/ Health

Is the NHS in intensive care?

Intensive care monitor

The government is taking a break from the Health and Social Care Bill in order to hear any ‘legitimate concerns’. So what does the Bill propose, why the ‘listening exercise’ – and what’s your prescription for the NHS?

When I wrote a Conversation back in January about the Health and Social Care Bill, it was clear that its contents would be hugely important to the future of the NHS.

What I didn’t expect was quite how many acres of newsprint would be dedicated to it – or that more than two months later the Health Secretary Andrew Lansley would be announcing a ‘natural break’ in its progress through Parliament.

The patient’s history

Last July, the White Paper Equity and Excellence set out Andrew Lansley’s vision for the NHS of the future, a ‘patient-centred’ service where no decision would be made ‘about me, without me,’ measured against better health outcomes rather than targets.

One of the biggest changes proposed was the way that services are planned and managed. Local Primary Care Trusts are currently responsible for making sure there are enough of the right kinds of health services in local areas.

In the future, groups of GPs (‘consortia’) would be responsible for much of this job – but opinion was mixed about whether they actually wanted to do it. Some people also feared that the NHS could effectively be ‘privatised’.

We patients were promised more choice about our treatment, and a new body called HealthWatch to look after our interests. But back then I wondered whether too much choice could mean no choice at all – and others had much stronger reservations…

The Bill has provoked enormous and heated debate across the political spectrum. The Leader of the Opposition has called it ‘a bad Bill, based on bad assumptions and dangerous ideology’, and the chairman of the British Medical Association has suggested that the ‘ideal scenario would be to withdraw it altogether.’

A break between treatments

In his statement to the Commons yesterday, Andrew Lansley recognised that ‘substantive concerns’ had been raised about the Bill, and the speed of the changes it proposes. He announced that the Government would ‘pause, listen and engage’, before making amendments to improve the plans further.

But as the Bill has already started on its journey through Parliament, could the Government really make major changes to it, even if they wanted to? The wheels already seem to be in motion, with 220 ‘pathfinder consortia’ in place, representing 87% of the country.

You’ve seen some of what the professionals had to say about the Bill, but what do you think? Would you make changes to it, and if so what? As a patient, what do you want from the NHS?


My prescription for the NHS – is simple

Get rid of this appalling “Government”!!!

Snowdin says:
5 April 2011

As a patient I appreciate that wants, expectations and increasing longevity will always outstrip funding, so I want a rationing system that is explicitly stated and fair for all. I want my GP to be my advocate, the role for which he or she was trained and which concurs with the values that encouraged my GP to join that profession. I do not want my GP to be my rationing agent, who may be rewarded for reducing or denying my referral or treatment, or who might gain financially by referring me to a private provider with whom he or she may have a financial or business relationship.
There is virtually no evidence that Fundholding produced any significant benefit, not just because New Labour eventually stopped it, and Fundholders were generally highly motivated and entrepreneurial types, so why should GP Commissioning, the next step, work when it includes far more of those who are kicking and screaming?
Finally I heard today that there are now fewer NHS managers and an extra 2000 doctors. How many of these 2000 were full timers? Could you count them on the fingers of 2 hands? I want the DH to treat me as an adult and tell me the truth.

Sybilmari says:
6 April 2011

I don’t use the NHS as I have found over the years that NHS dentists have ruined my teeth and I have had to pay privately to have them sorted out. I don’t have a GP because I found they made me worse, not better. I use alternative treatments which work well for me – even with serious problems. Financially I just have to juggle to manage it but it is better than losing one’s health completely and it leaves me in control of my own health care. I suspect that very few people genuinely benefit from modern medicine as it is practised in England. I don’t believe that chopping and changing works – that is like refurbishing a very dilapidated house full of dry rot and woodworm. There comes a time when it is better and cheaper to pull the house down and build new.
It would be more cost effective to start the NHS again and make it local. Cottage Hospitals always worked. Choice would be good. The French system works very effectively. Other European health care systems are also much better examples. Why don’t governments see what works elsewhere and what the outcomes of their systems are? Then get advice from those countries?


I have just tried to ring my GP’s surgery to be told I must now dial 0844 to get them – this means according to talk talk it will now cost me (instead of a free phone call to a local/national number) 9.9p just to dial the number and thereafter 1p to 5p (depending on what my surgery is demanding from them for payback on this line). I immediately rang my PCT to ask them what was going on and told that as long as it was a low call the Surgery could do this and they were not responsible if my provider happened to charge more(!!!) I pointed out that, apart from BT, Talk Talk is probably the second largest provider in the country. I am now serving a freedom of notice information on my surgery in order to find out exactly what monies they are getting and will then take it up with my MP. Anybody out there who is in the same boat suggest you do the same!! My calls to the surgery are always on hold and never less than 4/5 minutes in length these days. Dot


I have complained to mine and asked for the land line number – free to most people.
They refused.
Costing £1-50 a week in calls


I should have pointed out that that is 1p to 5p for every minute I then hold/speak to the surgery.

Andy says:
8 April 2011

Having been unfortunate enough to require the services if the NHS over the last 14 mnth and recently in Hospital the last week I can safely say that the service provided is a joke.
There was a time when this country could be proud of the service,, but no longer, although the myth and brainwashing prevails.
I have never seen such inefficiency and incompetence. couldn’t even deliver the correct meals that were ordered.
Went in on Thursday supposed to have scan on Friday never happened, kept in all weekend at god knows what cost , told that they don’t do scans at the weekend, finally got scanned on Monday at 14:30 no one able to give results till Tuesday at 13:00 hrs had to wait 7 hours for a discharge letter.
Overheard Doctor say that I was on antibiotics when I wasn’t challenged this and it was then prescribed.
Never saw the same doctor twice and had to repeat my symptoms and medical history to each one,very frustrating and annoying.
One doctor listened to my right lung saying he could not hear the crackle that had been previously reported, told him I wasn’t surprised as the blood clot was on my left lung.
In listening other patients and family’s this is not an isolated situation but the norm.
Many other examples happened to me during the past 14 mnth.
Hope and pray you never need the services of our wonderful NHS ,its a myth.
I did consider making a formal complaint but life’s too short


I’d much rather have my GP available to treat or refer me than spend half his time worrying about the paperwork involved in running a consortium. Let someone else with some medical knowledge but who hasn’t spent ten years in training do the administration. There were plenty of them around in PCTs. I assume they are being made redundant with big payouts and many will be recruited by GP consortia when they find they can be doctors and administrators. Were the PCTs really that bad that it is worth this cost and disruption to get rid of them?

There used to be the idea that the money followed the patient. I wonder how GP practices within a consortium will argue forr how much money their consortium will get and how they should split it between the GPs. What criteria will used to determine local need and allocate the money?

I’m deeply concerned that the government will be giving a significant tranche of our national funds to be allocated by an uncontrolled (other than by the BMA) unelected group of individuals. This wouldn’t be too bad if there were the possibility of moving to another practice if you didn’t like your local one, but in reality this isn’t an option for most people. For a market to work, you need choice. In the proposed system choice is limited, and the alternative – publicly elected representation – is completely absent unless at minimum local councils get a say.