/ 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?

Keith, Shipley says:
8 May 2011

At least 10% of GP practices are incapable of taking over the spending for the NHS. I refer to those practices that decided using a 0844 telephone service was a good idea. They got their cheap telephone system but have left their patients to pick up the bill. The on going cost to the patients is going into the pockets of private industry not the NHS. What will they do with the rest of the Health Service budget? As for the present PCT’s, it would seem they cannot stop these doctors from braking their new NHS contacts, so how have they been handling the rest of their commitments?

Interesting – Clegg is promising to stop the NHS “reforms” now that he has lost so many council seats. I don’t trust the man. He should have thought about this before, He didn’t – being totally drunk with power. I’m glad the result was so emphatic – but will he change?

Hopefully the Lib Dems will leave the “coalition” and bring in a new general election.

The system proposed is not fit for purpose. GPs should not run the NHS only consider their patients Privatisation is not the way to go for a Welfare State.

Hello all, we’ve just published a new Conversation on this. The NHS Future Forum has given its recommendations to the government’s NHS reform bill, with the prime minister today announcing that the main recommendations will be taken on board. But has it been changed enough?


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Luckily, in the UK, the NHS provides such treatment free. I don’t see why this case tells us that “The government is “on course ” for privatisation of the NHS”.

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Please explain what changes, such as you cite, he is pursuing. Is he, for example, proposing charging for heart surgery?

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He did hire a private jet to bring himself back from Aberdeen after signing a climate change deal with the Mexican president. And he accepted donations from a climate change sceptic organisation.

This does illustrate what’s wrong with the system: donations from any sorts of lobbyists ought not to be allowed.

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It would have to be the government’s policy, not ministerial connections. Do you believe that heart surgery, and other similar conditions, for example will be considered by any government to be taken out of the NHS remit and people made to pay?

I seriously doubt that any Tory Government would be stoopid enough to propose privatisation of the NHS.

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I don’t suppose Matt Hancock will be in the job in a year or two’s time and I suspect there are bigger things on the PM’s agenda right now than letting such a controversial distraction as privatising the NHS gain traction. In fact I would expect the S of S has been instructed to keep a tight lid on the whole notion.

Hancock has had a rather undistinguished ministerial career occupying a sequence of diverse positions but not usually for more than a year. His West Suffolk constituency struggled to select him as their candidate, although he does have a big majority and is presumably there for the long term. A spell in opposition possibly beckons in due course.

The problem with ‘creeping privatisation’ is that it’s inevitably less efficient. A glaring example of this is the G$ fiascos. “G4S promised to reduce costs by 23% but their own business model requires a profit of 20% so costs had to fall by around 40%. That could only be achieved by sacking one third of the staff and hiring people who were less experienced and qualified and therefore cheaper. The taxpayer is left to clear up the mess whilst G4S keep their profit.”