NHS Reform vote passed - what will it mean?

[CeliaFate]

Everyone I follow on Twitter (journos and media types) are lamenting what they see as the demise of the NHS. What are the planned reforms?

You might find this Q&A about healthcare reforms article helpful

The NHS to be broken up and bits sold off to the highest bidder. Even the Department of Health's 'myth buster' press release actually admitted hospitals will be sold off to foreign multi-nationals - but the NHS will still have all the liabilities so apparently that's fine and dandy.

It's already happening anyway, extremely fat multi-million pound contracts to run little things like the whole NHS in London have been awarded to the private sector.

You might also find this useful legal advice on the effects of NHS reforms

Anyone in any doubt about what the Coalition Government have in store for our N.H.S. can see what Andrew Lansley was up to on Wednesday, the day the bill was passed through the House of Commons: www.laingbuisson.co.uk/Events/IndependentHealthcareForum/IHFPPUConference.aspx

So he was talking to a conference run by a "provider of information and market intelligence on the independent health, community care and childcare sectors.".... why is that significant? As long as we don't have to pay (beyond the prescription charge that most seem to accept as a given) for healthcare and as long as that care is better than it is at the moment, is it really important how it is delivered?

Of course it's important how healthcare is delivered as much as what. The NHS is the best in the world for universal access. The US is shit on practically any outcome you want to name and hideously expensive to boot.

Allowing the private sector to cherry-pick profitable patients will lead to worse healthcare for everyone else, and destabilise NHS trusts as they lose income. Hospitals and community services will close as a result. The Royal Marsden will devote much of its effort and attention to private patients, having applied to lift the cap on their numbers. And even the profitable patients may well not get the best healthcare, just what is most profitable/ easiest/cheapest for the provider.

The private sector also doesn't have to pay for medical training - the state carries that burden, especially the NHS. As usual with government privatisations, the taxpayer gets the liabilities and costs, the private sector the benefits and the money and sod the poor old patient/passenger/service user/customer/employee.

I don't have any doubt about this - it's a total unmitigated disaster for the vast majority of us.

The only way we will be able to deal with the failings of the private health providers will be to take out health insurance. And - you heard it here first - the next step in this process will be to make it compulsory. And those who aren't insured won't get treated, just like in the US, where they do let people die if they aren't insured.

And with the health care providers not being subject to the Freedom of Information Act, there will be no way of finding out what happened during a bungled op, and no legal aid available if you want to take them to court. Nice.

Just been talking to GOSH. Now they have foundation trust status and the cap will be removed, they will increase private income to 1/3 of total business. Slightly confused about their charitable status and who the money raised for the new building is benefitting.

it means we're all fucked unless rich

I have been made to feel like a slacker by private doc support staff for not having medical insurance for DD. How many people have this? Cover is so limited. Private sector docs behave like quacks at the county fair - gone by morning. If anything's gone wrong it's back to the blessed NHS begging for help to clear up the mess - and they say 'Tsk. Why did you go there? What did you expect?'

CateofCateHall Thanks for the conference Independent Healthcare Reform
agenda. I felt physically sick reading that, esp 'What added value can the NHS offer to private patients?'

eico - let's not forget GOSH did their level best to cover up their failings in the Baby Peter Connolly case, including lying to the official inquiry (by only presenting a very edited version of events). AND refused to sack their chief executive or hold her to account in any way, despite protests from consultants. And their inept handling of Peter's case was because they cut costs at the clinic where he was treated, despite the consultant in charge begging them to sort it out and warning them it was dangerous.

I've no doubt their chief exec will be only too happy to 'maximise income' and sod patient care for ordinary people who can't afford to go private.

I know what they're like

I spoke to the spin doctor and he said the increase in 'international business', as they like to call it, will subsidise NHS services and enable them to retain top rank clinicians.

But I distinctly remember handing over a massive wad of cash direct to the consultant's bank account (the one who had such a massive NHS waiting list we had to pay to get assessment from - available next working day).

Some consultants will rush the NHS clinic to get to their private patients, a la Getting On with the delicious Jo Brand.

I think the main effect patients will feel is NHS staff whinging and whining because they'll have to work for their pay instead of whinging, whining and having a go at patients all the time.

Pseud Interesting point. I would like to see some lose the attitude and get on with what they're paid to do, which includes departmental systems management. Unfortunately the happiest docs are those who refuse treatment in order to manage their day, which will become more of an option even in the NHS when the obligation to treat is removed.

Of course, my remark was a generalisation - I know a lot of NHS staff are hard working and do care, but there are a lot who do not work hard and don't care as well. Hopefully the privatisation of the NHS providers will sort those out.

Yep. I can see how Any Qualified Provider jobs will attract good staff on flexible contracts. One problem now is insufficient consultant grade posts for dedicated people, jobs for life and dead man's boots. More flexibility might be nice, docs might have more opportunities and be happier.

The AQP organisations will be limited to their remit and to profit-making, and there won't be any teaching going on or treatment outside the remit. This will be their prime motivation, sometimes at variance with conscience. They will see treating the uninsured as a charitable act. Their medicolegal service will advise them not to share the notes with other providers. Docs will have to put aside their consciences, especially on obligation to treat, because AQP management will not support risk, having a permanent eye to their medicolegal position US-style.

Duties of a doctor registered with the General Medical Council: www.gmc-uk.org/guidance/good_medical_practice/duties_of_a_doctor.asp
"Patients must be able to trust doctors with their lives and health. To justify that trust you must show respect for human life and you must:
Make the care of your patient your first concern."

Please... is this just me?

I would be interested to hear what people think this will mean for maternity services. Do you think we will be going down the American route of more and more women having c-sections simply because it is more profitable for the hospital rather than because they actually need them?

www.property-magazine.eu/carecapital-resolution-to-grant-planning-permission-17860.html
Actually this sounds quite cool - it's a proposed private-sector Proton Beam Therapy unit in Moorgate, City of London, available through NHS Trusts for children who previously would be sent abroad @ £150k ea.

Under 'any qualified provider' money will be spent in the private health sector, thus taking money outof the NHS. When NHS facilities have been undercut for a while, they will be allowed to go bust and close. (Unlike banks). The Sec of State will no longer be responsible for providing a National Health Service. Now would be a good time to panic.

I am panicking! It's a slippery slope - Nye Bevan will be spinning in his grave. I can't really believe we are allowing this to happen with no protests... it seems to be slipping under the radar.