There is a great deal of NHS news today so I’ve tried to impose some order out of chaos™.
- There are many articles about the 63rd birthday of the NHS yesterday.
- Health Secretary Andrew Lansley was evasive while appearing before the Health Select Committee hearing yesterday. Lansley reveals that the bill does not address competition law which is left to be decided by the courts.
- Waiting times and cuts are to increase despite Prime Minister David Cameron’s commitments that they would not.
- Massive increase in NHS bureaucracy as a result of NHS reforms despite the claimed intention of the reforms to reduce bureaucracy.
- Conservative election poster 2010
A few recent news articles concerning the UK’s Conservative and Liberal-Democrat coalition government – the ConDem’s – brutal attack on the National Health Service.
NHS 63rd Birthday
Happy birthday NHS / Britain / Home – Morning Star
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TUC general secretary Brendan Barber said: “Despite some amendments to the controversial NHS reforms, many of the most damaging aspects of the Health and Social Care Bill remain. The changes presented to us by the government after its recent listening exercise amount to little more than smoke and mirrors.
“The government’s proposals go against the very principle of our NHS, in which care is based on need not ability to pay.
“They mean private providers will be able to increase their role in the NHS, simply cherry-picking the most lucrative parts for their own private profit to the detriment of the overwhelming majority of patients.”
Rehana Azam GMB National officer for NHS said “GMB wishes the NHS a happy 63rd birthday today.
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The Tory plan is to get the guts of the measures on the statute book and then by stealth break up the National Health Service.
The NHS was designed to be a cradle to the grave health and care service free at the point of use until the Tories in 1990 changed it to be a cradle to nursing home service. That is what people want and that is what politicians should respect and deliver.”
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Campaigners celebrate 63 years of NHS – Local news – Worksop Guardian
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Spokesperson for Bassetlaw Protecting our People and Services group Ann Donlan said: “Before the NHS they had to pay for medicine, pay for doctors and pay for treatment.”
“Since the NHS came in we have had first class service and an excellent hospital. We are here to remind people of its importance, we do not want to see it privatised again.”
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Spokesperson for Bassetlaw Protecting our People and Services group Ann Donlan said: “Before the NHS they had to pay for medicine, pay for doctors and pay for treatment.”
“Since the NHS came in we have had first class service and an excellent hospital. We are here to remind people of its importance, we do not want to see it privatised again.”
Birthday cake and banners at NHS protest over reforms – Health – The Star
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Campaign member Andy Turner said: “It is clear that the Department of Health is planning for the Health Bill to go through largely unchanged. It has clearly been a cynical exercise to take the heat out of the situation.
“We are gravely worried that the proposed changes will favour private healthcare providers accountable to shareholders and not patients, promote competition and not co-operation, and lead to drastic reductions in quality of patient care.”
Increased Bureaucracy
A new NHS commissioning board employing 3,500 staff and with a £20bn commissioning budget will oversee the government’s reforms to the health service, according to a leaked Department of Health document.
Labour said the document showed the government was planning to create a new layer of NHS bureaucracy, raising questions about the health secretary Andrew Lansley’s claim to be streamlining the management of the health service.
The document, which carries a warning “confidential draft – not for circulation” – was drawn up by the NHS chief executive, Sir David Nicholson, as he outlined the duties of an independent NHS commissioning board.
Nicholson said the new board will:
• Employ about 3,500 staff. It will have a chair and five non-executive directors. A chief executive will head a team of five executive directors – the four others will be a nursing director, a medical director, a director of commissioning development and a director of finance, performance and operations
• Directly commission £20bn of services and hold about 33,000 contracts for primary care services
• Oversee the new clinical commissioning groups across the country that will take responsibility for £80bn of the NHS budget.
England will be split into four “commissioning sectors” – with London as one of the “distinct” areas, raising questions about whether strategic health authorities are being reconfigured.
Nicholson proposed that the new board should be called NHS England, though he admitted that this might be a step too far.
The chief executive added in his report that his proposals would lead to savings because the board’s 3,500 staff would take over the duties currently performed by 8,000 workers.
Liz Kendall, the shadow health minister, said: “The government is wasting precious NHS resources on its huge re-organisation.
“Their original plan was going to cost at least £2bn. Their new plan will cost even more as the number of NHS organisations balloons from 160 to more than 500.”
Kendall also criticised Simon Burns, the health minister, who told the Commons committee examining the health and social care bill that it was premature to comment on staffing levels.
She added: “Today the minister Simon Burns told me it was ‘premature’ to say how much their new super quango, the NHS commissioning board, will cost and how many staff it will employ.
“Yet we now know from this leaked document it will employ at least 3,500 staff. The government must now come clean and spell out the true costs of their chaotic NHS plans.”
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“Massive bureaucracy” increase due to Health Bill » Hospital Dr
The government’s NHS reforms are set to treble the number of statutory NHS organisations, the Royal College of GPs’ chair Dr Clare Gerada warned MPs.
Giving evidence to the Parliamentary Health and Social Care Committee last week, Dr Gerada warned the reforms will send the number of statutory NHS organisations soaring from 163 to 521.
Gerada complained that NHS bureaucracy was being “massively increased”, while the revised bill had become “very incoherent”.
“It is neither liberating nor controlling. It neither allows for GPs to be innovative, nor does it give them tight restraints.”
The RCGP’s tally of new quangos includes 300 commissioning groups, 150 health and wellbeing boards, 50 PCT clusters, 15 clinical senates, four SHA clusters, the National Commissioning Board and the Department of Health.
Gerada said: “We are deeply concerned that commissioning consortia are going to be so bound up in bureaucracy that they will simply not be able to deliver the system leadership required.”
Cuts and related Increased Waiting Times
Managers warn of worsening access to NHS care – Main Section – Yorkshire Post
PATIENT access to NHS care will worsen in coming years as the health service faces “unprecedented” financial pressures, health bosses warn today.
In a survey of nearly 300 chief executives and chairmen, four in 10 say the financial situation facing their organisations is the “worst they had ever experienced” and another 47 per cent say it is “very serious”.
More than two thirds fear the pressures will intensify over the next three years, partly due to the impact of cuts by local councils, and that waiting times will worsen.
In a stark message, NHS Confederation chief executive Mike Farrar will today tell the annual conference of managers in Manchester that key decisions taken in the next 18 months over future health service reforms would determine “if the NHS is a going concern for future organisations to inherit”.
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related: BBC News – NHS chiefs warn of rising hospital waiting times Pledges on NHS waiting times in doubt | Society | guardian.co.uk Spending cuts will mean longer waiting times, say NHS managers – UK Politics, UK – The Independent
Lansley
Irritated MPs interrogate Lansley over NHS Bill / Britain / Home – Morning Star
Frazzled MPs spent a frustrating two hours today trying to cajole Health Secretary Andrew Lansley into revealing how much competition will be unleashed in the NHS.
Mr Lansley went round in circles before grudgingly admitting to Lib Dem MP Andrew George that many of the amendments to the Health and Social Care Bill were cosmetic.
Some amendments were introduced to address “misplaced concerns,” while others were to “reflect more accurately” the principles proposed in the Bill, explained the minister.
“Some of them are genuine changes,” he added chirpily in an appearance before the health select committee.
Parrying questions on the changes, he insisted: “It was not recommended to us by the NHS Future Forum that we should depart from the principles of the Bill.”
The forum had said that there was “widespread support” for the measure, he crowed.
Labour MP Valerie Vaz joined West Cornwall Lib Dem Mr George in trying to smoke out the minister over his latest emphasis on giving wide powers to a NHS National Commissioning Board, charged with promoting “integration” and improving quality.
NHS chief executive Sir David Nicholson confessed that the enhanced National Commissioning Board did not actually have any members yet.
“It’s just me at the moment,” he said.
There was a lot of “preparatory work” to do and adverts for a chair and a non-executive director would appear after the summer break.
Playing with words, Mr Lansley declared that NHS regulator Monitor would in future be using competition “as a means to an end” rather than the earlier intention of promoting competition as “an end in itself.”
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HealthInvestor – Article: NHS competition rules ‘still open to debate’, admits Lansley
There remains a lack of clarity about how competition law will be applied in the reformed NHS, the health secretary has admitted.
Speaking at a Health Select Committee hearing, Andrew Lansley said the full application of competition law in the health service would be determined gradually by the courts, rather than by his amended Heath and Social Care Bill.
“If you’re trying to establish with certainty what the boundary of the application of competition law is, then it’s a matter of debate and it will be something that will only be determined over time as there are cases brought before the courts,” he said.
At present, EU competition rules only apply to ‘undertakings’, meaning enterprises engaged in ‘economic activities’. This means that while it applies to private providers in the NHS, it tends not to cover public sector bodies. There remains considerable legal debate about what constitutes an ‘economic activity’ in public healthcare provision, especially amid efforts to introduce a genuine internal market within the NHS.
The health minister, giving evidence on the government’s response to the NHS Future Forum report, said clarity on competition law was not contained within his amended Health Bill and would only emerge as providers challenged decisions in the courts.
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27/11/13 Having received a takedown notice from the Independent newspaper for a different posting, I have reviewed this article which links to an article at the Independent’s website in order to attempt to ensure conformance with copyright laws.
I consider this posting to comply with copyright laws since
a. Only a small portion of the original article has been quoted satisfying the fair use criteria, and / or
b. This posting satisfies the requirements of a derivative work.
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