‘The official analysis from the House of Commons Library – which is independent of political parties – shows that in real terms, when inflation is taken into account, NHS spending fell by £800m in 2010-11.
The Prime Minister, whose party manifesto at the last election pledged to “increase health spending every year”, has gone out of his way to say the coalition government would protect frontline health cash.
In June Mr Cameron launched five NHS “guarantees you can hold me to and that I will be personally accountable for” – including “not to cut spending on the NHS, but to increase it”.
Yet Labour has claimed that the Treasury’s own figures reveal a cut in real terms in NHS spending from £102.8bn in 2009-10 to £102bn. Mr Cameron and the Health Secretary, Andrew Lansley, reject the claims, based on the Treasury’s July 2011 Public Expenditure Statistical Analyses (PESA).
The shadow Health Secretary, Andy Burnham, asked the Commons library to analyse the data and received the following information: “NHS total expenditure [fell] from £102.8bn in 2009-10 to £102.0bn in 2010-11 (in 2010-11 prices, rounded to nearest £0.1bn) – a real terms fall of 0.7 per cent.”
Mr Burnham said that another ministerial claim – that the PESA figures had not been adjusted according to the GDP deflator – rang hollow since the Treasury document made clear they were adjusted.
Mr Burnham has called on Simon Burns, the health services minister, to correct a statement to the Commons last week in which he said: “We gave a commitment in our election manifesto to provide a real-terms increase in funding in every year of the Parliament while we are in government – the lifetime of this Parliament. We have honoured that, and we will continue to do so in subsequent years.”
Mr Burnham told The Independent on Sunday: “It is official: David Cameron cut the NHS budget in his first year as Prime Minister despite promising he wouldn’t.
“He has inflicted the first real-terms cut in NHS spending for 14 years – the last being in the final year of the Major government.
“David Cameron stands at the dispatch box week after week claiming to have increased NHS spending. His hollow rhetoric will grate with NHS staff facing the reality of redundancies and patients who are being told they must wait longer for treatment. He is hopelessly out of touch.
“Cameron ruthlessly used the NHS to detoxify the Tory brand. But, one by one, he is breaking all the promises he made. He promised no top-down reorganisation, but launched the biggest since 1948.
“He promised a moratorium on hospital changes but is closing A&E and maternity departments up and down the land. He promised not to cut the NHS, but has done just that in his first year in office.”‘
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Andrew Lansley’s choice of Commissioning Board Chairman Malcolm Grant says of NHS reforms “… this is all going to be very messy.” Camden New Journal reports on a transcript of his interview before a cross-party panel of MPs. Highlights include “… I am not a patient of the NHS.” and “Can I say that this is all going to be very messy?”.
Andy Burnham, shadow health secretary calls for the Health and Social Care / Destroy the NHS Bill to be abandoned.
Campaign group 38Degrees reports on its meeting with peers.
NHS cuts in Hull
Protest at ‘worst funded’ GP practice
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
“I am not an NHS patient”, says new Commissioning Board Chairman Malcolm Grant
AS job interviews go, it was a merciless grilling.
When Professor Malcolm Grant, vying for one of the most important jobs in the health service, was asked to summon his “passion” for the NHS before a Parliamentary select committee, the University College London provost admitted it wasn’t the easiest of tasks.
A transcript, seen by the New Journal, reveals him pleading to the committee of MPs: “Come on, what do you want me to say?” He added: “I find it difficult to demonstrate because I am not a patient of the NHS.”
The lawyer had been nominated for the role of chairman of the NHS Commissioning Board – an independent body overseeing more than £100billion of NHS funding – by Conservative health secretary Andrew Lansley.
But after a lengthy interview for the £1,300-a-day post last Tuesday, the cross-party panel of seven MPs were not so impressed.
In conclusion, they said the panel did “not endorse Professor Grant’s candidacy”, adding that he had “demonstrated a lack of experience of NHS structures and processes”; “did not demonstrate to the committee a robust understanding of the issues”; received help in preparing his application by the Department of Health; and “demonstrated an assumption that his appointment was already confirmed”.
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Andy Burnham, shadow health secretary, today held an Opposition Day debate on the NHS, again urging Andrew Lansley to halt his controversial Health and Social Care Bill.
Introduced to the House of Commons in April 2011, the healthcare reform bill has generated significant opposition from all sides, including a unanimous vote calling for its revision by NHS nurses.
The motion in the name of Andy Burnham called on the Government to drop the Health and Social Care Bill, which is currently under consideration in the House of Lords and “accept the offer of cross-party talks on reforming NHS commissioning”.
The Bill passed to the House of Lords on 11th October, renewing calls from public sector unions to halt its passage.
“Peers must see through Lansley’s lies and vote against the Health Bill,” said Unison general secretary, Dave Prentis. “Just recently 400 health experts warned them to oppose it, joining a growing number of campaign groups, charities, patient groups, health unions and royal colleges.
Opposition to the reform proposals stems chiefly from the introduction of a competitive element from the private sector. Patient’s needs will be put before profit, argue the unions, whilst public funds will emerge as private profit.
Proponents simply argue that competition will reduce waste, and that there is no evidence that profits translate to reduced care.
I attended the meeting along with three lawyers – Stephen Cragg, our barrister, Alice Goodenough, our solicitor, and Peter Roderick, a public interest lawyer who runs the website dutytoprovide.net
Baroness Jolly set out some criticisms of our approach, which echoed comments made in the Guardian by Lord Paul Tyler, another Lib Dem Lord who voted with the government last week.Thankfully, given how badly the tone of Lord Tyler’s remarks had gone down with 38 Degrees members, Baroness Jolly was more polite and the words “crass” and “mob” did not feature! As lots of 38 Degrees members pointed out after that article appeared, it’s always woth engaging with criticisms like these and considering how we can campaign together most effectively. But it’s also true that if we’re being effective we should expect to be ruffling some feathers amongst politicians.
A ward is to close and two others will merge at Hull Royal Infirmary as an NHS trust tries to save £21m this year.
Hull and East Yorkshire Hospitals NHS Trust, which has to make £95m budget savings over the next five years, says 46 beds in total will go.
A general medical ward will close and two others, neurology and stroke, will merge at the hospital.
The trust says there are no plans for redundancies, with all staff to be redeployed.
A final decision is expected at a board meeting in December.
Earlier this year it emerged that the hospital was planning to close 300 beds over five to 10 years, an announcement which caused unions serious concern, as they amount to 20 per cent of capacity.
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Hundreds of patients turned out to demonstrate in support of a single-handed GP who claims his practice is the worst funded in the country.
Dr John Cormack has run the Greenwood practice in Chelmsford, Essex for 30 years and says that the PCT are refusing to fund the practice fairly.
Dr Cormack told Pulse: ‘We believe, on the basis of pretty good evidence, that this is the worst funded practice in the entire NHS.’
‘It goes without saying that this puts a question mark over the future of the surgery – at present, having exceeded our £25,000 overdraft we have had to ask the bank to increase it to £30,000 … and far from being able to draw a salary last month and the month before I’ve had to pay in a four figure sum in order that we stay solvent and the staff are paid.’
As a result Dr Cormack organized a demonstration of support where about 300 patients turned out.
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Andrew Lansley to face a creative protest in York.
NHS cuts, NHS cuts, NHS cuts.
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Health Secretary Andrew Lansley to face protest from York Stop The Cuts group
HEALTH Secretary Andrew Lansley will visit York this weekend to speak at a Conservative Party fundraiser – but he is set to face strong protests over his proposed NHS reforms.
Mr Lansley is due to be the guest speaker at a black-tie dinner organised by the York Conservatives organisation at the Merchant Adventurer’s Hall on Saturday night.
But campaigners from the York Stop The Cuts group plan to don tuxedos, ballgowns and masks and cut up a giant papier-maché pie outside the venue to voice their anger at what they claim is a threat to “slice up the NHS”.
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Mental health services say they are operating at “full stretch” to balance rising numbers of service users and substantial funding cuts.
Senior figures at Sussex Partnership NHS Foundation Trust say they are being “challenged like never before” with some services seeing a 44% increase in people needing help over the last three years.
The rising number of people turning to the trust, which now sees more than 100,000 people every year, has been blamed on the pressures of increasingly difficult economic times.
The increase comes as the trust has to make major financial savings of more than £14 million in the current financial year.
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PATIENT safety fears have been raised over plans to shave £78million from the NHS in north Essex in three-and-a-half years.
Stephen Beresky, non-executive director for primary care trust NHS North East Essex, said he believed services were already “creaking” from the cost-saving measures.
At a board of directors meeting in Braintree recently, he questioned plans which will see £27.7million cut from the PCT’s budget and £51million from the amount it pays to providers such as the ambulance service, hospital and mental health care by 2015.
Mr Beresky, of Stanway, who runs a consultancy business, said: “The biggest cost in most organisations is staffing.
“The quickest way to have an impact on reducing budgets is staff.
“I want to make sure the the consequences of the decisions which are being taken are understood because, anecdotally, and a little less than anecdotally, they are creaking.”
The trust has not yet revealed how many jobs will be shed however it plans to slash staff pay by £4million between now and 2015.
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Fears continue over A&E services at St Helier Hospital
Fears continue about the future of A&E services in Sutton after NHS London bosses refused to give assurances over the future of St Helier hospital.
Following a presentation to councillors last week, Andrew Woodhead, head of mergers and acquisitions at NHS London, said the transition board was “working on an assumption that services would remain”, but would not guarantee that St Helier hospital could continue to provide A&E and maternity services in the future.
He said the proposed merger of St Helier and St George’s in Tooting was an organisational matter, which would allow the hospital to achieve Foundation Trust status.
But he said the future of services was being dealt with by a separate review of healthcare in south west London called Better Services Better Value.
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The big NHS news today is further example of Liberal-Democrat spin that they opposed the Destroy the NHS Bill. Let’s get this clear: The NHS is getting destroyed by Conservatives and Conservative Liberal-Democrats acting in unison.
Lib-Dem peers have published a letter in the Guardian proclaiming that “The time for declaratory statements is past.” I had to find a definition for declaratory statements. It is unnecessarily complex and is inteded to exclude most people from understanding it but I think that it’s about explaining the law and stating the rights of parties. Liberal-Democrat hypocrisy is exposed by the letter also stating “Any politician who plays party political games with the NHS would be open to justified public criticism.” There you go then: justified public criticism.
The letter comes after Health Secretary Andrew Lansley signalled that he would accept an ammendment regarding ultimite responsibility for providing a health service. The ammendment appears to be a dimunition from responsibilty for providing a comprehensive health service to “retains ultimate responsibility” for NHS services. While I find this also a little complex it does seem to continue Con-Dem government’s attempts to evade responsibility for proving a health service but I’m waiting for commentary from others.
The Labour Party claims that Prime Minister David Cameron has broken three promises on the NHS: to end top-down reorganisations, to increase NHS funding in real terms and to stop hospital reconfigurations.
The British Medical Association repeats it’s call for the bill to be abandoned and states 11 changes it wants made.
The TUC highlights the government’s “credibity deficit”.
Campaign group Stroud Against the Cuts is continuing legal action against NHS Gloucestershire’s plans to transfer local health services to a community interest company.
trying to see what Gerada has to say about bloggers …
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
The time for declaratory statements is past. Patients who care passionately about the NHS, and staff who want to give the best possible service, need certainty about the future of the health service (The battle is far from over, 25 October). Any politician who plays party political games with the NHS would be open to justified public criticism. So it is now imperative that members of the House of Lords get on with their job of subjecting this bill to detailed, rigorous scrutiny.
In order to safeguard the NHS, free at the point of need and accessible to all, Liberal Democrat peers are putting forward amendments which require the secretary of state to remain responsible for health services being provided across England. In coming weeks we will seek to ensure that the NHS continues to develop cutting-edge research and that any income from private patients is used solely for the benefit of NHS patients. We will carry on scrutinising this bill so that the NHS can continue to deliver world-class care for patients.
Shirley Williams
Jonathan Marks QC
Paddy Ashdown
Liz Barker
Phil Willis
Floella Benjamin
Judith Jolly
John Shipley
John Alderdice
Navnit Dholakia
Monroe Palmer
Paul Strasburger
Diana Maddock
Chris Rennard
John Sharkey
Jenny Randerson
Ros Scott
Tim Clement-Jones
Dick Newby
Mike German
David Steel
Kishwer Falkner
Bill Bradshaw
Roger Roberts
Brian Cotter
Bill Rodgers
Anthony Lester
Sal Brinton
Paul Tyler
Mike Storey
Joan Walmsley
Trevor Smith
Shadow health secretary Andy Burnham has accused prime minister David Cameron of betraying the NHS ahead of a House of Commons debate on the Health Bill on Wednesday.
Labour said it was taking its fight against the Bill directly to the prime minister for ‘writing cheques in opposition that he couldn’t cash in government’.
In a debate in the House of Commons on Wednesday, shadow health secretary Andy Burnham will accuse the prime minister of breaking three personal pledges on the NHS.
He is expected to criticise David Cameron for performing a U-turn on his pre-election promise to end top-down reorganisation in the NHS. He will also say the government’s pledge to increase NHS funding in real terms has not been met, and that the government has broken a pledge to enforce a moratorium on hospital reconfiguration.
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The British Medical Association publishes the changes it would like to see made to the Health and Social Care Bill, as the legislation reaches the Lord’s committee stage
The British Medical Association (BMA) has called for further changes it would like to see made to the Health and Social Care Bill as the bill enters the committee stage in the House of Lords this week.
The BMA outlines 11 areas of significant concern it has with the current draft of the legislation, as well as a call for the “mitigation of damage” to the NHS which it believes the bill will cause.
Included in these recommendations is an amendment making it explicit that increasing patient choice will not be given greater priority than ensuring fair access for all, a call for the secretary of state to retain ultimately responsible for the provision of comprehensive health services and a reduction of the overly restrictive powers granted to CCGs.
The BMA also expressed a wish for the government to be clearer concerning the role and the future role of the CCGs, and that the secretary of state should have a duty to ensure there is an effective system for delivering medical education and training.
Dr Hamish Meldrum, chair of the BMA Council, commented on the publication, stating: “The BMA’s preferred option is for the Health and Social Care Bill to be withdrawn – However, during this stage of the parliamentary process, there is scope for further significant change to be made.”
He added: “We have today set out the areas where we believe there still need to be amendments. We hope the Lords will agree with us and change the proposed legislation, limiting the damage this Bill could do to the NHS.”
The gap between rhetoric and reality of the government’s public service reforms is growing, as privatisation and workforce opposition to the changes increase, according to a paper published by the Trades Union Congress (TUC).
In response to the government’s Open Public Services white paper, the TUC said a market-led approach to reform was increasing the private sector takeover of public services and public sector workers were turning against the measures:
The TUC pointed out that while health ministers were promoting social enterprise in the UK, NHS Surrey awarded the contract for its community health care services to private provider Assura Medical (75 per cent owned by the Virgin Group) rather than the government’s social enterprise champions Central Surrey Health.
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Gloucestershire’s primary care trust has paused plans to transfer local health services to a community interest company pending a hearing
NHS Gloucestershire has put on hold its plans to transfer community health services and a £100m budget from the local health service to Gloucestershire Care Services, a company spun out of the local primary care trust.
Jan Stubbings, the trust’s chief executive, said she had agreed not to sign the contracts needed to effect the transfer before the outcome of a legal hearing.
“Concluding the arrangements for the transfer is in the interests of patients and staff and will ensure service continuity and stability,” said Stubbings. “Timely resolution of outstanding legal matters is also in the interests of the taxpayer and public funds.”
Campaign group Stroud Against the Cuts said the pause followed a judicial determination that trust should not finalise its proposed transfer of more than 3,000 NHS health staff and a variety of health services out of the NHS, after a legal case presented by its solicitors.
The group has claimed that the proposed transfer would be highly damaging to NHS services in Gloucestershire. James Beecher, a co-ordinator of Stroud Against the Cuts, said that if the challenge is successful it will force managers to consider options which have been successfully implemented elsewhere in the country and would keep services and staff within the NHS.
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A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
The Lords may yet succeed in rewriting the health and social care bill, but they must truly understand the stakes
Critics of the controversial health and social care bill were taken aback by the partisanship of peers when debate moved to the House of Lords two weeks ago. Amendments by Lord Rea to reject the bill altogether, and by Lords Owen and Hennessy to send parts to a select committee for more forensic scrutiny were defeated after energetic whipping by party bosses.
But all is not what it seems. For many peers it was not pro-competition sentiment that caused them to oppose the amendments but the so-called Salisbury convention, according to which the Lords does not throw out legislative measures trailed in manifestos.
Nor is the battle over by any means. Many peers are determined to rewrite the bill, and the list of amendments for debate on the floor of the house is building daily. More than 350 amendments have been tabled, and more are expected during the debate. The royal medical colleges, professional bodies and the general public have registered their concerns about competition, loss of professional autonomy, conflicts of interest and rank commercialism. The amendments include proposals to delete or alter clause 1 of the bill – which abolishes ministerial responsibility for the health service – and to ensure principles of comprehensive care are written into the legislation.
Professor Malcolm Grant’s evidence to the commons health committee last week adds fuel to the fire. Health secretary Andrew Lansley’s nominee for chairman of the NHS commissioning board, which will run the marketised system, revealed the extent of the legislative chaos when he said that the bill was “completely unintelligible” and with the £20bn efficiency target a “double hammer” for the NHS.
The scale of criticism underlines the constitutional and epochal character that the debate has assumed. Few by now are in any doubt that the England’s social contract is potentially redrawn by measures that shred a public institution designed for universal healthcare.
However, the response brings difficulties of its own – peers have been inundated with advice from thousands of correspondents. Finding a clear line through a bill of such length and complexity that has been amended by the government right up to the last minute was always going to be a huge challenge. But without that clarity, opposition forces will be disorganised and voting patterns a lottery.
The solution to the overload is for peers to work out a clearer understanding of what’s at stake. Put simply, the legal effect of the bill is to abolish the statutory basis of a national health service by repealing duties to provide a comprehensive and universal service. The change is effected by creating clinical commissioning groups (CCGs) with an obligation to cover fewer services and responsibility for fewer patients and residents than primary care trusts (PCTs). Whereas PCTs act on behalf of the secretary of state, CCGs will exercise functions in place of him or her but without a clear primary legislative framework. The bottom line is that commissioners and providers in the new market will have freedom to select patients and services on financial grounds and to redefine eligibility for NHS care and in so doing introduce charges for care.
The blurring of boundaries and responsibilities for funding and provision will make it almost impossible for parliament to hold health bodies accountable for the various elements of their expenditure or for the secretary of state to carry out his or her duty to promote a comprehensive health service throughout England.
The key features of the bill are therefore the move from comprehensive, universal, geographical duties and the assignment of extraordinary discretion to CCGs and the NHS commissioning board. These elements are laid down largely in part one of the bill. It is vital that amendments focus in the first instance on clause 1, which deals with the existing duties of the secretary of state, and clause 10, which sets out the new powers of CCGs.
Reports of drastic cuts to NHS frontline services lie behind the extreme urgency with which the government is pushing its changes. Cuts on the scale envisaged are only possible if the duties laid on government by parliament are abolished. So it is the bill or the NHS; the people will rely on the crossbenchers to decide their fate.
• David Price, a senior research fellow at Edinburgh University, contributed to this article
Kingston Hospital could be hit with more swinging cuts as the NHS faces another £6.5m reduction in spending across its services.
The savings outlined for 2012-13 are on top of this year’s £6m target and form part of a national Quality, Innovation, Productivity and Prevention (QIPP) efficiency programme.
Draft plans show £3.3m of the potential identified savings will come from acute care at hospitals.
Another £650,000 will come from mental health, including the reprovision of rehabilitation units from Rose Lodge in New Malden and Fuschia ward in Tolworth Hospital.
Some of the money will be saved from reducing the number of people with minor injuries going to accident and emergency (A&E) and spending less on expensive drugs, although those figures have not been decided yet.
A spokesman for NHS Kingston said: “We will work closely with partners to minimise the effect on front-line services.
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Seriously ill and injured patients at New Cross Hospital are waiting too long to be seen in accident and emergency – with the situation worsening in recent weeks, a new report reveals.
The latest figures revealed at a meeting of the hospital’s trust board today show the majority of such patients waited up to 52 minutes for an initial assessment by a nurse in September.
This is almost 10 minutes longer than in August, when the majority waited up to 43 minutes.
NHS targets state such patients should be seen in under 15 minutes to reduce risks.
An initial assessment determines the priority patients are given.
The delays are on top of the time it takes doctors to treat or admit a patient to the hospital.
During September the average wait for treatment or admission was one hour and 12 minutes.
This means an average wait of more than two hours.
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A leaked memo reveals that the Health Secretary will not remain responsible for the NHS despite repeated ConDem assurances that he would. You can’t trust the Tories – or the Lib-Dem Tories – with the NHS.
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Malcolm Grant, the government’s choice to run the powerful NHS commissioning board, makes remarkable admission
The health secretary will “franchise” the running of the NHS to a quango for up to three years at a time – a move that will result in an unelected academic and the nation’s 38,000 family doctors, rather than ministers, being accountable for the day-to-day running of the health service, according to leaked documents obtained by the Guardian.
In unpublished evidence to the health select committee last week, Malcolm Grant, the government’s choice to run the powerful NHS commissioning board, outlined “an extraordinary transformation of responsibility” that appears to undermine claims by ministers that the proposed legislation will not dilute the government’s constitutional responsibilities to the health service.
At present, the cabinet minister for health has a “duty to provide a national health service” in England, but that disappears in the NHS bill’s proposals.
Grant, a law professor who runs University College London, told MPs that, under the new system, the secretary of state “mandates” the commissioning board to run the NHS every “two … possibly three years” and then retreats into the shadows. The board will hand over taxpayers’ cash to groups of GPs to buy services on behalf of patients.
He admitted there would be “a fundamental change of responsibility and accountability under the bill” because about £80bn of public money would be transferred to the board and GPs. He said these two groups – not politicians – would run the NHS and ensure patients received an adequate level of health provision in England.
“If [GPs] are dissatisfied with what happens in a hospital, they need to deal with it and not simply complain to a secretary of state who no longer has this responsibility, nor to the commissioning board which has given them the responsibility, but to complain to the hospital and get it sorted, and, if it is not sorted, to use their commissioning power to ensure that it is.”
With peers beginning line-by-line scrutiny of the coalition’s NHS bill on Tuesday, the government has been attempting to rebut detractors of all political persuasions influenced by the powerful Lords constitutional committee.
The committee warned last month about the “extent to which the chain of constitutional responsibility as regard to the NHS [will be] severed”. In what is perceived as a sign of panic over the level of peers’ opposition, a 72-page letter from ministers sent to all peers last week conceded a “necessary amendment” might be needed to rectify the impression the government would not be “responsible and accountable” for the NHS.
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UNISON, the largest health union, said today that its worst fears for accountability in the NHS were being realised. Leaked documents have today revealed that the Secretary of State for Health would lose accountability for the health service, under plans set out in the Health and Social Care Bill.
Christina McAnea, UNISON Head of Health, said:
“Here are our worst fears for NHS accountability realised. We have long been warning that the Bill would mean the Secretary of State for Health would lose accountability for the health service – and here is the proof. This is just another reason why the Bill represents the end of the NHS as we know it.
“But all is not lost – line by line scrutiny in the Lords begins tomorrow. If peers vote to amend Clauses 1 and 4 of the Health Bill, it could keep the Secretary of State ultimately responsible for the health service. We are calling on them to do so.”
RELATIONSHIPS between family doctors and their patients could be damaged by the Government’s controversial NHS reforms, according to new research published today.
The findings are revealed in a study published by the British Medical Association (BMA), which is described by the association as being the “most significant survey of GP opinion in recent years”.
Every family doctor in the UK was approached to take part in the research and around 40 per cent – 18,757 out of a possible 46,700 GPs – responded.
The figures show that seven out of 10 GPs are concerned about conflicts of interest resulting from the NHS reforms, and the same number also say they are concerned about the impact the Health and Social Care Bill could have on the patient-doctor relationship.
Sixty-nine per cent of doctors, meanwhile, say they are worried about their proposed role as both the commissioners and providers of care.
Dr Laurence Buckman, chairman of the BMA’s GPs Committee, said: “The huge response rate shows how strongly GPs feel about the topics in question, particularly when it comes to the changes being made to the health service in England.
“GPs do not want the trust patients put in them to be damaged by these reforms, yet this is exactly what they fear will happen.
“The Government must take heed and further revise its plans for the quality premium in particular, to avoid any potential damage to the doctor-patient relationship.”
The BMA said the results of the study should “serve as a crucial measure of GP opinion for years to come.”
Some three quarters of GPs said they do not agree with the Government’s proposals to link practice income to the performance of their commissioning group, while 85 per cent do not believe that practice boundaries should be abolished.
Other findings show that 88 per cent of doctors say the “intensity of their consultations” has increased in the last five years, while 84 per cent say the “complexity of their consultations” has increased over the same period of time.
Dr Buckman added: “General practice has undergone huge change since the last time we carried out a survey of this size in 2007 – and this is shown clearly by the belief among the vast majority of GPs that the nature of their work has become more complex and intense.
“Much of the work we do now, such as looking after people with diabetes, used to be done in hospital and even though it’s work we want to do because of the clear benefit to patients, it has made it harder to fit a consultation into a ten-minute time slot and it can make it more difficult to deal with surges in demand.
“I’d like to thank all the GPs who filled in the survey as it has given us a great insight into the GP workforce.
“It will be invaluable in shaping our priorities in the months and years ahead.”
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I have been experiencing network problems. The pattern of denial suggests that it is deliberate and consistent with the agenda of Full Spectrum Dominance i.e. control of all electronic devices worldwide. Some disruption is possible.
Dr. Clare Gerada was featured in yesterday’s NHS news review discussing the Health and Social Care / Destroy the NHS Bill incentivising GPs to restrict treatment and the consequent pressures on the relationship between GPs and their patients. The RCGP Annual Conference at Liverpool is to discuss similar issues later today
The moral maze: the affordability of future health care
Chair: Dr Richard Horton, Editor, Lancet
Panel of speaker to be confirmed:
Baroness Julia Cumberlege
Dr Clare Gerada, Chair of Council, RCGP
Sir Michael Rawlins, Chairman, NICE
Ben Page, Chief Executive, Ipsos MORI
Dr Hamish Meldrum, Chairman of Council, BMA
Scottish Nationalist Party (SNP) accuses the ConDem coalition of destroying the NHS.
Conservative election poster 2010
A recent news article about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
Scotland’s health secretary will accuse the UK government of trying to break up the NHS, in her speech to the SNP conference.
Nicola Sturgeon will tell delegates in Inverness that health service reforms in England amount to an experiment in privatisation.
Scottish ministers say they will protect NHS spending.
Deputy SNP leader Ms Sturgeon will also pledge to stop pensioners languishing in hospital beds.
The UK government’s controversial Health and Social Care Bill aims to increase competition and give clinicians control of budgets.
It says the changes are vital to help the NHS cope with the demands of an ageing population, the costs of new drugs and treatments and the impact of lifestyle factors, such as obesity.
But the legislation has already been substantially altered, following criticism from NHS staff and Liberal Democrat MPs.
Ms Sturgeon, who is also Scotland’s deputy first minister, will tell day two of the conference: “It now seems inevitable that the Tories, aided and abetted by their Liberal partners, will break up the NHS in England.
“Let me make this clear, the NHS in Scotland will remain a public service, paid for by the public and accountable to the public.
“There will be no privatisation of the NHS in Scotland.”
The health secretary will say: “I say that not out of blind ideology, though I have always thought that the ideology of a health service in public hands and free at the point of need is a rather fine one, I say it because I have no doubt that our NHS can and will outperform the privatised experiment south of the border.”
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Dr. Clare Gerada, chair of the Royal College of GPs is in the news today. She warns that the Health and Social Care / Destroy the NHS Bill is damaging the relationship of trust between GPs and patients, warns of a two-tier health system run like a budget airline and suggests that GP practices should explore alternative models of organisation to GP partnerships.
NHS cuts
SMEs are concerned at the ConDem govenment’s destruction of the NHS and nasty changes to the welfare benefits system.
Private doctors treat healthier patients.
Medical students…
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
NHS bill will lead to situation where healthcare is like budget airline with limited seats, says chair of Royal College of GPs
The NHS shake-up risks wrecking GPs’ relationship with their patients by turning them into rationers of care who deny the sick the treatment they need, warns the chair of the Royal College of GPs.
Family doctors could be “compromised” by having to decide between providing sick patients with the best possible treatment or meeting financial targets, according to Dr Clare Gerada.
Giving GPs control of health budgets, the cornerstone of health secretary Andrew Lansley’s restructuring of the NHS in England, could diminish the trust between patients and family doctors, she will tell the college’s annual conference.
“We must not risk long-term benefits being sacrificed in favour of short-term savings,” Gerada will tell the audience of 1,500 GPs in Liverpool. “How soon will it be, for example, before we stop referring for cochlear implant? An expensive intervention but one that in the long term saves enormous amounts of public money. But not a saving from our budget.
“How long will it be before we find ourselves injecting a patient’s knee joint – at Injections-R-us PLC – instead of referring to an orthopaedic surgeon for a knee replacement?”
In a detailed critique of Lansley’s health and social care bill, she will warn that: “As doctors we risk being compromised. We’ll have to choose between the best interests of our patients and those of the commissioning group’s purse. And, to make matters worse, we’ll also be rewarded for staying in budget – and not spending the money on restoring the child’s hearing. Now that’s what I call a perverse incentive.”
Her warning reflects widespread concern among doctors that exercising their financial responsibilities will lead some patients to believe they have been refused treatment on grounds of cost.
Lansley’s reforms also threaten to create a two-tier health service where the well-off can beat queues by paying for fast treatment as private patients in NHS hospitals, because of the proposed easing of the amount which foundation trust hospitals can earn from that source.
“I worry we’re heading towards a situation where healthcare will be like a budget airline. There will be two queues: one queue for those who can afford to pay, and another for those who can’t. Seats will be limited to those who muscle in first, and the rest will be left stranded on the tarmac.”
The British Medical Association, which represents hospital doctors as well as GPs, said it shared Gerada’s concerns.
“In general, we would agree with Clare Gerada’s comments about the impact of the health and social care bill. The BMA has concerns about the conflicts of interest inherent in the bill as well as the effects of the market on healthcare, and her comments fit with the views of most doctors,” said a spokeswoman for the BMA, which wants the bill withdrawn or substantially amended.
A Department of Health spokesperson said: “The NHS is not for sale and this government is committed to a real terms increase in funding for it. We want to give GPs the power and control to make the right decisions on behalf of their patients.
“Talk of budget airlines is nonsense pure and simple. In the new NHS, everyone will fly first class. Quality will improve as both patients and frontline staff are able to make choices.
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When I come home from work and my son asks me what sort of day I’ve had, on a good day I want to be able to say “I saved a life”, not “I met a budget”.
Of course, it’s important that GPs are mindful of resources. We have a responsibility to spend the public’s money carefully and wisely. That goes without saying.
But we must never lose sight of the patient as a person, at the heart of our practice. Patients are not “commodities” to be bought and sold in the health marketplace.
In this brave new cost-driven, competitive, managed-care world, I worry about the effect the language of marketing is having on our clinical relationships.
It’s changing the precious relationship between clinician and patient into a crudely costed financial procedure. Turning our patients into aliquots of costed tariffs and us into financial managers of care.
We are already embracing the language of the market when we talk about, for example, care pathways, case management, demand management, productivity, clinical and financial alignment, risk stratification.
We’re already accused of making “inappropriate referrals” whenever we put what’s best for our patients above what’s best for saving money.
We’re being forced to comply with referral protocols and so-called rules-based medicine, in an effort to control medical care before it’s delivered.
Referral management systems – already widespread – place a hidden stranger in the consulting room. A hidden stranger who interferes with decisions that should be made by GPs in partnership with their patients.
Insulting terms, like “frequent flyers”, are being used to describe people who are sick and need our care and attention.
The archbishop of Canterbury attacked what he described as “the quiet resurgence of the seductive language of the deserving and undeserving poor”. If we don’t watch out, the deserving and undeserving poor could soon be joined by the deserving and undeserving sick.
I worry we’re heading towards a situation where healthcare will be like a budget airline. There’ll be two queues: one queue for those who can afford to pay, and another for those who can’t. Seats will be limited to those who muscle in first. And the rest will be left stranded on the tarmac.
This can’t be right. After all, no one chooses to be sick. We must hold fast to the principle that good healthcare should be available to all, regardless of wealth.
GPs need to forget about the partnership model and look at new models of organising their practices, such as federations, says RCGP chair Dr Clare Gerada.
In a sometimes heated discussion over the lack of partnership opportunities for salaried GPs, Dr Gerada urged GPs to stop talking about the partner/salaried divide, saying that model belonged to the last century.
Delegates attending a ‘Partnership Debate’ at the RCGP annual conference backed a motion that the profession was doing new GPs ‘a disservice with a lack of partnership opportunities’, but RCGP leaders urged the profession to think more laterally about how the profession is organised.
Dr Gerada, a GP in Kennington whose practice employs around 100 salaried GPs, admitted the partnership debate was ‘complex’ but argued that a ‘new model’ of general practice was needed in the 21st Century.
She said: ‘I think we should stop talking about the salaried/partnership divide. I think we should start talking about federating – joining and collaborating across practices, sharing expertise and resources.’
‘While the partnership model may be the model for the 20th Century I think we need to move on and find a new model.’
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NIGHT time closure of Pontefract Hospital’s A&E department will start next month, it has been decided today (Thursday October 20).
At a public meeting of the Mid Yorkshire Hospitals NHS Trust all but one member of the board voted in favour of proposals which will see the unit shut from 10pm to 8am from November 1.
At the meeting at Pinderfields Hospital, Wakefield, the trust said the closure was due to staffing levels, adding if enough doctors at the right level could be recruited the opening hours would be reassessed.
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More than half of SME employers fear the cost impact of the government’s health and welfare reforms, according to Jelf Group.
As a result it called for the House of Lords to help prevent potentially severe consequences and examine the effects on business of the new regimes.
The employee benefits intermediary conducted a poll of 169 SME businesses at a recent seminar and found 55% worried about the reform’s implications.
It suggested the main reasons that employers were fearful of increased financial pressures came from government overhauls of the NHS and welfare systems.
“Anecdotal evidence of increased waiting lists on the NHS may mean key employees take longer to return to the workplace,” it said.
“In the current economic climate this could be catastrophic for marginally profitable employers and even worse for fledgling business yet to make a return.
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Patients seen in independent sector treatment centres (ISTCs) tend to be younger, in better health and from “far more affluent areas” than those seen by NHS hospitals, research suggests.
The research, published in the British Medical Journal, also shows patients undergoing surgery in ISTCs had “slightly better outcomes” than patients treated in NHS centres.
However, the researchers claim such differences are “minor” and “unlikely to be clinically significant”.
The researchers, led by Professor Jan van der Meulen at the London School of Hygiene and Tropical Medicine, claims the study proves ISTCs treat patients with a more “favourable mix case profile”.
Yet, they also claim the results of their research “lessons concerns that ISTCs are ‘cherry picking’ the healthiest patients.”
“Our findings support the idea that separating elective surgical care from emergency services could improve the quality of care,” said the researchers.
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The government’s preferred candidate to head the NHS Commissioning Board has described the Health and Social Care / Destroy the NHS Bill as “unintelligable” despite being coached by the Department of Health.
Increasing waiting lists.
Frenchay Hospital in North Bristol to be ‘part-privatised’.
Conservative election poster 2010
A few recent news articles about the UK’s Conservative and Liberal-Democrat (Conservative) coalition government – the ConDem’s – brutal attack on the National Health Service.
The new chairman of the NHS Commissioning Board (NCB) has been accused of lacking experience and understanding of the NHS and has described the Health Bill as ‘unintelligible’.
Members of the House of Commons health select committee were split along party lines over the appointment of Professor Malcolm Grant.
All three Labour committee members present at a hearing with Professor Grant voted against endorsing his candidacy for the role. But the two Conservative and one Liberal Democrat MPs present backed him, along with committee chairman Stephen Dorrell, also a Conservative.
An amendment backed by the Labour MPs warned that Professor Grant ‘demonstrated a lack of experience of NHS structures and processes’ and did not demonstrate a ‘robust understanding of the issues affecting the NHS’.
He had acknowledged being primed with answers by the DoH before facing the committee of MPs, was unclear about his role and about how the NCB would secure service changes locally, it said.
The amendment pointed out that he had referred to the Health Bill as ‘unintelligible’ and said that he had not convinced members of the committee that he would be ‘an effective counterbalance to executive members’ of the NCB.
The number of NHS patients waiting longer than a year to be treated in the Black Country and Staffordshire has jumped by almost 60 per cent, new figures revealed today.
The only hospital to cut the number of patients waiting longer than a year was Stafford Hospital, where the numbers fell from 45 down to 18.
Nationally, thousands of people are being left to wait for longer than a year because hospitals prioritise those patients they can treat within Government targets and, therefore, avoid health authority penalties.
The NHS should treat every patient within 18 weeks of them being referred by their GP.
If hospitals miss the targets they can be penalised but there is no incentive to treat those waiting beyond the target times.
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MENTAL health services will be slashed across Cambridgeshire in a bid to save £14 million, if proposals are given the go-ahead.
A 13-week public consultation has been launched as local health providers announced a host of proposed facility closures and mergers as part of a three-year cost-cutting measure.
The plans involve reducing eight inpatient wards to six, which will reduce the number of beds available from 28 to 16.
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Concerns over plans to ‘part-privatise’ Frenchay Hospital
CONCERNS have been raised over NHS plans to ‘part-privatise’ one of the region’s oldest hospitals.
Councillors in South Gloucestershire said they had been shocked at news the contract to run Frenchay Hospital would be outsourced to the private sector when it is downgraded to a health and social care unit.
Cllr Ian Scott (Labour, Filton), said: “This revelation came completely out of the blue.
“I don’t think anyone ever expected that the new community hospital at Frenchay would not stay entirely within the NHS.”
North Bristol Trust (NBT), which currently runs Frenchay, has announced that although doctors, therapists, staff operating diagnostic equipment and secretarial support will be NHS, the overall running of the community hospital will be operated privately when it opens in 2014. In addition, nurses in charge of 68 beds at a new rehabilitation centre will also be private. NBT chief executive Ruth Brunt said the move would make the project financially viable.
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