Death of the Nash
Discussion
http://www.publications.parliament.uk/pa/ld201011/...
An Excerpt below of a good speech.
Baroness Kennedy of The Shaws: My Lords, I make a declaration that I am a fellow of three royal colleges, too, like the noble Baroness, Lady Cumberlege. I should also say that I am married to a surgeon who has spent his life in the National Health Service. He is from a dynasty of doctors. His grandfather was a doctor, his mother a doctor, his aunt a doctor and now our daughter is entering medical school. They all entered medicine not because they are interested in making money but because they want to care for people. It is the idea of being at the service of others that draws most health carers into medicine. They do not want to run businesses; they do not see their patients as consumers or themselves as providers. They do not see their relationship as commercial and they do not want to be part of anything other than a publicly funded and provided National Health Service.
Health professionals also feel proud, as all of my husband's colleagues do, that Britain is the only country in the industrialised world where wealth does not in some measure determine access to healthcare. They are saddened that the National Health Service is now facing the prospect of becoming a competitive market of private providers funded by the taxpayer. When we hear talk of accountability, they point out that nothing in the Bill requires the boards of NHS-funded bodies to meet in public, so there will be a lack of transparency. That will be complicated by the fact that private providers are not subject to the Freedom of Information Act, so they can cite commercial sensitivity to cover their activities.
Others have spoken of the removal of the duty on the Secretary of State to provide healthcare services and pointed out that that duty is now to be with unelected commissioning consortia accountable to a quango, the national Commissioning Board. The Bill does not state that comprehensive services must be provided, so there may well be large gaps in service provision in parts of the country, with no Secretary of
11 Oct 2011 : Column 1552
State answerable. Providers will be able to close local services without reference of the decision to the Secretary of State. Although the Government say that the treatment will be free at the point of delivery-we hear the calm reassurances-the power to charge is to be given to consortia. That paves the way for top-up charging and could lead eventually to an insurance-based model.
Monitor, the regulator, is to have the duty to sniff out and eliminate anti-competitive behaviour-and, of course, to promote competition. According to the Explanatory Notes to the original Bill, Monitor is modelled on
"precedents from the utilities, rail and telecoms industries".
How is that for reassurance to the general public? If anything should be a warning that this spells catastrophe, it should be that this is another step in the disastrous selling-off of the family silver to the private sector, with the public eventually being held to ransom and quality becoming second to profitability.
The regulator, Monitor, will have the power to fine hospital trusts 10 per cent of their income for anti-competitive behaviour. Any decent doctor will tell you that for seamless, efficient care for patients, integration is key to improving quality of life and patient experience. The question is whether competition and integration can co-exist. Evidence from the Netherlands is that they cannot. There, market-style health reforms designed to promote competitive behaviour have meant that healthcare providers have been prevented from entering into agreements that restrict competition, so networks involving GPs, geriatricians, nursing homes and social care providers have been ruled anti-competitive. There is a fear that care pathways, integrated services and equitable access to care in this country will be lost when placed second to market interests.
Under the delusion of greater patient choice, people are to be given a personal health budget. I am interested to hear what happens if it runs out halfway through the year. Private hospitals will enter the fray as treatment providers and, as in other arenas, they will undoubtedly, as others have said, cherry-pick and offer treatment for cases where they can treat a high number of low-risk patients and make a profit-for example, hip and knee replacement, cataracts, ENT and gynae procedures.
It is essential in an acute teaching hospital to retain the case mix, though, so it will be the teaching hospitals that will also provide the loss-making services such as accident and emergency and intensive care and deal with chronic illness and the diseases of the poor, such as obesity-we can name them all. These are essential services but they are also very costly. An ordinary hospital cannot provide them if it does not have the quick throughput cases as well to maintain a financial balance. If relatively easy procedures go to private providers, the loss of revenue to the trusts will eventually lead to them being unable to provide the costly essential services. It will mean that doctors trained in these places are not exposed to all aspects of patient care. Private companies cherry-picking services undermines and destabilises the ability of the NHS to deliver essential services like, as I have mentioned, intensive care units, accident and emergency, teaching, training and research.
11 Oct 2011 : Column 1553
Clause 294 allows for the transferring of NHS assets, including land, to third parties, and the selling off of assets. Clause 160 allows for the raising of loans by trusts, so hospitals taken over by the private sector could be asset-stripped and then sold on, as happened with Southern Cross homes.
The removal of practice boundaries and primary care trust boundaries will mean that commissioning groups will not be coterminous with social services in local authorities, so vulnerable people are more likely to fall through the gaps between GP practices. GPs will also be able to cherry-pick by excluding patients who cost more money and can lead to overspend.
Then there is the issue of the cost of market-based healthcare. Advertising, billing, legal disputes-I say this as a lawyer-multimillion-pound executive salaries, dividends and fraud could end up consuming a huge amount of the pot that can be spent on front-line services. We will end up, as in America, with that extra stuff taking up 20 per cent of the health budget. The downward spiral of ethics, the increase in dishonesty and the conflicts of interest become huge, and you see the destruction of the public service ethos.
I want to scream to the public, "Don't let them do it"-and in fact the public are responding by saying in turn, "Don't let them do it". Market competition in healthcare does not improve outcomes. The US has the highest spending in the world and the outcomes are mediocre. The US overdiagnoses, overtreats and overtests. Why? Because that increases revenue. You change the nature of the relationship between doctors and their patients. You get more lawsuits and doctors therefore practise defensive medicine. You ruin your system.
I say this particularly to colleagues on the Liberal Democrat Benches. They may be being encouraged to think that voting against the Bill may bring down the coalition, but all I can say is that the electorate is watching. If people feel failed by the party on this, I am afraid that it will pay a terrible price.
This has been a 25-year project, done by stealth. It started with the internal market and is now moving to the external market. It was not thought up by mere politicians but by the money men, the private healthcare companies and the consultancies like McKinsey-the people, in fact, who in many ways brought us the banking crisis. They have funded pro-market think tanks and achieved deep penetration into the Department of Health, into many of our health organisations and right into some of the senior levels of my party as well as those on the other Benches.
The NHS is totemic. It is about a pool of altruism and it speaks to who we are as a nation. It is the mortar that binds us in the way that the American constitution does the American people. For us, it is about this system. It really is the place where we are "all in it together"-one of the few places, it would seem at the moment. Doctors get 88 per cent trust ratings with the public, while politicians get 14 per cent. The vast majority of doctors are saying to us, "Withdraw this Bill". We should be listening.
http://www.bbc.co.uk/news/uk-politics-15269207
This is the end of free at the point of care health care. RIP
An Excerpt below of a good speech.
Baroness Kennedy of The Shaws: My Lords, I make a declaration that I am a fellow of three royal colleges, too, like the noble Baroness, Lady Cumberlege. I should also say that I am married to a surgeon who has spent his life in the National Health Service. He is from a dynasty of doctors. His grandfather was a doctor, his mother a doctor, his aunt a doctor and now our daughter is entering medical school. They all entered medicine not because they are interested in making money but because they want to care for people. It is the idea of being at the service of others that draws most health carers into medicine. They do not want to run businesses; they do not see their patients as consumers or themselves as providers. They do not see their relationship as commercial and they do not want to be part of anything other than a publicly funded and provided National Health Service.
Health professionals also feel proud, as all of my husband's colleagues do, that Britain is the only country in the industrialised world where wealth does not in some measure determine access to healthcare. They are saddened that the National Health Service is now facing the prospect of becoming a competitive market of private providers funded by the taxpayer. When we hear talk of accountability, they point out that nothing in the Bill requires the boards of NHS-funded bodies to meet in public, so there will be a lack of transparency. That will be complicated by the fact that private providers are not subject to the Freedom of Information Act, so they can cite commercial sensitivity to cover their activities.
Others have spoken of the removal of the duty on the Secretary of State to provide healthcare services and pointed out that that duty is now to be with unelected commissioning consortia accountable to a quango, the national Commissioning Board. The Bill does not state that comprehensive services must be provided, so there may well be large gaps in service provision in parts of the country, with no Secretary of
11 Oct 2011 : Column 1552
State answerable. Providers will be able to close local services without reference of the decision to the Secretary of State. Although the Government say that the treatment will be free at the point of delivery-we hear the calm reassurances-the power to charge is to be given to consortia. That paves the way for top-up charging and could lead eventually to an insurance-based model.
Monitor, the regulator, is to have the duty to sniff out and eliminate anti-competitive behaviour-and, of course, to promote competition. According to the Explanatory Notes to the original Bill, Monitor is modelled on
"precedents from the utilities, rail and telecoms industries".
How is that for reassurance to the general public? If anything should be a warning that this spells catastrophe, it should be that this is another step in the disastrous selling-off of the family silver to the private sector, with the public eventually being held to ransom and quality becoming second to profitability.
The regulator, Monitor, will have the power to fine hospital trusts 10 per cent of their income for anti-competitive behaviour. Any decent doctor will tell you that for seamless, efficient care for patients, integration is key to improving quality of life and patient experience. The question is whether competition and integration can co-exist. Evidence from the Netherlands is that they cannot. There, market-style health reforms designed to promote competitive behaviour have meant that healthcare providers have been prevented from entering into agreements that restrict competition, so networks involving GPs, geriatricians, nursing homes and social care providers have been ruled anti-competitive. There is a fear that care pathways, integrated services and equitable access to care in this country will be lost when placed second to market interests.
Under the delusion of greater patient choice, people are to be given a personal health budget. I am interested to hear what happens if it runs out halfway through the year. Private hospitals will enter the fray as treatment providers and, as in other arenas, they will undoubtedly, as others have said, cherry-pick and offer treatment for cases where they can treat a high number of low-risk patients and make a profit-for example, hip and knee replacement, cataracts, ENT and gynae procedures.
It is essential in an acute teaching hospital to retain the case mix, though, so it will be the teaching hospitals that will also provide the loss-making services such as accident and emergency and intensive care and deal with chronic illness and the diseases of the poor, such as obesity-we can name them all. These are essential services but they are also very costly. An ordinary hospital cannot provide them if it does not have the quick throughput cases as well to maintain a financial balance. If relatively easy procedures go to private providers, the loss of revenue to the trusts will eventually lead to them being unable to provide the costly essential services. It will mean that doctors trained in these places are not exposed to all aspects of patient care. Private companies cherry-picking services undermines and destabilises the ability of the NHS to deliver essential services like, as I have mentioned, intensive care units, accident and emergency, teaching, training and research.
11 Oct 2011 : Column 1553
Clause 294 allows for the transferring of NHS assets, including land, to third parties, and the selling off of assets. Clause 160 allows for the raising of loans by trusts, so hospitals taken over by the private sector could be asset-stripped and then sold on, as happened with Southern Cross homes.
The removal of practice boundaries and primary care trust boundaries will mean that commissioning groups will not be coterminous with social services in local authorities, so vulnerable people are more likely to fall through the gaps between GP practices. GPs will also be able to cherry-pick by excluding patients who cost more money and can lead to overspend.
Then there is the issue of the cost of market-based healthcare. Advertising, billing, legal disputes-I say this as a lawyer-multimillion-pound executive salaries, dividends and fraud could end up consuming a huge amount of the pot that can be spent on front-line services. We will end up, as in America, with that extra stuff taking up 20 per cent of the health budget. The downward spiral of ethics, the increase in dishonesty and the conflicts of interest become huge, and you see the destruction of the public service ethos.
I want to scream to the public, "Don't let them do it"-and in fact the public are responding by saying in turn, "Don't let them do it". Market competition in healthcare does not improve outcomes. The US has the highest spending in the world and the outcomes are mediocre. The US overdiagnoses, overtreats and overtests. Why? Because that increases revenue. You change the nature of the relationship between doctors and their patients. You get more lawsuits and doctors therefore practise defensive medicine. You ruin your system.
I say this particularly to colleagues on the Liberal Democrat Benches. They may be being encouraged to think that voting against the Bill may bring down the coalition, but all I can say is that the electorate is watching. If people feel failed by the party on this, I am afraid that it will pay a terrible price.
This has been a 25-year project, done by stealth. It started with the internal market and is now moving to the external market. It was not thought up by mere politicians but by the money men, the private healthcare companies and the consultancies like McKinsey-the people, in fact, who in many ways brought us the banking crisis. They have funded pro-market think tanks and achieved deep penetration into the Department of Health, into many of our health organisations and right into some of the senior levels of my party as well as those on the other Benches.
The NHS is totemic. It is about a pool of altruism and it speaks to who we are as a nation. It is the mortar that binds us in the way that the American constitution does the American people. For us, it is about this system. It really is the place where we are "all in it together"-one of the few places, it would seem at the moment. Doctors get 88 per cent trust ratings with the public, while politicians get 14 per cent. The vast majority of doctors are saying to us, "Withdraw this Bill". We should be listening.
http://www.bbc.co.uk/news/uk-politics-15269207
This is the end of free at the point of care health care. RIP
Bing o said:
I think the NHS is wonderful. It employs all those millions of people, provides healthcare that is the envy of the free world. You only need look at how happy and healthy UK citizens are to see what a roaring success it is.
The NHS is a good idea badly executed by inept people who are out to line their own pockets at the first opportunity.The actual care and treatment given by those in the front line is good, they have literally saved my life more than once and I have paid nothing at point of care.
The country is f
ked because of the instant gratification culture that has spread over the land like a disease, a culture that encourages everyone to know their rights but not their responsibilities while firmly believing that they are entitled to everything just because they are alive. Because the country is f
ked so is the NHS. the whole rotten lot needs sorting out from the root, anything else is just fiddling while Rome burns.pacman1 said:
If I remember the stat correctly, the NHS are the third biggest employer in the world, after the Chinese Army and the Indian State Railway.
Not according to other parts of the internethttp://www.dailymail.co.uk/news/article-2038401/De...
Is it?
The NHS already has several competitive markets - most notably in elective care - introdueced by the last Government. Lack of accountability used to exist in the NHS too but part of these reforms will be forcing NHS Foundation Trusts (set up under the last Government) to meet in public for the first time.
For a barrister and peer, it is disappointing that her grasp of the law is so weak. The Government are extending Freedom of Information to apply to private companies that take significant public contracts or provide what are regarded as public services. Citing commercial sensitivity is a common tactic used by the public sector whenever they do not wish to release incriminating information.
[quote]Under the delusion of greater patient choice, people are to be given a personal health budget. I am interested to hear what happens if it runs out halfway through the year. Private hospitals will enter the fray as treatment providers and, as in other arenas, they will undoubtedly, as others have said, cherry-pick and offer treatment for cases where they can treat a high number of low-risk patients and make a profit-for example, hip and knee replacement, cataracts, ENT and gynae procedures.
And yet there a private firms running NHS hospitals and providing all sorts of NHS care. Despite all three major parties promising in their manifestos to open the NHS up to independent sector providers, the opposition have turned this into "evil private companies", ignoring the many social enterprises and charities that have developed better, cheaper treatments than what the NHS continue to insist upon (even where the clinical evidence shows they do more harm than good).nakulan7 said:
http://www.publications.parliament.uk/pa/ld201011/...
An Excerpt below of a good speech.
Baroness Kennedy of The Shaws: My Lords, I make a declaration that I am a fellow of three royal colleges, too, like the noble Baroness, Lady Cumberlege. I should also say that I am married to a surgeon who has spent his life in the National Health Service. He is from a dynasty of doctors. His grandfather was a doctor, his mother a doctor, his aunt a doctor and now our daughter is entering medical school.
According to Wikipedia, the Baronness is a lawyer by professional. The two Royal College fellowships mentioned are honorary. While she may be advised by her husband, it should be borne in mind that Consultants have a strong interest in preventing the balance of power moving away from them and the Hospital to GPs and primary care.An Excerpt below of a good speech.
Baroness Kennedy of The Shaws: My Lords, I make a declaration that I am a fellow of three royal colleges, too, like the noble Baroness, Lady Cumberlege. I should also say that I am married to a surgeon who has spent his life in the National Health Service. He is from a dynasty of doctors. His grandfather was a doctor, his mother a doctor, his aunt a doctor and now our daughter is entering medical school.
said:
They all entered medicine not because they are interested in making money but because they want to care for people. It is the idea of being at the service of others that draws most health carers into medicine. They do not want to run businesses; they do not see their patients as consumers or themselves as providers. They do not see their relationship as commercial and they do not want to be part of anything other than a publicly funded and provided National Health Service.
For as long as there has been an NHS there have been GPs running their practices as private businesses and doctors treating patients privately. It is very hypocritical for the BMA to suggest on one hand that doctors are not interested in the money while on other hand protecting the right of doctors to private practice. said:
Health professionals also feel proud, as all of my husband's colleagues do, that Britain is the only country in the industrialised world where wealth does not in some measure determine access to healthcare. They are saddened that the National Health Service is now facing the prospect of becoming a competitive market of private providers funded by the taxpayer. When we hear talk of accountability, they point out that nothing in the Bill requires the boards of NHS-funded bodies to meet in public, so there will be a lack of transparency. That will be complicated by the fact that private providers are not subject to the Freedom of Information Act, so they can cite commercial sensitivity to cover their activities.
The suggestion that Britain is the only industralised country that provides universal healthcare to all couldn't be further for the truth - not least as Italy and Norway follow the same Beveridge model. Nor do those in countries which employ the Bismarck model want for lack of wealth.The NHS already has several competitive markets - most notably in elective care - introdueced by the last Government. Lack of accountability used to exist in the NHS too but part of these reforms will be forcing NHS Foundation Trusts (set up under the last Government) to meet in public for the first time.
For a barrister and peer, it is disappointing that her grasp of the law is so weak. The Government are extending Freedom of Information to apply to private companies that take significant public contracts or provide what are regarded as public services. Citing commercial sensitivity is a common tactic used by the public sector whenever they do not wish to release incriminating information.
said:
Others have spoken of the removal of the duty on the Secretary of State to provide healthcare services and pointed out that that duty is now to be with unelected commissioning consortia accountable to a quango, the national Commissioning Board. The Bill does not state that comprehensive services must be provided, so there may well be large gaps in service provision in parts of the country, with no Secretary of State answerable. Providers will be able to close local services without reference of the decision to the Secretary of State. Although the Government say that the treatment will be free at the point of delivery-we hear the calm reassurances-the power to charge is to be given to consortia. That paves the way for top-up charging and could lead eventually to an insurance-based model.
Again, her grasp of the Bill is wanting. Section 1 of the Bill is virtually identical to Section 1 of National Health Service Act 2006 - the SofS has and will continue to be required to promote a comprehensive health service in England. This has been one of the most underhand attacks critics have used - by suggesting that duty is being changed from "provide" to only "promote" when in fact both the 2006 Act and the new Bill use "promote". said:
Monitor, the regulator, is to have the duty to sniff out and eliminate anti-competitive behaviour-and, of course, to promote competition. According to the Explanatory Notes to the original Bill, Monitor is modelled on "precedents from the utilities, rail and telecoms industries". How is that for reassurance to the general public? If anything should be a warning that this spells catastrophe, it should be that this is another step in the disastrous selling-off of the family silver to the private sector, with the public eventually being held to ransom and quality becoming second to profitability.
As a peer, she ought to be well aware that the bill has changed considerably since it's introduction. In any event, the NHS Cooperation and Competition Panel will retain its role as the main competition regulator in the NHS - enforcing the Principles and Rules of Cooperation and Competition that were introduced in 2007. said:
The regulator, Monitor, will have the power to fine hospital trusts 10 per cent of their income for anti-competitive behaviour. Any decent doctor will tell you that for seamless, efficient care for patients, integration is key to improving quality of life and patient experience. The question is whether competition and integration can co-exist. Evidence from the Netherlands is that they cannot. There, market-style health reforms designed to promote competitive behaviour have meant that healthcare providers have been prevented from entering into agreements that restrict competition, so networks involving GPs, geriatricians, nursing homes and social care providers have been ruled anti-competitive. There is a fear that care pathways, integrated services and equitable access to care in this country will be lost when placed second to market interests.
On the other hand, there is evidence that competition can co-exist with integration - particularly as the integration between providers she is thinking of tends not to be between providers in competition - because there are responsible for non-competing parts of the clinical pathway. Equally, there is plenty of evidence of barriers to integration in the current NHS. Certain GP groups used Practice Based Commissioning to tear up the existing convulted clinical pathways by making use of new, safer, cheaper and yet more effective diagnostic technology in private sector clinics, and bringing NHS consultants out of the hospital and into the community - cutting pathways from weeks, or even months, down to days with considerable benefits both to patients and the NHS.[quote]Under the delusion of greater patient choice, people are to be given a personal health budget. I am interested to hear what happens if it runs out halfway through the year. Private hospitals will enter the fray as treatment providers and, as in other arenas, they will undoubtedly, as others have said, cherry-pick and offer treatment for cases where they can treat a high number of low-risk patients and make a profit-for example, hip and knee replacement, cataracts, ENT and gynae procedures.
said:
It is essential in an acute teaching hospital to retain the case mix, though, so it will be the teaching hospitals that will also provide the loss-making services such as accident and emergency and intensive care and deal with chronic illness and the diseases of the poor, such as obesity-we can name them all. These are essential services but they are also very costly. An ordinary hospital cannot provide them if it does not have the quick throughput cases as well to maintain a financial balance. If relatively easy procedures go to private providers, the loss of revenue to the trusts will eventually lead to them being unable to provide the costly essential services. It will mean that doctors trained in these places are not exposed to all aspects of patient care. Private companies cherry-picking services undermines and destabilises the ability of the NHS to deliver essential services like, as I have mentioned, intensive care units, accident and emergency, teaching, training and research.
Perhaps if the NHS, or rather the politicians, bit the bullet and supported the clinicians and the independent reviews that have studied the clinical evidence, the NHS might close more of these hospitals in favour of community care and better regional specialist departments. It's clear that the NHS in it's current form is not sustainable. The problem isn't competition or cherry-picking; it's simply the outdate structure of the NHS that has not kept up with medical advances. said:
Clause 294 allows for the transferring of NHS assets, including land, to third parties, and the selling off of assets. Clause 160 allows for the raising of loans by trusts, so hospitals taken over by the private sector could be asset-stripped and then sold on, as happened with Southern Cross homes.
The removal of practice boundaries and primary care trust boundaries will mean that commissioning groups will not be coterminous with social services in local authorities, so vulnerable people are more likely to fall through the gaps between GP practices. GPs will also be able to cherry-pick by excluding patients who cost more money and can lead to overspend.
Another important pledge by the 3 parties was to allow more NHS staff to run their departments and services as mutuals/social enteprises - because employees with a stake in the running of their employer tend to perform better.The removal of practice boundaries and primary care trust boundaries will mean that commissioning groups will not be coterminous with social services in local authorities, so vulnerable people are more likely to fall through the gaps between GP practices. GPs will also be able to cherry-pick by excluding patients who cost more money and can lead to overspend.
By removing practice boundaries, patients will be allowed to register with the GP of their choice. For anyone who works in another area from where they live, the opportunity to join a GP closer to work or with later opening hours will make a major difference. Likewise for those patients who feel their GP doesn't provide them with good enough care (perhaps because the GP doesn't believe their illness geniunely exists as some patients with rarer syndromes experience), they will have the opportunity to go to a GP who will support and care for them as you would expect. Equally it makes sense to allow Commissioning Groups to organise themselves according to local needs and topography, instead of artificial political boundaries.
said:
Then there is the issue of the cost of market-based healthcare. Advertising, billing, legal disputes-I say this as a lawyer-multimillion-pound executive salaries, dividends and fraud could end up consuming a huge amount of the pot that can be spent on front-line services. We will end up, as in America, with that extra stuff taking up 20 per cent of the health budget. The downward spiral of ethics, the increase in dishonesty and the conflicts of interest become huge, and you see the destruction of the public service ethos.
I want to scream to the public, "Don't let them do it"-and in fact the public are responding by saying in turn, "Don't let them do it". Market competition in healthcare does not improve outcomes. The US has the highest spending in the world and the outcomes are mediocre. The US overdiagnoses, overtreats and overtests. Why? Because that increases revenue. You change the nature of the relationship between doctors and their patients. You get more lawsuits and doctors therefore practise defensive medicine. You ruin your system
Again, it is entirely disingenuous to suggest that none of this exists in the NHS currently or that the NHS does not waste huge amounts on bureaucracy. And yet again, the go-to example is always America, disregarding that the reforms will be nothing like the US system, but bringing us on a par with the highly successful Bismarck systems of Europe. The situation cannot not be boiled down to NHS v USA. Doing so makes the "I love the NHS" brigade as bad as the Republicans they laughed at two years ago.I want to scream to the public, "Don't let them do it"-and in fact the public are responding by saying in turn, "Don't let them do it". Market competition in healthcare does not improve outcomes. The US has the highest spending in the world and the outcomes are mediocre. The US overdiagnoses, overtreats and overtests. Why? Because that increases revenue. You change the nature of the relationship between doctors and their patients. You get more lawsuits and doctors therefore practise defensive medicine. You ruin your system
There is evidence from within the NHS that competition improves outcomes without harming equity.
said:
I say this particularly to colleagues on the Liberal Democrat Benches. They may be being encouraged to think that voting against the Bill may bring down the coalition, but all I can say is that the electorate is watching. If people feel failed by the party on this, I am afraid that it will pay a terrible price.
This has been a 25-year project, done by stealth. It started with the internal market and is now moving to the external market. It was not thought up by mere politicians but by the money men, the private healthcare companies and the consultancies like McKinsey-the people, in fact, who in many ways brought us the banking crisis. They have funded pro-market think tanks and achieved deep penetration into the Department of Health, into many of our health organisations and right into some of the senior levels of my party as well as those on the other Benches.
The NHS is totemic. It is about a pool of altruism and it speaks to who we are as a nation. It is the mortar that binds us in the way that the American constitution does the American people. For us, it is about this system. It really is the place where we are "all in it together"-one of the few places, it would seem at the moment. Doctors get 88 per cent trust ratings with the public, while politicians get 14 per cent. The vast majority of doctors are saying to us, "Withdraw this Bill". We should be listening.
That is a fantasy of the "I love the NHS" brigade. For many people, especially the elderly and those with long term conditions, the NHS is badly letting them down. Furthermore, in it's current 20th century structure where the Hospital is King, it is unprepared for meeting the needs of the 21st Century. There are too many patients dying of heart attacks and trauma because some NHS trusts still take them to the nearest emergency unit rather than straight to highly-experienced and equipped trauma centres. There are too many patients dying around the country at the hands of surgeons who simply do not see enough cases to be safe. There are too many patients who have needless hospital stays because the new hospital was built with too many overnight wards/theatres and not enough day theatres and private rooms. The NHS is too focused on crisis cures in secondary care instead of doing more to prevent manageable illnesses becoming crises in the first place. All in spite of the overwhelming clinical evidence that the NHS is not fit for purpose.This has been a 25-year project, done by stealth. It started with the internal market and is now moving to the external market. It was not thought up by mere politicians but by the money men, the private healthcare companies and the consultancies like McKinsey-the people, in fact, who in many ways brought us the banking crisis. They have funded pro-market think tanks and achieved deep penetration into the Department of Health, into many of our health organisations and right into some of the senior levels of my party as well as those on the other Benches.
The NHS is totemic. It is about a pool of altruism and it speaks to who we are as a nation. It is the mortar that binds us in the way that the American constitution does the American people. For us, it is about this system. It really is the place where we are "all in it together"-one of the few places, it would seem at the moment. Doctors get 88 per cent trust ratings with the public, while politicians get 14 per cent. The vast majority of doctors are saying to us, "Withdraw this Bill". We should be listening.
Rollin said:
Never had NHS dental treatment then?
My 7 yr old daughter is STILL waiting for emergency [dental hospital] treatment for a developing abscess 7 days after diagnosis at an emergency dental appointment 9 AM last Sunday. None of the practices use gas so she's just gotta WAIT.Last night was fun-NOT.
Getragdogleg said:
The NHS is a good idea badly executed by inept people who are out to line their own pockets at the first opportunity.
I think the fact that health was to be used as a political football by said inept and corrupt people is fundamental enough to invalidate the idea.pacman1 said:
If I remember the stat correctly, the NHS are the third biggest employer in the world, after the Chinese Army and the Indian State Railway.
I can't vouch for the efficiency or otherwise of the Chinese army, but I knew someone whose train from Dehli to Calcutta was 36 hours late. scenario8 said:
pacman1 said:
If I remember the stat correctly, the NHS are the third biggest employer in the world, after the Chinese Army and the Indian State Railway.
Not according to other parts of the internethttp://www.dailymail.co.uk/news/article-2038401/De...
Getragdogleg said:
The NHS is a good idea badly executed by inept people who are out to line their own pockets at the first opportunity.
No the NHS is not a good idea, it is fundamentally flawed in its design and was a product of the statism of the immediate post war period and has not been reformed enough since.The reason why the NHS is frequently cited as one of the world's biggest employers is that few other countries have been stupid enough to set up a single monolithic organisation to provide all their nations healthcare.
The choice is not between the NHS and private healthcare for those who can afford it and the poor dying in ditches. But between the NHS and a european style state organised health insurance scheme with independent hospitals.
Bing o said:
I think the NHS is wonderful. It employs all those millions of people, provides healthcare that is the envy of the free world. You only need look at how happy and healthy UK citizens are to see what a roaring success it is.
It's something I touched on in my assignment regarding Winky and his economic miracle (
), the fact that we have so much money thrown at the health service yet we're one of the sickest countries in the world with regards to time off work and long term 'disabled'.Gassing Station | News, Politics & Economics | Top of Page | What's New | My Stuff