The main NHS news story today is that Health Secretary Andrew Lansley is due to announce a 60-point review of NHS performance. Lansley is expected to announce that surveys will concentrate on patients’ experience. The reviews are getting spun as imposing tough new targets on the NHS demanding improvements. It raises two issues.
Firstly, it appears very much like a top-down organisation of the NHS and is inconsistent with Lansley’s acknowledged aim to distance himself and the government from responsibility for providing and overseeing the NHS.
Secondly, following yesterday’s big news item concerning allowing private companies access to patient databases and access to drugs before they are licensed it suggests that the Con-Dem Coalition are attempting to dominate the NHS news agenda.
Pulse reports that even supportive GPs are leaving CCGs (Clinical Commissioning Groups) because of the roles’ excessive demands.
How cuts will make Britain more unfair | The wrong cure | False Economy
How cuts will make Britain more unfair
The government says that its cuts programme is not just unavoidable, but also fair and progressive. Is this true?
You can argue about the meaning of fair, but progressive has a definition. If what the government is doing is progressive it would take from the rich and give to the poor (or at least hit them much less than the rich).
Independent experts say the cuts are not progressive.
Let’s first look at the changes in tax and benefits, and then at the impact of cuts in services.
Tax and benefits
Whether changes in tax and benefits are progressive is relatively easy to measure as these are flows of cash.
The Institute of Fiscal Studies is well respected as an independent analyst. It says that the government’s claim that the tax and benefit changes in the budget and spending review are progressive is wrong.
This graph is from their analysis of George Osborne’s first budget:
It shows the biggest losers are the poorest 10 per cent of families with children.
The IFS also had this to say about October’s spending review:
Our analysis (of the budget) shows that … the impact of all tax and benefit measures yet to come reduces the incomes of lower income households by more than that of higher income households, with the notable exception of the richest 2% of the population who are the hardest hit. Therefore the tax and benefit changes are regressive rather than progressive across most of the income distribution. And when we add in the new measures announced yesterday this finding is, unsurprisingly, reinforced. So our analysis continues to show that, with the notable exception of the richest 2%, the tax and benefit components of the fiscal consolidation are, overall, being implemented in a regressive way.
This is the IFS analysis of all government policies on tax and benefit by 2015. The poorest lose the most. It is only the impact of the previous government’s tax increases for the wealthy that make the top ten per cent bigger losers than some of those who are poorer.
Spending cuts
Working out the impact of the cuts in spending on services is harder. Some parts of public spending benefit all of us – such as many environmental protection measures.
But other parts of public spending do benefit some people more than others. To give a simple example the richer you are, the less likely that you use the bus.
Researchers for the TUC trawled official statistics to gather information about how different income groups benefit from public spending. With these figures, and by assuming that everyone benefits equally from spending like environmental protection and defence, they were able to work out whether the cuts were progressive.
This chart shows the value of the services lost as a proportion of household income.
Again the impact of the cuts is much harder on the poor and those in the middle than it is on the rich. The poorest ten per cent suffer 15 times more than the richest.
The impact on women
The Womens’ Budget Group is a group of independent experts who have been working with the Treasury to analyse the effect of economic policies on women.
This is what they said about the impact of the Spending Review:
- Lone parents and single pensioners – most of whom are women – will suffer the greatest reduction in their living standards to public service cuts. Lone parents will lose services worth 18.5% and female singles pensioners services worth 12% of their incomes.
- Overall single women will lose services worth 60% more than single men as proportions of their incomes, and nearly three times the amount lost by couples.
- The cuts will lead to hundreds of thousands of women losing their job. 53% of the jobs in the public sector services that have not been protected from the cuts are held by women. The pay and conditions of all public sectors workers, 65% of whom are women, are likely to deteriorate.
- Cuts in welfare spending fall disproportionately on women’s finances. Child benefit is paid almost 100% to women; while 53% of housing benefit claimants are single women. Both benefits have been cut significantly in real terms and eligibility has been tightened.
- 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.
BBC News – New NHS goals are to centre on patients’ experiences
Patient surveys are to be at the centre of new goals to measure the quality of care received in the NHS in England.
Speaking at a London hospital, Health Secretary Andrew Lansley will call for focus on what matters most to patients.
The latest NHS “Outcomes Framework” stresses surveys of patients, including children, and bereaved relations.
In an interview with The Daily Telegraph, Mr Lansley said patients would be asked: “Was the service and experience you had good or not?”
Of bereaved relatives he said: “We’ll be… asking them, after a suitable passage of time, what was their loved one’s experience of care and how well were they looked after towards the end of life.”
He added: “[We will] ask children about their experience. So five to 16-year-olds would be part of this survey, with their parents, so for the first time we’ll be measuring as part of the outcomes, the children’s experience of their care.”
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NHS hospitals are to be measured against 60 new benchmark targets with the aim of saving more than 20,000 lives a year.
Health Secretary Andrew Lansley has said doctors and hospitals will be judged on the quality of care patients receive, rather than the speed they are treated at, in an attempt to restore faith in the system.
The NHS outcomes framework includes a focus on improving cancer survival and a zero-tolerance approach to hospital-acquired infections such as MRSA and Clostridium difficile.
…[yawn]
Tough new goals for NHS – UK – ITN.co.uk
Health Secretary Andrew Lansley will impose tough new targets on the health service on Wednesday, telling hospitals they must improve patient outcomes.
The Government is producing a 60-step plan called the NHS Outcomes Framework which will focus on improving cancer survival rates and ridding the health service of hospital-acquired infections such as MRSA and Clostridium difficile.
The plan is also designed to improve services for women and families, ensuring better maternity facilities and increasing the number of people who can access an NHS dentist.
… [yawn]
Announced by Lansley to the Torygraph: Health reforms: sixty-step plan to restore faith in the NHS – Telegraph
GPs quit CCG roles as commissioning enthusiasts lose heart – Pulse
Exclusive GP commissioning leaders are quitting the boards of clinical commissioning groups amid concerns that even enthusiasts for the NHS reforms are being ground down by excessive workload and frustration at bureaucracy.
A Pulse investigation covering 50 PCTs found 15 CCG board members have stepped down since April. Among those who resigned from board roles were CCG chairs and commissioning enthusiasts who found it impossible to juggle commissioning with their clinical work.
Board members have stepped down in Fareham and Gosport, Southampton, Wiltshire, Coventry and Warwickshire and Dorset.
Dr Patrick Craig-McFeely, a GP in Salisbury, resigned as chair of Sarum NHS Alliance commissioning group and stepped down from the CCG board last month. Dr Craig-McFeely, who was previously heavily involved in practice-based commissioning, said the experience had had a major impact on his professional and personal life.
‘It was taking over my family life and hitting the care I felt I could provide to my patients. It seemed to be getting ever worse,’ Dr Craig-McFeely said.
‘When commissioning was announced it sounded like GPs would be able to do what they thought was right. But it has shifted to us being accountable here and accountable there and a whole lot of management speak. You never seem to be making any progress.’
The time pressures on CCG chairs have also led to one of the country’s most prominent advocates of GP commissioning standing down. Dr Johnny Marshall, chair of the National Association of Primary Care, quit as chair of the United Commissioning LLP, soon to become a CCG in Buckinghamshire, after he found it impossible to devote enough time to the role alongside his other commitments.
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