Big changes to the NHS on the way?

Greg T

notsoblue wrote:

Its just another way of funneling tax payer's money to the private sector.

You are right.

Considering all the money comes from the private sector in the first place, why bother to go to the expense of collecting it all and then pushing it back?

DonDaddyD

Greg T wrote:

notsoblue wrote:

Its just another way of funneling tax payer's money to the private sector.

You are right.

Considering all the money comes from the private sector in the first place, why bother to go to the expense of collecting it all and then pushing it back?

How's that bonus looking Greg? :twisted:

notsoblue

Greg T wrote:

notsoblue wrote:

Its just another way of funneling tax payer's money to the private sector.

You are right.

Considering all the money comes from the private sector in the first place, why bother to go to the expense of collecting it all and then pushing it back?

Why bother with the middle man (the NHS in this instance) then? Would remove the overhead of collecting the tax just to employ people to spend it. Why have an NHS when people can just buy healthcare directly from the private sector?

Greg T

DonDaddyD wrote:

How's that bonus looking Greg? :twisted:

I'll pay a nurses salary for a month with the tax I pay on it and everyone's happy - right . . . .

DonDaddyD

notsoblue wrote:

Greg T wrote:

notsoblue wrote:

Its just another way of funneling tax payer's money to the private sector.

You are right.

Considering all the money comes from the private sector in the first place, why bother to go to the expense of collecting it all and then pushing it back?

Why bother with the middle man (the NHS in this instance) then? Would remove the overhead of collecting the tax just to employ people to spend it. Why have an NHS when people can just buy healthcare directly from the private sector?

Welcome to Britain pre 1946 (I think).

I'd hate to break my leg, get it fixed and worry that my health insurance premiums (America) or my credit/debit card won't cover the cost and I'll have to sell my car/house/body becase the hospital that saved my life wants paying and they're gonna send the heavies round to er.. break my legs to get it....

Greg T

Greg T wrote:

DonDaddyD wrote:

How's that bonus looking Greg? :twisted:

I'll pay a nurses salary for a month with the tax I pay on it and everyone's happy - right . . . .

And NSB - that's the other position. I have my money taken off me to fund the service, some of it is fair dinkum as there are people who couldn't afford the care or insurance, there are others who can but they still get caught up in the net as they can't be trusted to spend their own money.

The NHS's record of providing value for money is not good, reform is required, I don't know what to do about it - I have no background or insight. It does need reform though as it's not good enough for the money it soaks ups.

The problem with Change on this scale is that no-one who gets changed likes it. Public services have the lender of last resort to pay the bills - so commercial reality of the company going down the pan doesn't put a break on the resistance

The five stages of grief are a good analogy

Anger - Denial - Bargaining - Depression - Acceptance.

bails87

Greg T wrote:

Greg T wrote:

DonDaddyD wrote:

How's that bonus looking Greg? :twisted:

I'll pay a nurses salary for a month with the tax I pay on it and everyone's happy - right . . . .

And NSB - that's the other position. I have my money taken off me to fund the service, some of it is fair dinkum as there are people who couldn't afford the care or insurance, there are others who can but they still get caught up in the net as they can't be trusted to spend their own money.

The NHS's record of providing value for money is not good.

Isn't it?

Any figures around that? I've seen plenty that show our healthcare is pretty cheap, with good outcomes. Especially compared to the USA.


Oh, and Andrew Lansley has David Cameron's full support.....so he'll be gone soon then

notsoblue

bails87 wrote:

Greg T wrote:

Greg T wrote:

DonDaddyD wrote:

How's that bonus looking Greg? :twisted:

I'll pay a nurses salary for a month with the tax I pay on it and everyone's happy - right . . . .

And NSB - that's the other position. I have my money taken off me to fund the service, some of it is fair dinkum as there are people who couldn't afford the care or insurance, there are others who can but they still get caught up in the net as they can't be trusted to spend their own money.

The NHS's record of providing value for money is not good.

Isn't it?

Any figures around that? I've seen plenty that show our healthcare is pretty cheap, with good outcomes. Especially compared to the USA.

Yeah, I was going to respond the same way. The impression I've gotten (I could be wrong) is that compared to most healthcare systems the NHS is very good value for money. Also, GregT, do you think that the private sector will provide better value for money?

Greg T

This is interesting

http://www.publications.parliament.uk/p ... 13vw26.htm

It outlines how hard it is to benchmark performance against standards even intra country due to the problems inherent in wide scale data collection and aggregation.

Anyway, a quick bit of googling

http://www.somersetlmc.co.uk/documents/ ... arency.pdf

What is the problem under consideration? Why is government intervention necessary?
The NHS currently achieves relatively poor healthcare outcomes in certain major healthcare areas when compared to our peer countries.

Transparency in outcomes - a framework for the NHS
Department of Health

I don't know if the private sector will be better - it is in other countries.

DonDaddyD

notsoblue wrote:

bails87 wrote:

Greg T wrote:

Greg T wrote:

DonDaddyD wrote:

How's that bonus looking Greg? :twisted:

I'll pay a nurses salary for a month with the tax I pay on it and everyone's happy - right . . . .

And NSB - that's the other position. I have my money taken off me to fund the service, some of it is fair dinkum as there are people who couldn't afford the care or insurance, there are others who can but they still get caught up in the net as they can't be trusted to spend their own money.

The NHS's record of providing value for money is not good.

Isn't it?

Any figures around that? I've seen plenty that show our healthcare is pretty cheap, with good outcomes. Especially compared to the USA.

Yeah, I was going to respond the same way. The impression I've gotten (I could be wrong) is that compared to most healthcare systems the NHS is very good value for money. Also, GregT, do you think that the private sector will provide better value for money?

The worry isn't whether it will provide better 'value for money' but how will this change affect 'quality of care'.

Of course the private sector could run the service at less, they wouldn't have to offer pensions, as much holidays and Unions can f*ck right off. So can all those staff that don't fit the bill, the disabled, coloured and ginger because you know 'Equal Ops' has no sway in the Private Sector. But at what cost to patient care, that's the issue.

Incidentally I don't entirely disagree with GregT, despite my bonus dig. That was just a bit of rib tickling....

If the decision was monetary then everything should be made available on the free market and let the chips fall where they may. But we've seen what the Rail Industry looks like.

DonDaddyD

The knives are being sharpened as notions of Cameron's support are just lip service, he'll be distancing himself soon enough.

http://www.bbc.co.uk/news/uk-politics-16930980

Good assessments:
Why 2012 will be a big year for the NHS
http://www.bbc.co.uk/news/health-16304079

NHS comissioning Q&A
http://www.bbc.co.uk/news/health-12177084

Now to me the new system looks more complex than the old one...

Is it too late to stop
http://www.bbc.co.uk/news/health-16632291

This is really valid question, the Government have laid the foundations down (closed PCTs and SHAs) so that the transition to Lansley vision is made smoother. They've done this before it's been passed through Lords. I'm not sure if the cost of going back to the old system is workable, certainly there would be a cost of hiring some of those that have been made redundant - I know a person who has taken the full (20+yrs service) wack on redundancy pay and was then (hasn't even finished working yet) contacted by her former HR department asking if she'd like her job back (won't have to pay back the redundancy) because of changes back and forth from this Health and Social Care Bill.

If it doesn't go through it's political suicide on Lansley's part.

rjsterry

DonDaddyD wrote:

The knives are being sharpened as notions of Cameron's support are just lip service, he'll be distancing himself soon enough.

http://www.bbc.co.uk/news/uk-politics-16930980

Good assessments:
Why 2012 will be a big year for the NHS
http://www.bbc.co.uk/news/health-16304079

NHS comissioning Q&A
http://www.bbc.co.uk/news/health-12177084

Now to me the new system looks more complex than the old one...

Is it too late to stop
http://www.bbc.co.uk/news/health-16632291

This is really valid question, the Government have laid the foundations down (closed PCTs and SHAs) so that the transition to Lansley vision is made smoother. They've done this before it's been passed through Lords. I'm not sure if the cost of going back to the old system is workable, certainly there would be a cost of hiring some of those that have been made redundant - I know a person who has taken the full (20+yrs service) wack on redundancy pay and was then (hasn't even finished working yet) contacted by her former HR department asking if she'd like her job back (won't have to pay back the redundancy) because of changes back and forth from this Health and Social Care Bill.

If it doesn't go through it's political suicide on Lansley's part.

Here's hoping :twisted: Is 'full support' the same as 'the full support of the board' in football - i.e. get your cv in order?

DonDaddyD

rjsterry wrote:

Here's hoping :twisted: Is 'full support' the same as 'the full support of the board' in football - i.e. get your cv in order?

Who gains and who loses? Lansley has been very very good at meeting with Service User Groups, Charities and Lobbying Groups and bought them into the belief that

"they will somehow have more say in how their local hospital is being run".

At the same time he has paid lip service to the Trust's that run these hospitals and said

"You will have the freedom to change services and close hospitals, A&E etc to save money".

While also counting the coins bought in by private sector companies he has promised

"Will be able to bid and run NHS services".

The vision and the deal is dodgy and it's clear who gains the most out of it.

Patients
It's not the patients and they do get more say in how the NHS is run.

The Trusts
It's certainly not the Trusts even though he has made it so each FT can go more corporate and technically generate more money (inflation busting pay rises, I've said too much - sorry Greg) it motivates and careers are being carved.

GPs
GPs are being set up as the fall guys, there's plenty of them. The budget will be reduced and not enough will be available to maintain the level of service the NHS needs to provide. People will get frustrated and the GPs will get the blame, but the smart ones will make money through private referals.

The private firms
So that leaves the private sector, namely the pharmaceuticals, which have remained silent. Would I a major drug company like to run an Alcohol and Drug misues service in war torn great unwashed London. Open up some pharmacies recommend my drugs offer 'private services'. Yeah money can be made from that. And the Government would only have to franchise out the NHS logo so it makes it's money too.

If I'm not heard from tomorrow it's because they've caught me.

DonDaddyD

Spot on Nick

As I said I can't see it going through

Glad Mental health won, but the margin of votes proves that more work must be done.

Hope the naysayers keep chipping away at it. Come on!

rjsterry

Bump.

Days are numbered by the look of it

http://www.guardian.co.uk/society/2012/feb/10/cameron-scrap-nhs-bill-lansley

DonDaddyD

The sad thing about it is that if I had to be absolutely honest this Bill has been the catalyst for the biggest, largest and most progressive period of change I've seen in the NHS. And unlike Labour's reforms that were clearly unsustainable, these changes appear to be cost effect, hugely cost effective, motivational and career building while seemingly allows each NHS Trust to make the "efficiency" (workforce, service cuts/reforms) savings it has wanted to make over the past decade.

I think this is why Lansley seemingly still has the support of NHS Trust directors.

It's his approach that may be his biggest downfall. And while the Bill will go down as the Coalitions greatest failure it would have ushered the biggest amount of positive change in the NHS. Ironic really.

notsoblue

DonDaddyD wrote:

And unlike Labour's reforms that were clearly unsustainable, these changes appear to be cost effect, hugely cost effective, motivational and career building while seemingly allows each NHS Trust to make the "efficiency" (workforce, service cuts/reforms) savings it has wanted to make over the past decade.

Really? Thats your analysis? My impression was that all the unsustainable, disruptive stuff that Labour did was all around PPI. The tory proposals were in the same vein.

DonDaddyD

Yes, really. Labour increased NHS spending and staff hiring/retention and then slapped on a 3% saving regime. It was managable but not sustainable.

Patient, Public, Involvement I like. Led to things like care in the community and has been a catalyst of change for the mindset of health providers who didn't use to consider the patient.

Lansley's proposals are good in some places, overall it needs scrapping. The changes I mentioned that are happening aren't a result of what's written in the Bill it's purely because the Bill exists and partly because the Tories have begun changing the infrastructure before the Bill has passed. NHS Foundation Trust's are using this period to change things that needed changing "in the view of the forth coming Bill".

notsoblue

DonDaddyD wrote:

Yes, really. Labour increased NHS spending and staff hiring/retention and then slapped on a 3% saving regime. It was managable but not sustainable.

Patient, Public, Involvement I like. Led to things like care in the community and has been a catalyst of change for the mindset of health providers who didn't use to consider the patient.

Lansley's proposals are good in some places, overall it needs scrapping. The changes I mentioned that are happening aren't a result of what's written in the Bill it's purely because the Bill exists and partly because the Tories have begun changing the infrastructure before the Bill has passed. NHS Foundation Trust's are using this period to change things that needed changing "in the view of the forth coming Bill".

Er, whoops, I meant PPP (Public Private Partnership).

What changes are NHS Foundation Trusts making that needed changing?

DonDaddyD

Each Foundation Trust (FT) is an individual entity with enough automony to manage their services in their given area. Therefore a FT in Lambeth will be run differently and could have slightly different services than a FT in Wandsworth despite focusing on the same area of health.

What I do know is that the majority of FT's are making many services/staff/structual changes in the name of the bill but because it can save money do things more efficiently. And the normal naysayers, protestors and lobbyists are more willing to accept said changes because (i) their too absorbed by the Bill or (ii) they believe these changes are a result of the Bill.

notsoblue

DonDaddyD wrote:

What I do know is that the majority of FT's are making many services/staff/structual changes in the name of the bill but because it can save money do things more efficiently. And the normal naysayers, protestors and lobbyists are more willing to accept said changes because (i) their too absorbed by the Bill or (ii) they believe these changes are a result of the Bill.

Yeah, but what kind of changes are you talking about here?

DonDaddyD

I don't want to talk about my Trust but things like:

The establishment of Busines Development teams. New IT systems/mobile working/One Trust I know rents it's Servers to other Trust as though it's a server provider (the money reinvested into services). Other opertaional changes to public services, care teams, reduction in hospital beds. Internal Structural Changes. Closing A&E and other walk-in day care centres in favour of cheaper community teams. Aquisitions of new business, even those unrelated to the original area of healthcare the Trust originally focused on. New partnerships and establishments of Academic Health Science Centres. Mergers.

Those kind of changes, some small other large. Many of which would or have been opposed but are seen as part of the needed change in view of the Bill (even though it hasn't passed yet.

notsoblue

DonDaddyD wrote:

I don't want to talk about my Trust but things like:

The establishment of Busines Development teams. New IT systems/mobile working/One Trust I know rents it's Servers to other Trust as though it's a server provider (the money reinvested into services). Other opertaional changes to public services, care teams, reduction in hospital beds. Internal Structural Changes. Closing A&E and other walk-in day care centres in favour of cheaper community teams. Aquisitions of new business, even those unrelated to the original area of healthcare the Trust originally focused on. New partnerships and establishments of Academic Health Science Centres. Mergers.

Those kind of changes, some small other large. Many of which would or have been opposed but are seen as part of the needed change in view of the Bill (even though it hasn't passed yet.

Ok, I see. Those sound like sensible changes. But why are you giving credit for this to Lansley for threatening to have the private sector jizz all over the NHS? Or did I misunderstand what you said?