Govt White Paper on NHS-reforms will cost billions to implement and will see further privatisation of healthcare.

[ArcticRoll]

Government are selling this to the public that it is about giving power back to clinicians rather than managers but really their main objective is to break up the NHS and line the pockets of shareholders in the private sector.
If the plans go through the focus over the next couple of years will be all abour re-organisation diverting resources from the frontline.

Privitisation came in through the front door about 4 years ago when the likes of Assura were allowed to provide GP services. Many people now receive GP services from the Branson / Virgin empire (who bought out Assura) but just don't know it.

Just to clarify - that's 3 million people who are covered for primary care services by Virgin / Assura (according to their website).

Stealth - does look terribly like PCGs mark 2 IF it works well. GP leadership should, in theory, make a difference. In practice, who knows?

If it's just a front for privatisation (which it could well be, they are lifting the cap on foundation trusts doing private work) then it's shit. Not surprised the Lib Dems are in favour though, their right wing free-market liberals are right wing free market liberals who are naturally in favour of privatisation. Lansley is talking about making all trusts Foundation Trusts (chasing FT status is what gave us the Staffs scandal) AND then turning them into social enterprises i.e. privatising them but saying 'hey guys, they are not horrid nasty big business'.

I'm not aware that social enterprise on that scale has been tried before or is mature enough as a concept or sufficiently well-regulated or accountable to the public. But could be wrong, I dunno if it works in other countries? Even so, the NHS is one of the biggest employers in the world with 1.4m employees - how the hell will that work? And is it just a front for forcing people off NHS terms and conditions and out of the pension scheme?

see here re. moving towards privatising hospitals

exactly, edam, could well be a front for forcing 1.4m out of an expesnive final salary scheme. This debate is mumsnet at its best, imho! (And thankfully no NHS pen-pusher bashing as yet)This is a huge issue not only for the workforce but for the public, nhs change on an unprecedented scale..

Out of interest, PCT managers what are you going on a personal level? Polishing your cv, jumping ship to the likes of capgemini, tribal or hanging on in there for Gp consortia to be set up??

yes edam, getting people out of the PCT T&Cs was my thought too.

I'm hanging around...don't feel that I have a lot of options at the moment.

The point imo is to privatise the NHS whilst telling people that the NHS still exists. And yes it will for a few years yet, but the natural consequence of what they are doing is the removal of everything which makes the NHS what it is.

I realise that I sound dramatic but I honestly believe that the introduction of this change will destroy the NHS.

You have GPs who are businesses, hospitals which will all be businesses by 2013 and pharmacist and dentist, who for all intents and purposes are businesses. What is left?

A social enterprise is still a business just a 'nice' one.

And the social enterprise hospitals will be required to bid for contracts alongside private providers - if they don't win work, they become financially unviable and close.

I can picture in 6 years time, the Tories telling us that the Market and patient 'choice' has determined what services should be available and where - "nuthin to do with us honest"

Agree munstersmum that there has been a lot of contracting out to private sector already but think the new proposals will hand over swathes of the NHS to the private sector.
Agree with expatagain about one of it's aims is to remove the terms and conditions for the NHS workforce.
This governement is hell bent on bashing the public sector and seems to have forgotten that one of the main reasons for the economic mess was because taxpayers bailed out the private sector big time. However the Tories are still clinging onto their ideology that private sector would run public services better than the state.

Edam - Think you have hit the nail on the head there with you comment "And is it just a front for forcing people off NHS terms and conditions and out of the pension scheme?" This is what i was alluding to in my post last night. The job will still need to be done, but instead of a NHS staff(PCT or whatever) the private sector will provide the service. I will withhold my comment of this so called companies with so called "expertise"......Watching PM questions earlier Cameron inferred that the re organisation would cause LESS bureaucracy - It wont, it will just be moved else where(with costs to match I'm sure) The merry-go-round continues....

Agree pinky about the private sector and the their 'expertise'-seems completely crazy to have spent millions on training NHS managers and to discard all their knowledge and experience and hand the job over to private companies who know nowt! Also agree that it won't reduce bureaucracy or save money.

Its depressing.

I also think they are hell bent on dismantling the NHS.

I haven't read the paper yet. (on the to do list)
but it begs the question of who is going to be responsible for the training of staff.

The limited experience I have of working alongside private healthcare companies suggest that they do not like complicated patients or undertaking care that may have a higher element of risk. Are they now prepared to do this?

Why on earth do they think this is the best way of running the NHS when the American model is unsustainable as it takes up double the amount of GDP.

How can they justify the ethics of handing over taxpayers money to private business for them to make a profit out of? How is that more efficient or cost effective?

there wont be any choice over treatment - or at least no more than there is now. most people are restricted by geography to their local hospitals.

Agree nellie it is extremely depressing.
There doesn't appear to be a clamour for change from GPs/consultants/ other healthcare professionals also not from patients.
The only groups that appear to be championing this are the right wing think tanks and of course the private companies who will make huge profits.
I agree that the NHS has become rather bloated with management but feel that these reforms will merely hand the bureaucracy over to private sector and there will be no savings to NHS.
It is purely ideology driven-public sector= bad private sector= good.

"How can they justify the ethics of handing over taxpayers money to private business for them to make a profit out of?"

very good question

also agree about choice - people don;t want choice, they want quality care at their local hospital, surely?

I'm not sure they will have to justify themselves that much tbh.

The general public only hear the headlines - GPs will be taking over decision mkaing re what services are available, this will save millions in unneeded management costs and you get increased choice

Oh, they've been handing shedloads of taxpayer's cash to the private sector to make hay with it for decades. Look at PFI hospitals - now there's a goldmine. Railtrack AND the train operating companies. Or the bank bail out... or Capita or as people have said firms running GP services.

"The Board will have an explicit duty to promote equality and tackle inequalities in access to healthcare"

so do they advise GPs? will they have any power to do this? If there are inequalities because of the way the GPs are commissioning - so what?

OK so the local authority are responsible for public health/health improvement!

The purpose of the NHS is to provide health care that is free at the point of delivery. I don't see that it makes a difference who provides it in terms of the NHS continuing to exist. You can argue about if these change are more or less efficient, good or bad for patients etc. but even if every single part of the NHS becomes run by a private company, as long a patients are not being charged directly then there is still an NHS.

"Why on earth do they think this is the best way of running the NHS when the American model is unsustainable as it takes up double the amount of GDP."

I don't see any suggestion of the American system here. That is based on almost 100% private health insurance, that leads to spriraling costs as it is in the interests of both the insurers and the health care providers to keep prices high and the consumers (patients) have no influence on the system.

Have you read about the personal health budgets? I don't know the details but have a feeling that is the first step towards government provided health insurance

OK up to 3 and going to bed

Interesting article in today's Guardian

thx AR

Yes a major/key tenet of the NHS is free at the point of delivery but there are many other things that make the NHS a national health service.