NHS Reforms

[Dave2002]

I can't understand the current goverrnment's continuing attempts to make new policies and practices. Just because there may be problems with established policies and practices in organisations doesn't mean that abandoning them all will lead to improvement.

In the case of the proposed NHS reforms, I view the notion that GPs should run hospitals etc. with some horror. I know of several GP practices where those that run them, whoever they are, can barely run the practice properly, so heaven help us if they get to run hospitals as well. Maybe I missed something!

[johnb]

Dave,

I don't think that the GPs will run hospitals!

There is a real danger of the system going into meltdown between now and when the new process will begin in 2013. At the moment, as I understand it, the Primary Care Trusts do the commissioning of services etc. These are to be abolished, so staff will be looking for other jobs before then. 2000 have already taken redundancy and the PCTs in London are having to cluster together so that they are able to continue providing their essential services. Heaven knows what is going to happen as we approach 2013.

Article in today's Indie

[Eine Alpensinfonie]

I can't understand the current goverrnment's continuing attempts to make new policies and practices. Just because there may be problems with established policies and practices in organisations doesn't mean that abandoning them all will lead to improvement...
... Maybe I missed something!

I don't think you've missed anything. The problem with all government reforms - not just those from the current coalition - is that politicians think they know everything, particularly when they know very little. Instead of listening to the people who run the NHS, they impose their disasterous ideas, and when it all goes pear-shaped, they say "there was no way we could have forseen this". Basically, government ministers are pen-pushers, with little conception of the consequences.

[johnb]

EA,

+1

[Frances_iom]

.. Basically, government ministers are pen-pushers, with little conception of the consequences.

no they are mostly lawyers who know exactly where the money is and how to get their hands on it - most (all ?) of them can easily afford to go private and give two fingers to the rest of the population.

[Eine Alpensinfonie]

I wasn't just thinking of the NHS. The same disasterous games are played in education and defence. Michael Gove is probably the least competent Education Secretary in living memory (and there have been several pretty dire ones in the last 25 years).

[Frances_iom]

.. Michael Gove is probably the least competent Education Secretary in living memory (and there have been several pretty dire ones in the last 25 years).

can you name a recent Education secretary (or shadow) who sent his/her children to a state school ?

[James Wonnacott]

Basically, government ministers are pen-pushers.

The problem is the pen-pushers brought in to run the hospitals.
The thing hasn't worked properly since they repaced matrons with managers.

[Eine Alpensinfonie]

I don't know. Going backwards from Mr Gove, we had:
Ed Balls
Charles Clarke
Estelle Morris
David Blunkett

I don't know which ones had children, but I can't imagine David Blunkett sending any offspring to a private school.

[Dave2002]

Dave,
I don't think that the GPs will run hospitals!

I don't think so either, but it appears that they often don't run their own practices, though they may be responsible for them. Many GPs are good as doctors, but the management of their practices is sometimes left to others who couldn't run a booze up in a brewery. The suggestion seems to be that these latter people should now be allowed to "manage" other perhaps more critical parts of the health service. Of course there have been problems with PCTs, and there may well be more managers than people actually doing work which is directly related to health, but allocating responsibility to GPs, or managers notionally working for them, doesn't seem sensible at all.

There must be better ways to initiate reform than the current proposals, though I fear that those who are starting them are unwilling or unable to admit this. Having visited hospitals (not as a patient) quite a number of times in recent years, I'd say that often doctors are hard to find. Some doctors are not in fact allocated to wards, or are specialists not related directly to a ward. There may be apparently quite a lot of nurses, but when you check it all out you may find that some are in fact orderlies or tea ladies. There are times when hospital wards are seemingly overstaffed (sometimes, for example, on bank holiday Sundays), and many times when there are just not enough nurses to go round. Monitors attached to patients are often ignored or turned off, and visual checks on patients put into off-ward rooms are not carried out often enough. There may be an emphasis on record keeping (not necessarily a bad thing), but this may mean that when a patient needs attention it is not provided because nurses are spending time on writing up notes. These are problems which should be addressed, not fiddling around with the PCTs. There are also many wonderful people working in the NHS, including some who even come in on their days off to help - very possibly for no extra pay. Patient/staff ratios in NHS hospitals are high, whereas in private hospitals there may be perhaps only four patients/medically trained nurse. However, for critical health issues there seems little doubt that all the expertise is within the NHS hospitals. Funding is probably the major difficulty, since it seems that being ill is an expensive business.

[Dave2002]

johnb

Totally off track, your indie article also had a link to recommendations for whiskies - http://www.independent.co.uk/life-st...s-1488408.html Not heard of most of them - might be worth checking out.

[Ferretfancy]

The extraordinary thing is that a number of recent surveys have shown that the public satisfaction with the NHS is the highest it has been for many years,so naturally wholesale changes are necessary! This is just a back door way of allowing hospitals to create a bigger private market.
What really worries me is that for all the coalition posturing we seem to have no cabinet consensus on anything, each minister rolls out his own raft of huge changes, seemingly without full consultation, and No. 10 then expresses reservations and offers to give it a second look. I have never known a time in which I have felt so seriously misgoverned, we can only despair.

[rauschwerk]

I have never known a time in which I have felt so seriously misgoverned, we can only despair.

I can only agree wholeheartedly with that statement. Lansley is going to pilot the GP-led scheme, but is then going to roll it out nationwide regardless of the results. He is also imposing 'efficiency savings' so draconian that no heath service anywhere in the world has ever achieved them. What this will amount to is spending cuts in thin disguise. It's well known (except to this government, apparently) that such savings take years to achieve and money has to be spent in the short term to achieve savings in the long term.

The use of targets in recent years has demonstrably improved NHS performance and patient satisfaction, so what does this government do? Scraps them at the earliest opportunity. I give up.

[Philidor]

I wouldn't trust the Tories to go within a mile of an NHS hospital. They've always hated it and fought it from the start:

By NHS D-Day, July 5, 1948, 90% of doctors had signed up for the new service. But although Bevan had in the end comfortably won the battle, he could not resist one last attack on those who had stood in the way of his dream.

In a speech on the eve of the heath service's launch, Bevan called the Tories "lower than vermin". When the prime minister, Clement Attlee, suggested the opening of the NHS should be celebrated as a national institution supported by the whole nation, it was too much for Bevan, who replied:

"The Conservatives voted against the National Health Act, not only on the second but on the Third Reading. I do not see why we should forget this."

BBC

[Ferretfancy]

I had a bad fall a couple of days ago, saw my GP this morning at 10 30, popped on a bus to my local hospital, had a blood test in one department, and an X ray in another, and was home by noon, much reassured. What more could I wish for ? It really ain't broke!