Robdixon

there is no such thing as NHS primary care services in the UK. The GP service and out of hours has always been private sector. GPs are not employed by the NHS. They work for private businesses, usually owned by some or all of the GPs at the practice, that has a contract to provide services to the NHS.

I do find it ironic how the GP community are so anti privatisation and like to give the impression that they are part of the NHS when in fact they are no different to Bupa, Circle and all the other private health providers.

Privatisation meh,

The only certainty is that over time more aspects of health care will need to be funded and provided outside the public sector especially if the notion of free at the point of delivery is to be maintained in some format. The stealth accusation rhetoric is massively overdone. tell me one gov dept that doesn’t have some private sector provision?

Binners, how does you political analysis fit with the fact that health is a protected sector under these nasty Tories?

(It doesn’t matter which party is in power in the future, the numbers, demographics, economics (if not the politics) are clear.)

Binners, how does you political analysis fit with the fact that health is a protected sector under these nasty Tories?

By ‘protected’ I presume you mean ‘hasn’t been cut as much as everything else’?

‘Protected’ does sound better though. I’ll give you that

How much has it been cut then?

The only certainty is that over time more aspects of health care will need to be funded and provided outside the public sector especially if the notion of free at the point of delivery is to be maintained in some format.

Are there any Tories here today?

Some sections of the Welsh NHS are truly amazing.
Other sections are bloody awful.

Well THM… they stopped claiming that they hadn’t cut NHS funding in 2012. After their own figures proved that they had.

its not just the funding. Its what its being spent on. They’ve spaffed countless billions on a completely unnecessary, ideologically driven reorganisation that they explicitly promised they weren’t going to do. Where do you think that moneys coming from?

My mam died just three weeks ago today. She was treated at Ysbyty Wrecsam Maelor and for some reason I couldn’t find the work-shy evil nurses etc in Wales that the mail and the tories like to bang on about. They treated her in her dying days with respect (even getting whiskey put on her prescription for a nightcap!).

Oh, but of course, NHS Cymru isn’t managed by the Tories. Therefore only bad press about it.

I thought when Cameron got in that perhaps the Tories weren’t *that* bad. I was right. They’re far far worse.

http://www.bbc.co.uk/news/uk-england-nottinghamshire-29636743

http://www.dailypost.co.uk/news/north-wales-news/betsi-cadwaladr-ex-health-board-7381407

Mary Burrows got nearly 500k from NHS funding to be completely shit at her job.

Belief in the NHS has replaced orthodox religion in Wales (& on STW!)

Are there any Tories here today?

Probably, I also hope that there are realists who can look beyond party political BS. An 80 year old costs the NHS 7x a 39 years old. Do the maths and then start your own planning for old age. Ditto pensions. Alternatively heads can be stuck in the sand and fingers crossed.

At the start of the 2000s health spending represented around 25% of gov spending. Under the nasty NHS hating Tories this will be 33%.. The bas*****s…..!

But it’s not a party thing, since 1992 health spending has had the largest real increases among all areas of gov expenditure

An 80 year old costs the NHS 7x a 39 years old.

Am I supposed to be surprised by this?

I do find it ironic how the GP community are so anti privatisation and like to give the impression that they are part of the NHS when in fact they are no different to Bupa, Circle and all the other private health providers.

Are you sure about this? Are their fees not set by the NHS?

An 80 year old costs the NHS 7x a 39 years old.
Am I supposed to be surprised by this?

Not at all. But you should be prepared. Same with your pension. Doesn’t matter who is in power you can’t buck these trends. Like a scout much better to be prepared.

I’ll still working to I’m 80 if the Tories stay in power. 😀

Na, you’ll have been privatised way before then.

blurty – Member
Belief in the NHS has replaced orthodox religion in Wales (& on STW!)

Not really. I’m kinda into both. 😀

Na, you’ll have been privatised way before then.

Ah so retired with a huge gold plated private sector pension. Sweeeet!

Binners, you’ve still missed the point that Lansley didn’t “lay the NHS open to competition law” – he simply enacted the requirements for open public tendering that are enshrined under EU competition laws.

Unless you are suggesting that Lansley should have made the case for leaving Europe, he had no choice but to enact competition and procurement rules – this is consistent with the previous government who signed up to them in the first place.

The Welsh do struggle with public spending because they get shafted on the distribution of tax revenues. Would like to see DM article comparing English NHS with SNP run Scottish NHS.

… as much as I hate to say it the NHS reform has been on a straight like trajectory since the early 1990s with the creation of NHS trusts and the splitting of commissioning and provision of healthcare. labour continued this, the and the coalition have followed that lead. Unless Labour have a fundamental change of heart then they believe that competition between providers is the way to drive efficiency and that private sector v public sector providers is part of that process. So much so simplistic neo-classical orthodoxy.

Although this is the model in social care and some elements of healthcare (usually community care, end of life care, etc) there is little chance with hospital based private provision, beyond some elective surgery.

The problem is that that the financial and political barriers to entry for any meaningful competition for the private sector into the secondary healthcare provision are so high that it isn’t really worth the risk. I can’t see a private provider building a £500m hospital with the hope of attracting business away from the NHS. The problem will come if smaller elective units in existing private hospitals cream off all enough of the NHS caseload to make existing NHS general hospitals uneconomic. The Government would still need to fund the full infrastructure of the exiting public provision though, making the system less efficient not more – IMO anyway.

TBH Government would be best served by ensuring that the NHS providers are kept fully occupied and properly managing the whole healthcare landscape including public health, community care and social care. There is plenty of evidence that prevention and early community intervention is better for patient and cheaper. Fragmenting the services and half arsed attempts to create a market that would always be broken make this almost impossible

And on whether NHS has been cut. Although increases in Govt spending may have just matched the GDP inflation measure there is a huge efficiency assumption built into NHS spending plans to cover both increased activity and the unavoidable fact that price inflation in the NHS is generally much higher than GDP inflation – albeit that freezing/holding down pay increases does reduce the gap.

You need to decide whether the funding provided is sufficient for what we want the NNS to do – the fact it does or does not reflect a real terms increase is irrelevant – political posturing

robdixon – Member

Binners, you’ve still missed the point that Lansley didn’t “lay the NHS open to competition law” – he simply enacted the requirements for open public tendering that are enshrined under EU competition laws.

I’m no expert but this doesn’t seem to be the case- as a social function rather than an economic one, the NHS isn’t explicitly bound by EU competitive rules. It’s only once it starts actively promoting competition between profitmaking service providers that it becomes an economic activity.

So basically, come in through the door marked wossnames, get treated as a wossname. But since it’s the competition itself that brings the NHS under competition rules, removing the competition seems to be allowed

Northwind – if you think that’s not the case you should probably be asking the likes of Andy Burnham and Alan Johnson why they oversaw literally hundreds of procurements that use the associated frameworks and rules… For all of the talk of a “change” under Andrew Lansley there are very few (if any) examples of what the change supposedly is – all of the practices that are used by critics to illustrate it are ones you can find under the last government.

What’s effectively going on is that Labour are busy hoodwinking the public by remaining silent on what they really did during their previous time in office, their sudden damascene conversion to principles that run at odds with their most recent policies, and finally, alluding to new policies without giving us any detail on how they will work, who will pay for them OR explaining why they have done a 180 degree turn.

This will probably work quite well though as it’s impossible to have any kind of rational discussion of healthcare in the UK and despite the public wanting the best healthcare, they will only vote for it if they are certain someone else will pay the incremental cost.

… I think that what is changing is the increased use of the private sector for direct clinical delivery of healthcare as opposed to infrastructure or support services.

If Labour want to draw a division between them and the Tories then perhaps that is where they need to look. Maybe I should actually read their policy if they have published it yet.

robdixon – Member

Northwind – if you think that’s not the case you should probably be asking the likes of Andy Burnham and Alan Johnson why they oversaw literally hundreds of procurements that use the associated frameworks and rules…

Not really sure where you’re going with this… It’s not about this lot vs the last lot. While trying to out-Tory the Tories, New Labour chose to drive the NHS in this direction; that doesn’t tell you anything about EU competition law.

The response to criticism often seems to be “but the last lot did it too!” My response to that is, why does that matter? It’s a bad idea regardless of who’s driving it.

Just spotted this on that there Twitter. Seemed relevant (though I’ve not read the thread so apologies if not).

http://pic.twitter.com/gUIlpJxQNB

Grammar police!!!!

Is that letter a case of English as a foreign language? 😉

The alliteration does add a poetic touch though!

Walk around any hospital grounds and you will usually see dedicated spaces for certain depts staff, as opposed to communal parking, nice sets of offices and treatment areas all branded as belonging to that area, health centres incorporating a pharmacy, physio and minor injuries drop in.

All done to fragmentise the nhs and sell it off as small pre formed groups.

Then look inside the building, facilities management, catering, security,cleaning, hospitality services,patient records,patient transport and lots more all run by outside companies, other bits can also and will probably be split off if this lot by any chance get back in, x ray and scannning, physio, OT,chiropody, maternity, and many more.

And lets not forget everyday as we age, we get closer to the day we may and will need the extended care of a joined up NHS..

Now here is a good daily mail headline, DRUNKS TO BE CHARGED FOR AMBULANCE ATTENDANCES, JUST LIKE YOUD BE CHARGED FOR A TAXI.

If youre drunk and paid for drink, surely a charge to transport you hospital should be charged, to many pissheads blocking up the nhs, and taking valuable ambo time up.

Would I have to pass a breathalyser or pay the money.
And if I refuse to pay would I be left in the street.

Man left to die in street after refusing to pay ambulance fare.
That would be a headline.

Like a parking fine you would be billed and failure to pay will result in a bailiffs visit,wether breathalyser or blood test i dont really care, just dont want drunks blocking ambos.

If youre involved in an rtc, youre usually billed by the health authority, i was last accident i had, and i walked into a and e, not arriving by ambo

Man left to die in street as he hadn’t paid his last ambulance fare.

Ambulances are there to help people who need them irrespective of how they came to need them.
If you started charging people for what ever reason it’s a slippery slope.

If there are not enough ambulances to go around then we need more.
If we have a social problem with peoples attitude towards drink, let’s tackle that.

But to charge people because they were drunk is ridicules.

The number of alcohol-related admissions to hospital in Northern Ireland annually rose by 61 per cent between 2000 and 2010 to 11,453. In England, admissions related to alcohol more than doubled between 2002 to 2012, to 1,220,300 admissions per year, and similar increases were seen in Wales. In Scotland admissions have been declining since 2008 – partly driven by improved support outside of hospital for people with alcohol problems.

Ambulances need staff, people attending a and e require staff, other treatment and transport services are available, this government have cut staff and funding.

If you cann afford to derink to excess you can afford to pay for transport to hospital or a place of treatment.

“Walk around any hospital grounds and you will usually see dedicated spaces for certain depts staff, as opposed to communal parking, nice sets of offices and treatment areas all branded as belonging to that area, health centres incorporating a pharmacy, physio and minor injuries drop in.”

I’d hazard a guess you’d been walking round the same areas for the last 40 years you’d see the same thing irrespective of what party is in power.

This is actually the symptom of a different problem which is that the NHS operates as a loose consortium of feifdoms – all being run for the convenience of the staff who work in them but with different rules… with the poor patient typically bouncing round between them because none of the departments talk to each other – perfectly illustrated by the need for endless repeat visits (and time off work) for a series of routine diagnostics that can and should be done on the same visit and centrally coordinated. This is seen as a vision of Utopia in the NHS but something the rest of Europe has managed for at least the last 15 years.

If youre involved in an rtc, youre usually billed by the health authority, i was last accident i had, and i walked into a and e, not arriving by ambo

That’ll be because it’s the hospital trust who’ll charge you.

If you cann afford to derink to excess you can afford to pay for transport to hospital or a place of treatment.

+1 and it’s completely out of order to expect NHS staff to have to work in battle-zone like conditions every Friday and Saturday night, not to mention the distress it causes to other patients who have genuine urgent care needs but have to wait for hours in a room with people shouting vomiting and fighting around them

If your figures are correct project, the government need to ask why and try to work to reverse them.
It used to be an offence to have a drunk person in your pub.
That was only ever enforced if a pub had a problem with trouble.
But it encouraged the publicans to be responsible with how they served there drinks.

If the government has a problem with the amount of drunk people spilling out onto our streets every weekend.
That is a problem they need to take up with the establishments who are serving them and making a prophet from these people barely able to stand up straight that are causing a strain on our health resources.

I’m a nurse and I started my career in the NHS. Sadly we were sold out, and I know work for a private company, won’t mention who but they also do holidays, flights, trains, money, TV to name but few. Is it better? No. Why because it’s all about how quick can we get people in and out, and how many people are we seeing because we have to meet our targets or otherwise there will be commissioning issues. I have yet to meet a nurse who thinks privatisation is good. We are being conned. In ten years we will have an American health care system, absolutely shocking.

I’m a nurse and I started my career in the NHS. Sadly we were sold out, and I know work for a private company, won’t mention who but they also do holidays, flights, trains, money, TV to name but few. Is it better? No.

So youre no VIRGIN then to the NHS,