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!!!

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

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

Just before we start that one again….

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 clusterfeck.

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, citing the ‘irreparable damage’ it could cause to patient care

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, not as a matter of self interest, but to guarantee
patient care 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 risk we believe the legislation poses to patient care, the RCN is
now moving to a position where we oppose the Health and Social
Care Bill.
The

http://www.rcn.org.uk/__data/assets/pdf_file/0003/426909/Why_the_RCN_is_opposing_the_Health_and_Social_Care_Bill.pdf

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 huge damage to patient care 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

The present government know they will never get support of the overwhelming majority of helth and social care workers so they have nothing to lose by angering them further. (they lost another voter yesterday when one of my friends, a dyed-in-the-wool son-of-a-conservative-councillor announced to us all his disgust with the H&SC bill and his disillusionment with his longstanding party of choice).

The reality for me is that as a frontline clinician, (failing me getting struck off for biting a politician on the leg or something), I will always have a job of some sort, albeit under rather worse condistions, pay and pensions than I signed up for, and the senior managers and SHA folk I have seen lose their jobs since the election are educated and very well-connected folk who I am sure can look after themselves. The real losers in this bill will be the most vulnerable, who cost the state in welfare/benefits and contribute usually only by the VAT they pay on what they consume, and the least likely to vote for any party come elction time; that is the very old and infirm, and those with mental health problems. Funny that. 🙁

Cameron and Osborne pictured yesterday

It will be a wacky race to the bottom.

Ba-boom-tish – here all week, etc.

The real losers in this bill will be the most vulnerable

Indeed. It’s going to be interesting when the Daily Mail finally clocks that hiving off profitable elective services (e.g. tickbox ops in the generally fit) is not going to do anything for frail elderly patients.

Ok TJ, I accept that it is a subtle argument and that you will continue to do your best to mis-represent what I say. But even here, it is about patient care, not about patients themselves. Where is the noun, the subject, in all of this?

I do not doubt the dedication of most of the people who work in the health service and am in awe of their skills and contribution. But that shouldn’t blinker one to the fact that “service” is, at times, a misnomer.

And forgive me from starting with the wrong premise – the patient?????

If we want to start with the idea of premises lets take the NHS’s vision statement (excuse the ghastly phrase):

a comprehensive service, available to all, free at the point of use, based on need, not ability to pay’

…and consider, “available to all.” So is this true from the patient’s perspective? NO, it is true from the governments and hospitals perspective. Who makes the choice…..the government devolves power to the medical staff who determine what they will make available and in what time frame. Again its a matter of perspective. And this is not the patients perspective.

One day, the patients truly will come first. In the meantime, the usual mess will prevail….

If Milliband is correct – that we are passive recipients – there are few services in the world that survive like that without reform.

Edit at 12 mins: [TJ – 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] ok very small sample but that’s exactly what I did. Two links were made, neither put patients first. But fair to say that this was a ludicrously small sample 😉

there are few services in the world that survive like that without reform.

THN: simple question… how can there ever be a perfect (i.e. properly informed) market in healthcare? If I walk into A&E with abdo pain, there are any number of things which could be wrong with me. All I ask is that battle-hardened staff sit on me till it’s resolved or solved – I don’t want to be either over-investigated (ker-ching), or fobbed-off with Crapita-value provision.

I’m all for patients being at the centre, always. But political platitudes about “choice and competition” can be utterly meaningless at the actual coalface – and we are seeing services fragmented for the sake of spurious soundbites.

The point is not that the NHS is perfect – it ain’t – but these reforms will not improve matters. Moreover, they look suspiciously like a pre-prepared blitzkreig. Indeed, much has already been [un]done.

Noteeth – I think we are in complete agreement.

Noteeth – I think we are in complete agreement.

I suspect that most of the world’s ills could be sorted on one big STW ride. And on that day, Stoner and TJ will ride a tandem together.

That, or there’d be a massive fight. 😉

One day, the patients truly will come first

🙄

Platitudes like this are half the problem; if you give people what they want, we would have a fully equipped state-of-the-art hospital at the end of every street, fully staffed 24 hours a day, 365 days a year with every medical speciality under the sun represented and available.

Bit of a dear do though…. and outcomes? Would be worse.

if you give people what they want

It’s interesting how MPs say one thing… and do another, when it concerns hospital closures in their own backyard. For my part, I’d like more Burger Kings in hospital foyers. 😈

Lansley has already ducked/palmed off the difficult issue of (necessary) hospital closures and consolidating acute care into a smaller number of centres. And given that the Gov is apparently making funding available to cover some PFI debts, it makes one wonder what will happen in the event of a Southern Cross style failure among the new & willing providers…

How much did the Iraq and Afghan wars cost? And Trident? And bankers, dont forget the bankers. Basically, if folk would stop ripping the arse out of it the NHS would be grand.

On the contrary crikey – putting patients first is not the same thing as giving them what they want in extremis. Any person knows that health has a fundamental problem of unlimited demand BUT limited supply. The question is, how best to deal with this?

If you think that being available for all, should be determined by the supplier/government then so be it. Others may prefer it if the patients made those choices ie, putting patients first. Its a matter of perspective.

The one thing that everyone seems to be in agreement with (including the BMJ in the link above) is that governments are not very good at doing this!

Yes teamhurtmore – you are as usual coming from a totally false premise. seasoned by a refusal to listen to anyone who does not agree with you and then garnished with a bit of denigration of those who disagree with you.

The false premise is that the patients are not put first. Giving people “choice” does not put the patients first. It puts some patients first – the noisy ones and and it makes strategic planning impossible.

its been shown over and over again that this is not what people want ( bar a very small minority) – they want good local services. They do not want to have to make a choice between services indeed such a thing is actually not possible as it is impossible for lay people to be able to make meaningful choices on care issues in this way 99% of the population do not have the background to be able to make meaningful choice.

The only way choice can be exercised is to give a democratic oversight into the running of the healthservice – withdrawn by this government.

You have been drawn in by this bogus concept – putting the patients first means a planned system that gives the best care for the least cost. Introducing patient choice make care more expensive and fragmented and does not actually achieve what you want it to – it cannot.

anyway these reforms will reduce democratic and patient iimput.

TJ – again? You are incorrigible? I really can’t work out if your first paragraph is a joke or for real? Read this thread and look at the one person who has been rude and denigrating on it???? Hmmmm???

Meanwhile, nice to have a discussion with polite people…!!

**** you hurtmore 😉

I’m up in Scotland and work in the the Nhs but that’s by the bye (or whatever the phrase is- not important in the context of the discussion). Anyways, I know this doesn’t directly affect us but this bill and the changes being implemented scare me, a lot. Tons of points involved in this so I’ll just jot them down in random- ish order and folk can flame me or whatever..
No1- did the libdems or torys campaign on a total overhaul of the NHS? Don’t think so.
No2- bringing private healthcares into the NHS seems stupid, it’s a service not a business. But then if there wasn’t going to be profits involved why would these businesses be queuing up to provide healthcare services?
No3- on the topic of profits I do agree with the sentiment the private companies providing services will cost more in the long run than they do now under current provision- profits remember?
No4- if the privately provided aspects of the NHS take up proportionately more of the NHS budget non-private parts of the NHS will have less money to treat folk so patient care will suffer
No5- I agree that the majority of folk in the the NHS are against this, not because of vested interests, but because they already have a good insight into the current state of the NHS and probably have a decent idea of what the changes will do to their organisation..

I’ve prob got a few more points about Gp groups and political donors involvement with some of the private companies but my wee boy wants out the bath so have to go..

Evening JY – how are you?!?

Doing ok thanks for asking- these threads tend to be just folk espousing their left or right wing view Personally i dont actually believe the Tories have either the political or moral mandate to do this and they are making a pigs ear of it

it is obvious that any organisation the size of the NHS could always be improved and is imperfect but I doubt this will actually achieve it

These threads are just the same old same old
Not many [ on either side] are that rational or wiling to accept that sometimes the other person/side has a point

Well said.

teamhurtmore – Member

TJ – again? You are incorrigible? I really can’t work out if your first paragraph is a joke or for real? Read this thread and look at the one person who has been rude and denigrating on it???? Hmmmm???

teamhurtmore – Member

Ok TJ, I accept that it is a subtle argument and that you will continue to do your best to mis-represent what I say.

thats pretty rude and denigrating. You are saying I am incapble of understanding yuor argument and that I am misrepresenting you .

I am not misrepresenting what you say. I am trying to explain to you where your lack of knowledge and understanding leads you astray. However you do not want to listen or understand – you prefer to denigrate.

Others may prefer it if the patients made those choices ie, putting patients first

this is the false premise – putting the patients first means making objective choices using professional knowledge

But no – you know better that the professionals who work in this sytem do

Others may prefer it if the patients made those choices ie, putting patients first

so how is the person living with dementia supposed to make a choice?
How is the person with learning difficulties suppose to make a choice?
How is the person with severe mental health issues supposed to make a choice?

giving patients a “choice” means the shouty middle classes get their choice at the expense of those who cannot shout for themselves.

there is an important principle in the legal stuff that surrounds care which is that we as professionals should do for people not as we want but as they would want were they able to do so.

Your “Others may prefer it if the patients made those choices ie, putting patients first” means that the frail, the vulnerable and the old will get less.

One middle aged womans herceptin is 20 hip replacemnts not done. Thats what “choice” is about.

dog eat dog isn’t it.

No not in teh NHS – we do our best to make sure its equal access for all

Now teamhurtmore – just have a think about this. Do you want whats best for all with objective decision making or do you want spurious choice that will disenfranchise the marginalised?

And forgive me from starting with the wrong premise – the patient?????

So the FT today:

Q: How will the reforms make life better for the patients?

A: AL’s inability to find a compelling answer to this simple question has done the most to undermine his own position and that of his bill….he has never found a way to put a human face on the changes….became too caught up in “NHS speak.”

One day…… 😕

Sat between two consultants at dinner last night. Pro reform (desperately needed), but unsurprisingly not keen on these botched reforms despite promising starting point. Recognised conflict of interest but managed better than colleagues – NHS and private kept completely separate – but lamented the fact that all standards could not be bought up to the private ones. But still justified the status quo with, “how else can I send three kids to private school.” !!!! Hmmmm….

Totally agree TJ that, the “shouty middle classes get their choice at the expense of those who cannot shout for themselves.” Exactly why the status quo should not be supported.

No teamhurtmore.
Your still starting from the wrong premises. Yo do not agree with me – thats 180 degrees from my position.
However its pointless attempting to explain it to yo as yo are so wedded to your far right view that you simply will not listen.

1) reform is not need bar removing the idiocies created by the last set of changes. See kingsfund research etc
2)Private healthcare is worse in terms of cost and outcomes
3)the spurious choice agenda is wrong because it ioncreases inequalities
4)This bill did not have a

promising starting point

unless you want a US style health care system – it is intended to prepare for privatisation. do not be fooled – the whole proposed structure is to do this as laid down by the tories while in opposition. its following that blueprint.

TJ- you are 100% correct that I do not agree with you that the NHS does not need reforming as are the consultants I shared dinner with, but not correct that my premise is wrong or that it is a far right position (although I know you love to claim that!). For sure central planning by design is not consumer-oriented (in this case the patient, poor thing!) but that doesn’t mean that a different solution has to be a FAR RIGHT one.

Agree with the idiocies of last (and more) recent changes and that the status quo that delivers (2) and (3) is not desirable. And yes, agreed with the consultants that the US model is not the one we want for the UK.

I am prepared to listen (if not agree with you) but having also spoken to many doctors on the issue (albeit different specialities to yours) I reserve the right to have a different viewpoint!!

Still struggle with your defence of the status quo when it currently delivers some of the outcomes that you abhor?

as are the consultants I shared dinner with

There you go again…….you just can’t help yourself can you teamhurtmore ?

Still never mind, I’m sure some people will be impressed by your ‘added-value’ opinions. Do you think TJ will be ?

Can’t help it if I have the chance to ask other medical professionals can I? Always good to have different opinions to complement TJ’s. But we have traded views before 😉 on making the most of opportunities that face you. And I certainly leant a lot from them. Would have been a waste to merely talk about the weather.

No.

Not in the slightest.

For sure central planning by design is not consumer-oriented (in this case the patient, poor thing!) but that doesn’t mean that a different solution has to be a FAR RIGHT one.

As I have explained to you – you cannot have meaningful patient choice in healthcare. If you want lay input it has to be thru the democratic process and in setting priorities adn processes

TJ

so how is the person living with dementia supposed to make a choice?
How is the person with learning difficulties suppose to make a choice?
How is the person with severe mental health issues supposed to make a choice?

The whole idea of “choice” in this sort of area is a far right idea. It means giving power to the powerful and taking choice away from the powerless. it is a meaningless bit of sloganeering from the right

What people chose is tohave the best possible service in their local hospitals.

Still struggle with your defence of the status quo when it currently delivers some of the outcomes that you abhor?

WTF are you on about? I said we need to get rid of the nonsense of foundation hospitals and the like from the last round of reforms. what the NHS needs more than anything is a period of stability

the reforms proposed make all the faults I see in the NHS far worse for no gain at all. Its all about privatisation. thats all it is.

Agree (mostly) with the first line of the final sentance and have stated that before.

But focusing businesses around the consumer if not Far Right, it’s merely basic business sense. That’s what frustrates me about the NHS and that is not a political thing, merely comes from experience as an end-user.

Inequality on provision of health care predates foundation hospitals surely?

ITS NOT A BUSINESS, THERE IS NO CONSUMER! this is the bit you seem unable to understand.

Its a service and there are service users who are at the centre of things and rightly so

again I ask you

so how is the person living with dementia supposed to make a choice?
How is the person with learning difficulties suppose to make a choice?
How is the person with severe mental health issues supposed to make a choice?

focusing businesses around the consumer if not Far Right it’s merely basic business sense

Talking about universal healthcare provisions as a “business” is very much an extreme right-wing thing.

TJ – happy to disagree on consumer point, asked that specifically to the doctors (sorry ernie) and they agreed. I think the distinction between service users and consumers is not a clear as you suggest.

But (from here) perfectly happy for you to win the argument on STW.

Sure ernie -if you say so. Obviously should have just said common sense, if business is such a provocative word 😉