ChatterBank2 mins ago
NHS reforms, what are they?
Can anyone point me at a succint factual description of what the reforms are. Heard a lot of hulaballo about it but I can seem to find what is actually being proposed, at least laid out in summary form. Thanks
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I'll have a look for you after lunch. One problem with governments is they like to change things- schools, hospitals, etc have all undergone reforms, most of which cause admin problems and line the pockets of consultants rather than improving outcomes for 'customers' and taxpayers.
Having said that, any changes to the NHS, especially by the Conservatives, are treated with suspicion/hostility and claimed to be 'privatisation by the back door' by people who often know very little about what the changes are actually about.
Having said that, any changes to the NHS, especially by the Conservatives, are treated with suspicion/hostility and claimed to be 'privatisation by the back door' by people who often know very little about what the changes are actually about.
"Summary of the Bill
The Bill proposes to create an independent NHS Board, promote patient choice, and to reduce NHS administration costs.
Key areas
-establishes an independent NHS Board to allocate resources and provide commissioning guidance
-increases GPs’ powers to commission services on behalf of their patients
strengthens the role of the Care Quality Commission
-develops Monitor, the body that currently regulates NHS foundation trusts, into an economic regulator to oversee aspects of access and competition in the NHS
-cuts the number of health bodies to help meet the Government's commitment to cut NHS administration costs by a third, including abolishing Primary Care Trusts and Strategic Health Authorities."
That all sounds good but of course the devil will be in the detail. The main issue of concern I think is "increases GPs’ powers to commission services on behalf of their patients" which some take to mean privatisation since it means they can choose the provider
The Bill proposes to create an independent NHS Board, promote patient choice, and to reduce NHS administration costs.
Key areas
-establishes an independent NHS Board to allocate resources and provide commissioning guidance
-increases GPs’ powers to commission services on behalf of their patients
strengthens the role of the Care Quality Commission
-develops Monitor, the body that currently regulates NHS foundation trusts, into an economic regulator to oversee aspects of access and competition in the NHS
-cuts the number of health bodies to help meet the Government's commitment to cut NHS administration costs by a third, including abolishing Primary Care Trusts and Strategic Health Authorities."
That all sounds good but of course the devil will be in the detail. The main issue of concern I think is "increases GPs’ powers to commission services on behalf of their patients" which some take to mean privatisation since it means they can choose the provider
// -increases GPs’ powers to commission services on behalf of their patients //
There is no evidence that GPs are up to performing this service or particularly want to. What will happen is that the GPs will get in huge operators like Serco do do the commissioning for them. They will want to make as much profit as possible, so they will not prioritise the best for the patient, but what will be best for their shareholders. Vast amounts of money will go to private companies and not to patient care.
There is no evidence that GPs are up to performing this service or particularly want to. What will happen is that the GPs will get in huge operators like Serco do do the commissioning for them. They will want to make as much profit as possible, so they will not prioritise the best for the patient, but what will be best for their shareholders. Vast amounts of money will go to private companies and not to patient care.
Rather a sweeping scaremongering statement there Gromit.
Is your opposition based on the fact it is the Tories not Noo Labour implementing this? The NHS cannot go on like it is, I dont think anyone in there right mind would disagree, indded Noo labour were cutting well before the election (my Missus works in the NHS so I do know).
Is your opposition based on the fact it is the Tories not Noo Labour implementing this? The NHS cannot go on like it is, I dont think anyone in there right mind would disagree, indded Noo labour were cutting well before the election (my Missus works in the NHS so I do know).
Youngmagbog,
The last Labour Government were guilty of privatisation of parts of the NHS. Was it a coincidence that when private firms were contracted to do cleaning there was a huge rise in MRSA, CDif and superbugs? That was bad enough, but that was tiny compared to what is proposed here. Private firms first object is to make as much profit as possible. A service funded by the taxpayer should aim to aim to spend the budget as wisely as possible without compromise. It should not aim to spend as cheaply as possible on a 'will do' basis to pay its shareholders.
The result will be, we will end up paying more for a far inferior service.
And there was a typo in your answer. I think you meant 'new' Labour, not noo.
The last Labour Government were guilty of privatisation of parts of the NHS. Was it a coincidence that when private firms were contracted to do cleaning there was a huge rise in MRSA, CDif and superbugs? That was bad enough, but that was tiny compared to what is proposed here. Private firms first object is to make as much profit as possible. A service funded by the taxpayer should aim to aim to spend the budget as wisely as possible without compromise. It should not aim to spend as cheaply as possible on a 'will do' basis to pay its shareholders.
The result will be, we will end up paying more for a far inferior service.
And there was a typo in your answer. I think you meant 'new' Labour, not noo.
I have read with great interest the comments made about this subject, so please will a Tory follower answer the following question. If the proposed changes to the NHS are so good why are some of the top medical professions against it & why has David Cameron not invited them to the meeting at No 10 ?
er, some high-profile bodies opposed to the reforms, such as the British Medical Association (BMA), Royal College of Nursing, Chartered Society of Physiotherapy (CSP) and Royal College of General Practitioners, have not received invitations.
The BMA questioned why such influential groups had been excluded from the dialogue.
A spokesman said: 'The BMA does not appear to have been invited to an NHS summit at Downing Street next week.
'If there is such an event, it would seem odd if the major bodies representing health professionals were not included.'
Phil Gray, chief executive of the CSP, said: 'It is extremely concerning that many of the key professional bodies and healthcare organisations, which will be expected to work with the changes that the bill will bring, have been excluded from what is clearly a crucial meeting.'
er, some high-profile bodies opposed to the reforms, such as the British Medical Association (BMA), Royal College of Nursing, Chartered Society of Physiotherapy (CSP) and Royal College of General Practitioners, have not received invitations.
The BMA questioned why such influential groups had been excluded from the dialogue.
A spokesman said: 'The BMA does not appear to have been invited to an NHS summit at Downing Street next week.
'If there is such an event, it would seem odd if the major bodies representing health professionals were not included.'
Phil Gray, chief executive of the CSP, said: 'It is extremely concerning that many of the key professional bodies and healthcare organisations, which will be expected to work with the changes that the bill will bring, have been excluded from what is clearly a crucial meeting.'
Well, professionals working within the system are of course going to have a vested interest in how the service should be run - Its that very experience that is required to make any sort of informed decision about the way that the health service should most effectively be managed. When you see not just the trade unions such as UNISON and the BMA but virtually all of the royal societies and professional associations expressing profound reservations about the bill, then you should surely recognise that there are some major issues here that need addressing.
1. Despite promising no more top down reforms, this government is doing precisely that - and one of the most far reaching reforms, too.
2. Against a background of asking the NHS to save £20 billion pounds by 2014, they are asking for a yet another far reaching "re-organisation" of the services, with all the costs that such reforms have.
http://www.bbc.co.uk/news/uk-politics-11583648
3.The concept of GP led commissioning has been tried before, with mixed results at best. The majority of GPs do not want to be accountants or fund managers - so such a reorganisation will require additional staff - in all likelihood the very same staff that are being made surplus to requirements as a result of the abolition of the PCTs. And can anyone seriously claim that negotiating patient care packages for the 500 or so GP consortia is going to be more cost efficient than through 12 PCTs?
Such a service reorganisation is being painted as bringing choice to the patient and localism to the service - but that just surely helps to promote the postcode lottery that I thought we were trying to get away from? Surely everyone is deserving of the same quality of care from their GP?
4. These selfsame GP consortia will be nice juicy targets for american - led health insurance companies - not a development to be welcomed by many over here in the UK
http://www.nuffieldtr...ence-gp-commissioning
5. The prospect of raising the cap for private care earnings from its current level, around 5%. to 49%. with little or no explanation of how that will impact on NHS patients, waiting times and operating schedules is a source of concern, I think.
6. It always makes me uneasy when some of the biggest supporters of the bill in the house appear to have a financial interest in such changes.
http://www.bbc.co.uk/news/uk-politics-17104463
So, the government offered a listening exercise, and made 100s of amendments - and yet despite this, opposition has hardened if anything.
There are, I have no doubt, efficiency savings to be made, particularly in the areas of administration and middle management. And there are elements of the NHS service that could effectively be privatised, provided that strict service levels, schedules and financial penalties are put into place. But to bullheadedly plough on with a reform package in the face of strong negative public opinion, and against the declared concerns of the vast majority of the professional societies will only lead to a more fragmented, variable quality service, with less integration that is available right now.
1. Despite promising no more top down reforms, this government is doing precisely that - and one of the most far reaching reforms, too.
2. Against a background of asking the NHS to save £20 billion pounds by 2014, they are asking for a yet another far reaching "re-organisation" of the services, with all the costs that such reforms have.
http://www.bbc.co.uk/news/uk-politics-11583648
3.The concept of GP led commissioning has been tried before, with mixed results at best. The majority of GPs do not want to be accountants or fund managers - so such a reorganisation will require additional staff - in all likelihood the very same staff that are being made surplus to requirements as a result of the abolition of the PCTs. And can anyone seriously claim that negotiating patient care packages for the 500 or so GP consortia is going to be more cost efficient than through 12 PCTs?
Such a service reorganisation is being painted as bringing choice to the patient and localism to the service - but that just surely helps to promote the postcode lottery that I thought we were trying to get away from? Surely everyone is deserving of the same quality of care from their GP?
4. These selfsame GP consortia will be nice juicy targets for american - led health insurance companies - not a development to be welcomed by many over here in the UK
http://www.nuffieldtr...ence-gp-commissioning
5. The prospect of raising the cap for private care earnings from its current level, around 5%. to 49%. with little or no explanation of how that will impact on NHS patients, waiting times and operating schedules is a source of concern, I think.
6. It always makes me uneasy when some of the biggest supporters of the bill in the house appear to have a financial interest in such changes.
http://www.bbc.co.uk/news/uk-politics-17104463
So, the government offered a listening exercise, and made 100s of amendments - and yet despite this, opposition has hardened if anything.
There are, I have no doubt, efficiency savings to be made, particularly in the areas of administration and middle management. And there are elements of the NHS service that could effectively be privatised, provided that strict service levels, schedules and financial penalties are put into place. But to bullheadedly plough on with a reform package in the face of strong negative public opinion, and against the declared concerns of the vast majority of the professional societies will only lead to a more fragmented, variable quality service, with less integration that is available right now.
From inside the NHS, may I attempt a reply, with a very simple overview?
Funding for commissioning of healthcare services from hospitals and other healthcare providers is currently delegated to the Primary Care Trusts (PCTs) by the Department of Health.
After April 2013, the PCTs will disband, and then 80% of the current funding will be delegated direction to the new Clinical Commissioning Groups, which are not just clumps of GPs, but which will be proper statutory bodies within a new NHS, with people employed in them who understand healthcare commissioning and who are used to managing this sort of money. The CCGs will commission services based on what they need for their local patient groups (bearing in mind that a CCG may well cover for example several large towns or a large part of a county). Every GP practice has to belong to a CCG, but not all GPs will be commissioners, the CCG will commission on their behalf.
The other 20% of the money is going to the National Commissioning Board, which will comission centrally some essential service (I believe cancer care will be one example), and the NCB will also commission core GP services (the CCGs can't commission their own GPs to deliver normal GP-practice services, there would be conflict of interest).
That's it, in a nutshell - and money-saving measures are being imposed along the way. Part of the complaints currently being voiced is that making this huge change in the way care is commissioned, plus imposing these huge savings at the same time, is a mistake - there could have been one first, then the other.
There are of course all sorts of complexities in both these processes, but what I've described above are - IMO - the bare bones of the changes.
Funding for commissioning of healthcare services from hospitals and other healthcare providers is currently delegated to the Primary Care Trusts (PCTs) by the Department of Health.
After April 2013, the PCTs will disband, and then 80% of the current funding will be delegated direction to the new Clinical Commissioning Groups, which are not just clumps of GPs, but which will be proper statutory bodies within a new NHS, with people employed in them who understand healthcare commissioning and who are used to managing this sort of money. The CCGs will commission services based on what they need for their local patient groups (bearing in mind that a CCG may well cover for example several large towns or a large part of a county). Every GP practice has to belong to a CCG, but not all GPs will be commissioners, the CCG will commission on their behalf.
The other 20% of the money is going to the National Commissioning Board, which will comission centrally some essential service (I believe cancer care will be one example), and the NCB will also commission core GP services (the CCGs can't commission their own GPs to deliver normal GP-practice services, there would be conflict of interest).
That's it, in a nutshell - and money-saving measures are being imposed along the way. Part of the complaints currently being voiced is that making this huge change in the way care is commissioned, plus imposing these huge savings at the same time, is a mistake - there could have been one first, then the other.
There are of course all sorts of complexities in both these processes, but what I've described above are - IMO - the bare bones of the changes.
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