Tuesday, July 13, 2010

qotd: England's liberation of the NHS

Quote of the Day
August 17, 2009
Conservative leader David Cameron on the NHS

"One of the wonderful things about living in this country is that the moment you're injured or fall ill – no matter who you are, where you are from, or how much money you've got – you know that the NHS will look after you. That's why we as a Party are so committed not just to the principles behind the NHS, but to doing all we can to improve the way it works in practice."

(Since this quote, Conservative David Cameron was elected Prime Minister.)


July 12, 2010
NHS shake-up grants new powers to doctors and patients
By Rebecca Smith

GPs are to be handed £80bn of the NHS budget to buy care from hospitals and other doctors for patients in their area, as hundreds of middle-management organisations are swept away.

Family doctors will be responsible, in consortiums, for commissioning the care for patients in their area by buying treatment from hospitals, charities and other doctors.

Under the new Coalition government's health white paper, ministers will step back from the day-to-day running of the health service and hand power to the front line.

Andrew Lansley, Health Secretary, said the white paper represented a "vision based on the principles of freedom, fairness and responsibility".

However, there was immediate criticism from Labour and the unions, saying handing £80bn to GPs who are private contractors was a mistake and that the plan was a 'Trojan horse' for widespread privatisation.

The document entitled Equity and Excellence: Liberating the NHS includes wide-ranging reforms covering all aspects of the NHS and healthcare.

Mr Lansley said 'process-driven' Labour government targets, such as the 18-week waiting time between GP referral and hospital treatment, will be scrapped and the focus will instead be on quality of outcomes for patients.

All hospitals are to become a Foundation Trust or part of one, giving them far greater freedoms from Whitehall and allowing them to earn more money from private patients.

Management costs are to be cut in half but the Government has already admitted that the NHS would be forced to make staff redundant. It is estimated that around 25,000 jobs could be lost.

Nigel Edwards, acting chief executive of the NHS Confederation, which represents all NHS organisations, said the changes would represent a huge upheaval.

"It is hard to stress just how radical this is. The NHS will look much more like the gas, electricity or telecom's market than it will the monolithic state bureaucracy we have come to understand," he said.

Dr Jennifer Dixon, director of the think thank, the Nuffield Trust, said handing billions of pounds of taxpayer's money to GPs was 'risky' and is a significant change from their current role.

Andy Burnham, Shadow Health Secretary, called the white paper a 'giant political experiment' and warned that the government were taking an '£80bn gamble with the great success story that is out National Health Service today'.

"At a stroke, you are removing public accountability and opening the door to unchecked privatisation; you are demoralising NHS staff at just the time you need them at their motivated best," he told Mr Lansley in the House of Commons.

David Fleming of Unite, said: "This is an untested, expensive Trojan Horse in political dogma that will give private companies an even greater stake in the NHS – this way of operating has already happened in the USA.

"Before the election, the Tories promised no major reorganisation of the health service – within three months that pledge to the British people, the majority of whom did not vote for further privatisation of the NHS – has been broken. So much for the 'new politics'."


Department of Health (England)
July 2010
Equity and excellence: Liberating the NHS

5. Cutting bureaucracy and improving efficiency

The scale of the NHS productivity challenge may prompt calls during this Parliament for even bigger increases in NHS resources; but the reality is that there is no more money.

So our first task is to increase the proportion of resource available for front-line services, by cutting the costs of health bureaucracy. Over the past decade, layers of national and regional organisations have accumulated, resulting in excessive bureaucracy, inefficiency and duplication. The Government will therefore impose the largest reduction in administrative costs in NHS history. Over the next four years we will reduce the NHS's management costs by more than 45%.

The Department will shortly publish a review of its arm's-length bodies. Subject to Parliamentary approval, we will abolish organisations that do not need to exist. We will streamline those functions that need to remain, to cut cost and remove duplication and burdens on the NHS. In future, the Department will impose tight governance over the costs and scope of all its arm's-length bodies.

The Government will cut the bureaucracy involved in medical research. We have asked the Academy of Medical Sciences to conduct an independent review of the regulation and governance of medical research. In the light of this review we will consider the legislation affecting medical research, and the bureaucracy that flows from it, and bring forward plans for radical simplification.

We are moving to a system of control based on quality and economic regulation, commissioning and payments by results, rather than national and regional management. Within that context, we are committed to reducing the overall burdens of regulation across the health and social care sectors. We will therefore undertake a wide-ranging review of all health and social care regulation, with a view to making significant reductions.

Equity and excellence: Liberating the NHS (61 pages):

Comment:  The British National Health Service (NHS) is one of the most effective health care systems in the world. That is a remarkable achievement considering that they devote only half as much funds to their health care as does the United States (percent of GDP in 2008: UK 8.7% versus US 16.0%). Yet in their white paper, "Equity and excellence: Liberating the NHS," the Conservative government of Prime Minister David Cameron states, "the NHS productivity challenge may prompt calls during this Parliament for even bigger increases in NHS resources; but the reality is that there is no more money."

No more money!? Excuse the vulgarity, but... bullshit!

The Cameron government is using this false claim to dramatically pull back the government's role in the NHS, and to push privatization. They are not only cutting back on essential government administrative functions (as opposed to the profound administrative waste in the U.S. system), but they are also failing to honor their duty as stewards of the taxpayers' funds to maintain adequate regulatory oversight of their public health care system.

They are even going so far as to reduce the government's role in medical research. Could you imagine the Congress of the United States defunding our National Institutes of Health merely because it is a composite of government bureaucracies?

Is this really what the people of England voted for?

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