it wrong then the trust is protected from blame as they can shift it onto the health professional who they gave all the supervising responsibility to .

So mumzy, maybe we'd better be checking the qualifications of some NHS staff too? The thing is I think I would be too embarrassed to ask, face to face, as it's not the individual's fault, is it?

The trouble with the NHS, speaking as one who works in it, is the ridiculous amounts of bureaucracy and paperwork. Every time somethings needs doing we get more managers and less room for common sense.

Unfortunately cuts never seem to reduce the managers, paperwork or lack of practicality but often hit clinical staff and services.

BTW can I second the opinions about the importance of staff qualifications. I have worked for a large high street chemist and seen the problems arising when they "imported" spanish and polish pharmacists who were cheaper than their fully trained UK counterparts

jade - people complain because the NHS is a complex organisation dealing with people at their most vulnerable and sometimes mistakes are made. Sometimes staff aren't all they should be. Sometimes equipment fails. Sometimes despite every effort things go wrong and the only way you could have prevented it is with hindsight. There are lots of reasons for complaints. There are also lots and lost of people who aren't harmed by their care but who are healed and supported and cared for from their birth to their death. THere will always be complaints and if you meet someone who tells you they can deliver cheap and totally safe care then you are talking to a liar and a charletan.

Northernlurker, I remember a thread on here about how great the NHS is.

Maybe that would be a better focus. Everyone to write to their local hospital to say thank you - evidence that they are absolutely fantastic. Then D & C wouldn't hve a leg to stand on when they say the NHS is second rate best.