All 4 entries tagged NHS

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March 01, 2007

Tick tock… Tick tock…

Tony Blair - Time to go?I’ve said it before and I’ll say it again. The longer Tony Blair stays in power, the worse things will get for the Labour Party.

But it’s becoming more and more important that he goes sooner rather than later. Poll results predicting a Conservative lead of 11-13% perpetrate the view that a Conservative government in 2009 is almost inevitable.

That’s a perception that Gordon Brown needs to change. Back in 1995/6, it was obvious the Conservatives were on their last legs. There was little they could do to change the perceived wisdom that the Tories were sleazy, old and without fresh ideas.

Well skip forward to 2007, and it’s becoming hard to disassociate Labour from the same problems. The Cash for Honours inquiry is an unfortunate mirror of the Cash for Questions row – albeit with the threat of jail sentences for added flavour – and there’s only so many tweaks the government can make to the NHS and the education system before running out of ideas.

We’re about halfway through a Labour government. The bristles on a new broom are being weakened every day Mr Blair stays in charge.

September 13, 2006

NHS closures will 'improve care'

Today’s Guardian reports that the NHS is planning to “reconfigure” a number of health services in the UK in order to make further cost savings. A&E Departments and Maternity wards are likely to be worst hit.

David Nicholson, the man leading the reforms told the newspaper:

[changes] will be aimed at redesigning the NHS to improve care by concentrating key services in fewer hospitals

When will the NHS realise that in many cases, fewer hospitals means anything but “improved care”? In rural hospitals, many find that treatment is simply unavailable because they cannot travel to the ‘nearest’ hospital department, which thanks to these kind of NHS reforms will be further away than ever before.

Fewer departments might mean ‘cheaper’ care, but I have no idea how it will be ‘improved’ care.

March 07, 2006

Fetch Gordon Brown some aspirin. He'll need it.

When a news story happens so slowly that it's practically impossible to see, it often gets ignored in favour of the fast-paced action-packed news story.

It's often left to social commentators such as Polly Toynbee in the Guardian to recognise slow-burning problems and suggest remedies. Not they'll ever do any good.

One such problem which is almost certain to cause Gordon Brown to reach for the paracetamol is, ironically, the NHS.

Sir Nigel Crisp, the chief bureaucrat in the National Health Service resigned today, admitting that the service's financial crisis was his greatest failure.

I think he's being hard on himself. The financial crisis in the NHS isn't his fault – it's the fault of government policy which is determined to use rising debt as an excuse to cut uneconomical services. Cottage hospitals will have to go not because of government targets but because of the market – or that's what they want you to think, anyway.

Because the rising debt in the NHS is a completely predictable by-product of introducing marketisation into the Health Service. Certain procedures need to be carried out, but if the government is only willing to pay 99% of that operation's cost, then the hospital performing the operation will go into debt. Add up all the deficits and you have the £620m debt that the NHS predicted in December for this financial year (the unofficial figure is considerably closer to £1bn).

It's all well and good to try and force hospitals and NHS trusts to be more efficient by getting them to cut costs. But certain things have a fixed price, and you can't just stop performing heart bypasses because doctors cost more per hour than you've been budgeted for that operation.

Inefficiency in the NHS needs to be tackled in new ways – and ways that don't rely on market principles. Because yes cottage hospitals are relatively inefficient, but don't the positive effects of a self-sufficient local community deflect the added costs of providing health care at a local, accessible level?

Perhaps the government needs to undergo a transplant so that it realises that efficiency isn't the be-all-and-end-all of running the country.

August 27, 2005

The NHS: Crisis looming?

Has Labour's overspending in the NHS pushed it to crisis point?

I've just done two weeks work experience at a regional newspaper in England, where the main stories they featured were three separate exclusives on bed/hospital closures.

Two of these are to do with not enough money for beds to remain open, and another is to do with a complete reorganisation of the NHS (involving the scrapping of Primary Care Trusts – which you may remember are only a few years old).

The first observation to make is that something has clearly gone wrong with the government's health proposals from 1997 onwards.

Primary Care Trusts (their idea) will be replaced so that local primary health services are managed by 'local' groups, which may be private sector, voluntary (a joke according to hospital Leagues of Friends) or run by doctors (again, ha ha ha). But what is wrong with PCTs? Well apparently they're too bureaucratic and splitting them up into smaller bureaucracies will improve efficiency. Umm… worked well with devolution to Scotland and Wales. Also, why didn't they decide to do this when PCTs were invented? And there's big question marks hanging over who actually will want to take over the running of the hospitals. Except of course businesses, who will love the chance to milk the Department of Health dry.

So there still doesn't seem to be a good reason why they're disappearing. Other than 'change is good' being one of the government's mottos.

The second point (relating to bed closures) is why are services being reduced when health funding has rocketed over the past few years? One reason presented itself on a BBC news report the other day. It followed a GP whose income had gone from £60k to £100k because of new 'out-of-hours' contracts the government signed with GPs recently. Basically, Doctors successfully got shed loads of money out of the government for working night shifts. And some have nearly doubled their income.

Good for them, but this along with other pay increases in the NHS means that these increases (in proportion to GDP) in health spending have gone, mostly, on wage increases. If this was the 1980s, then this would have caused chaos, but Gordon Brown is very fortunate that the economy's doing okay at the moment. Important qualification there: at the moment.

But while wages have risen, so have services since 1997. Yet this seems simply to have stored up trouble for the DoH which is beginning to realise it can't keep funding these new services (such as foundation hospitals). So big, new hospitals: very good. Older, smaller, local, essential to rural areas hospitals: very very bad.

And indeed the government is shutting them. If the three proposals found out by the newspaper I was working at happen, then thousands of people would have had to wait 30mins for an ambulance (minimum) before another 30–40min journey to the big new PFI-funded megahospital. A megahospital with overcapacity. But that's fine, because they can close the smaller hospitals to make up the difference.

Essentially, rural areas are going to be kicked squarely in the teeth by these measures. And they're inevitable. Services in the NHS will have to be cut, which sounds pretty worrying considering how much people have been paying in tax over the past 8 years.

And rural areas – which, happily don't contain many Labour voters – will be worst off because big hospitals there are far less economical, and small, local hospitals, while nice, are easier to dispose of.

What surprises me (although it doesn't really) is that the national press haven't picked up on this trend. Because it does seem to be a common theme. Smaller, local hospitals which have better satisfaction ratings – especially with the elderly – face being closed in favour of one-size-fits-all mega-hospitals.

Isn't it time to stop quietly changing the structure of the NHS through non-transparent quangos and think again about what the NHS is and should be about? Because some of the most vulnerable people are going to those worst affected by the changes made inevitable by over-spending in the NHS.

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