[Closed] NHS Reforms defeated in House of Lords - What does that mean?

So Kimbers what is your point on that article, is it bad that a NHS hospital makes £48 million a year from private patients whilst still meeting its targets under the NHS and providing outstanding care for NHS patients at the same time.

People with vested interests in maintaining the status quo in resistent to change shocker

I think its interesting that the people are now cheering on the House of Lords blocking the will of the democratically elected government,

Teamhurtmore - I was replying to your direct views as expressed above

So Kimbers what is your point on that article, is it bad that a NHS hospital makes £48 million a year from private patients whilst still meeting its targets under the NHS and providing outstanding care for NHS patients at the same time.

the point is that to use this as a an exemplar of how all NHS hospitals could be is unwise.It is is in the richest borough in the country and therefore it is atypical by definition ..FFS how explicit does this point need to made for you to get it?

It is not a great example of an "average" NHS hospital whatever your politics.

my point is that when they finally get their wish and are able to leave the nhs, it will be a sad day, this bill is the next step towards that

I dont use it as an example of all NHS Hospitals, but the principles are there.

using the example I see it as a good thing that NHS hospitals can make extra money treating private patients, in fact a lot of people who have private medical get treatment from NHS now, so nothing is changing dramatically, just the percentage that can be earned in private work.
when I had my eyes done it was by a NHS doctor in a NHS hospital but it was a private operation and I was happy with that arrangement.

I think there is too much hysteria about this and the argument too often breaks down

kimbers the bill is doing nothing to privatise hospitals

Sancho - yes it is - thats the whole point of it. Are you really that ill-informed? It will allow and encourage privet health providers to take over the functions of hospital - so while the actual buildings may not be privatised the functions will be transferred to the private sector - and in some cases the buildings will be as well

really - I suggest you read up on this and look into the history of it.

The only people who say this bill is good are those ideologically opposed to state healthcare, those who are set to make profits out of it and thse who do not understand the issues but are taken in by the tory propaganda.

when I had my eyes done it was by a NHS doctor in a NHS hospital but it was a private operation and I was happy with that arrangement.

So Sancho, what motivated you to make this decision ie, have a private operation in an NHS hospital by a NHS doctor?

Well Junky - when the NHS was first introduced, the BMA voted 85% against joining it, in fact they campaigned pretty heavily against it

so yes, maybe we should have listened to the experts... or do you want to pick and choose which experts you listen to.

It's not just the unions, opposition groups and professional bodies that are opposed to it.
This editorial last week was unprecedented; the three biggest players in the British medical media coming together. An excellent summary of the situation too [url= http://www.bmj.com/highwire/filestream/563512/field_highwire_article_pdf/0.pdf ]BMJ/HSJ/NT editorial[/url]

my motivation was that the surgeon was one of the best in his field and the equipment was the best available and I had most confidence in the success of the operation.
the cost I thought was worth paying.

But this bill is not about privatising the NHS there is too much delirium going on about this.
allowing private companies to operate in the field of health care is happening already and works very well, the privatisation of the NHS is not happening.
if I have mis read the bill, can someone point out the sentence that I missed defining privatisation.

To repeat my earlier post Sancho

[i]The hand grenade contained within the bill is the separation of doctors 'commissioning' services and NHS hospitals 'supplying' them

Once that essential division is in place, then the NHS is open to the legal enforcement of EU competition law, which states that any services commissioned have to be open to bidding from 'any qualified supplier'

That means that private healthcare companies can legally demand access to the 'market' in healthcare.

Will they be interested in all services the NHS provides. Of course not. They'll cherrypick the profitable bits. Then leave a rump public service dealing with long-term care etc that they can't be arsed with, while they cream profits off[/i]

opening up the NHS to EU competition law means they don't have to come out and say they're privatising it.They haven't got the balls for that. But Private companies will then legally be able to demand to tender for every piece of NHS work. So privatisation will be the end result. And the Tories know this full well!!!

I disagree with your point binners.

Works the other way also. NHS patients are being Treated in Private Hospitals for example, due to the ever increasing waiting lists.

Using myself for example, routine Hernia surgery i had to wait over the 18 week maximum waiting list target for my local Hospital and was therefore, re booked into a BMI hospital. From seeing the GP to having the actual Op took 2 weeks.

You just have to ask for this service to see if your local NHS offers it.

Sok thanks for the post. Interesting article that not just because of the acceptance that some reform is necessary and initially welcome, but then botched (my points early) but the importance placed on the issue that binners raises here ie the split between commissioners and providers (page 2) and the role of choice and competition. Ignoring the facile idea that New Labour were Tories in disguise, and assuming that the BMJ are correct, why has there been a 30 year misalignment between governments and the NHS on this fundamental issue?

Sancho you raise an issue that always makes me question the argument that if the doctors are against reform then it must be correct for us all to be against it. I spent my social life surrounded by doctors (surgeons and consultants especially) who work in both the public and private sectors. And why on earth would they not oppose reforms to a current situation that serves their interests so well? A steady guaranteed income from the NHS, and lucrative work from the private sector. So why do they get the latter? Presumably because, like you, people perceive that they will be treated better (on subjective criteria) if they pay to go privately. So it is in the interests of my mates to maintain a real or perceived difference between the service they provide privately and the service that is free-for-all. Hardly a recipe for universal improvement in the provision of healthcare in the UK? A blatant conflict of interest that will ensure that they vote for the status quo.

Surgeon friend to my neighbour. Yep, can do that operation for you easily. Tomorrow if you pay me, June if you want it on the NHS. Only difference is the timing. Turkeys, Christmas anyone?

Sancho - the whole plan was dreamt up to privatise the NHS - and thats its intention. You follow it back to when the tories were in opposition and its made clear this is so.

The aim of this bill is to provide the structure to do so. Its been set up by advisors to private health companies. Private healthcare is always more expensive with worse outcomes than state run.

thats why the whole medical and paramedical profession bar a tiny minority are against it

the split between commissioners and providers (page 2) and the role of choice and competition. Ignoring the facile idea that New Labour were Tories in disguise, and assuming that the BMJ are correct, why has there been a 30 year misalignment between governments and the NHS on this fundamental issue?

there hasn't - Once again you argue from false premises and show your rightwing bias.

Labour removed the previous attempt at a provider/ commissioner split and competition does not work in healthcare.

This is the first time ever that there has been a serious attempt to take the NHS to a commisioner of care only with providers competeing.

"Private healthcare is always more expensive with worse outcomes than state run."

Not strictly true. The local tertiary hospital costs more to do some opps than it does in the local private hospital so some of the opps are commissioned at the private hosp. In that way you could actually end up if you live in this area having your opp done in a private hospital on the NHS already.

There are also privately run NHS Branded hospitals in place, one such which 'specialises' in Orthopaedic work. Its already proved expensive in the fact that patients often get complications that then getting followed up at main NHS hospitals as these 'centres' can only do the opps and not patient care.

TJ - again? I am quoting that article from the BMJ, nothing to do with my premise or perceived bias. What should I do, submit to TJ bashing as per, or read what the experts in the field are saying?

To clarify again (!?!)[b][u] according to the BMJ[/u][/b]

There has been a [b]broad consensus[/b] among policy makers from [b]all major parties[/b] for over [b]30 years[/b] about what is needed to deliver an effective and efficient health service. [b]Cornerstones[/b] of this world view[b] include a division between commissioners and health providers and the use of choice and competition to drive improvement.[/b] Yet relatively [b]few healthcare staff share these views[/b]...

Now please behave yourself!

My only problem with the whole thing is the fact that GP's will determine your treatment.
GP's are shit and more often than not miss the obvious signs of diseases and so allow disease to get hold and become harder to treat.

A NHS for my mind would do away with GP's and put all treatment in hospitals.

Funkydunc the private hospitals arenot paying the full costs and the state hospitals will be being nominally charged a premium to make the private look cheaper. ( called the comparator IIRC)

Private hospitals do not pay for the training of the staff.

"My only problem with the whole thing is the fact that GP's will determine your treatment.
GP's are shit and more often than not miss the obvious signs of diseases and so allow disease to get hold and become harder to treat.

A NHS for my mind would do away with GP's and put all treatment in hospitals."

That whole statement just shows your ignorance and lack of understanding of what the reforms are about (the good or bad bits of the reform...)

Sancho - does your obvious distaste for GP's come from them constantly prescribing you the wrong medication?

Keep trying. They'll get there in the end

bwfc et al.

Yes, if you only ever want a hernia in life, that's fine, pop down to your local private hospital.
But what happens when your elderly mother is struggling to control her diabetes, who is going to provide that care? She falls and breaks her hip, but private providers aren't interested in providing complex care. So, they fix her hip (if she's lucky) but there's no-one there to review her diabetes which was off causing her to fall in the first place. And there's no-one there to provide any rehab and get her ready to go home. But the private provide won't do it, they've taken their money for the op. So, in fact, no-one will do it, and no-one will have the obligation anymore to provide comprehensive health care.

Private providers will cherry pick the nice, neat, discrete healthcare. It's what you and I need now but it's not what are families and we will need in future years as we start to age.

Funky dunc, my little comment is not meant as an understanding of my view on the reforms, its my annoyance at my GP, who is shit.
I am having to get treatment for Nephrotic Syndrome at the moment diagnosed by a mate who happens to be the consultant in A&E in BRI, the GP diagnosed my symptoms as my age and to accept it.

sok, the NHS will provide the care for your elderly mother as it does now, please dont get hysterical about "Privatisation of the NHS".

Its not happening and the doomsday scenarios of private American style health care arent happening either.

And there's another problem too.

Services provided by the NHS are free at the point of delivery for everybody in the UK, regardless of social factors or ability to pay. However, much of public health (prevention of disease and provision of effective and efficient services) is being moved to the local authorities. And local authority services are not free at the point of delivery. In fact, they are almost invariably means tested.

Some services currently provided by the NHS will no longer be part of the NHS and will therefore be open to normal local authority funding arrangements, which includes means testing. Just as much care for the elderly is means tested, it becomes possible that all these other services will also be means tested. Oh, and these servicecs include health services for children and young people, health promotion and education, stop smoking services, drug and alcohol, and sexual health services.

You best start a health insurance policy. And one for your kids too.

Sancho - you've missed the point. There will be no 'NHS' to provide these integrated services as there will no longer be a requirement for anyone to provide these.
Could you highlight the differences in the current American system and the future English system, I'm not clear how you think they'll be different.
And my mother doesn't have diabetes but thanks for your concern.

OK, really not trying to troll here but why on earth do you still listen to and maintain the House of Lords. (Regardless of whether the current gov. is any use.)

They´re not an elected body and as far as I can see and their purpose seems to be checking out Bills and (usually) refusing to accept them.

Wouldn´t a publicly electable body be much more qualified?

I have family living in the UK which is why I keep in touch with what´s happening there though personally it doesn´t affect me.

Re-reading the BMJ article it is telling how often the word 'patient' comes up.

Re-reading the BMJ article it is telling how often the word 'patient' comes up.

I'm not sure what your point is - are you saying this is proof of their oh-so-vested producer interest?

Besides, whatever AL's homely rhetoric, the ConDem reforms will not be putting "the patient" at the centre of things.

On the other hand, the likes of [url= http://www.guardian.co.uk/commentisfree/2012/feb/08/nhs-professional-service-ripe-reengineering?INTCMP=SRCH ]Ali Parsa[/url] will be very well placed indeed.

Will this bill take effect in Scotland?

Will this bill take effect in Scotland?

No.

STW would crash if it did. 😀

Good - carry on as you were because I simply dont care what happens to the NHS in England.

SBZ - NHS scotland is run from holyrood - that s why we have no wasteful foundation hospitals - no private treament centres taking money out of the NHS and none of this nonsense will apply

i predict health tourists from England becoming a real issue tho

I simply dont care what happens to the NHS in England

Fair enough. But you would do well to observe.

I have every confidence in my fellow Scots to set England adrift on its own sea of mediocrity come the referendum. 😉

Noteeth - a simple point really, confirmed by the Ali Parsa piece (patient x1 and in a passive phrase) and possibly, if I can find time to read the bills, in the governments documentation etc. I wish people would put patients first.

This debate seems to centre round lots of people - politicians, doctors, nurses, private suppliers, administrators ad nauseam.....and so rarely about the people who matter, the patients. Hence the word count. So, yes, confirms my "suspicion" of vested interests and conflicts of interest.

In contrast, it was interesting to read what Millburn said and where he focused!!!

"[b]And patients should become active participants in their healthcare, rather than mere passive recipients."[/b]

Surrounded By Zulus - Member
I have every confidence in my fellow [s]Scots [/s]residents of Scotland to set England adrift on its own sea of mediocrity come the referendum.

set England adrift on its own sea of mediocrity

Is it Scottish independence thread time already? 🙂

Teamhurtmore - and once again you start from the wrong premise. It really is funny watching you do this.

Opposition to these reforms from the professionals is all about the patients. Just read the press releases from them. I even quoted some a while back

In contrast, it was interesting to read what Millburn said and where he focused!!!

"And patients should become active participants in their healthcare, rather than mere passive recipients."

shows his idiocy.

Its been tested time and time again - the vast majority want good local services they do not want meaningless choice nor meaningless soundbites.

confirmed by the Ali Parsa piece

Parsa's CiF piece is platitude dribble of the highest order, coming from somebody who happily decries the NHS as 'broken', whilst his well-timed venture (Circle) profits off the back of NHS staff, expertise, workforce training and infrastructure. And Alliance Medical Milburn has got some nerve, given that NuLav helped lay the foundations for all this (see the woefully poor value ISTC contracts etc).

I agree that patients should be at the "centre" - unfortunately, they are likely to be at the centre of an impending cluster****.

This is the truth teamhurtmore - dedicated public servants are desparatly concerned about the health and social care bill because of the damage it will inflict on patient care.

RCGP

The RCGP has written to Prime Minister David Cameron to formally call for the withdrawal of the Health and Social Care Bill,[b] citing the ‘irreparable damage' it could cause to patient care[/b]

We cannot sit back. Instead, we must once again raise our concerns in the hope that the Prime Minister will halt this damaging, unnecessary and expensive reorganisation which, in our view, risks leaving the poorest and most vulnerable in society to bear the brunt.

http://www.pulsetoday.co.uk/article-content/-/article_display_list/13381509/in-full-rcgp-statement

The RCN has clearly and consistently set out which areas of the Bill
must be changed, [b]not as a matter of self interest, but to guarantee
patient care [/b]and to retain the NHS as a national institution providing
high quality care, free at the point of need.
Due to the Government’s refusal to concede on sufficient points, and
the [b]risk we believe the legislation poses to patient care[/b], the RCN is
now moving to a position where we oppose the Health and Social
Care Bill.
The

The NHS that we know and love is under threat. The government plans to massively shake-up the NHS, which has the potential to cause [b]huge damage to patient care[/b] and waste vast sums of public money.

http://www.unison.org.uk/ournhs/

In 30 years working in the NHS I have never seen such united opposition.

Of course the government have very cleverly used the pensions nonsense they stirred up to attempt to portray the NHS workers as self serving. Its simply not eh case.

Of course the government have very cleverly used the pensions nonsense they stirred up to attempt to portray the NHS workers as self serving. Its simply not eh case.

Those dastardly Tories, and you all fell for their cunning plan, didn't you...

Cameron and Osborne pictured yesterday, before jetting off to a Bilderberg meeting with their lizard chums

[img] [/img]