Interesting that the Con-Dem Conservative Liberal-Democrat coalition government is applying the ideology of the abolition of the NHS to public services generally. “Please, sir, I want some more.”
Cuts to fire services mean that fire engines will not be routinely despatched to hospitals when alarms ring.
- 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.
It may have “paused” temporarily, and been cosmetically adjusted in a bid to defuse Lib Dem opposition, but Andrew Lansley’s Health Bill is far from dead.
Instead Lansley himself has now urged more rapid progress in implementing it, even before the delayed parliamentary process is complete.
David Cameron and Lansley are so fixated on carrying through their plan, which seeks to transform the NHS into a competitive market and slice off billions of the £100 billion NHS budgets to benefit private providers that they are ignoring even major setbacks like the high-profile resignation of national heart tsar Professor Roger Boyle.
Boyle, a highly respected doctor and author of the influential 2007 policy to reform stroke services, told the Health Service Journal he was opposed to the government laying waste to large parts of the NHS.
He opposed the closure of primary care trusts and strategic health authorities and ridiculed the idea that the NHS is “over-managed” to the extent claimed by ministers.
Boyle is not the only one expressing concerns.
Supporting a motion moved by GPs, the BMA has again, despite pleas from its leaders, voted overwhelmingly for the Bill to be withdrawn, branding it the biggest-ever threat to the NHS.
The BMA has also published a survey showing thousands of GPs are planning to retire rather than implement the Bill and that a large majority of GPs have major concerns about Lansley’s wholesale restructuring of the NHS.
These are the key people who are supposed to implement the changes and the only ones seeming to benefit from them.
Their hospital colleagues have now woken up to the fact that the Bill would largely exclude them from any voice, relegating them to the back of the NHS terraces while the GPs are dragged reluctantly into the directors’ box.
Royal College of General Practitioners (RCGP) president Clare Gerada has also challenged government attempts to “railroad” the Bill through.
The amendments to it do not address fundamental problems, but would mean that 163 NHS bodies being abolished would be replaced by more than three times as many new bodies to be involved in the decision-making process.
“The RCGP’s tally of new quangos includes 300 commissioning groups, 150 health and well-being boards, 50 PCT clusters, 15 clinical senates, four SHA clusters, the national commissioning board and the Department of Health,” she told the GP magazine Pulse.
The government has published its Open Public Services White Paper, which aims to enshrine the right to a choice of public service provider in law.
It comes as government documents come to light warning ministers that hospitals and schools must be allowed to fail if the transformation of public services is to be successful.
The public services white paper, published today, sets out a series of reforms to help drive competition and localism across the entire public service industry. The Any Willing Provider model is expected to be applied to every part of the public sector to allow charities, mutuals and private providers to flourish and give people a range of service providers to choose from. The Ombudsmans’ role will be changed to “an enforcer of choice” to ensure a plurality of providers are available to anyone accessing health, education and neighbourhood services.
Prime minister David Cameron, announcing the public service reforms, said it was “something very big and very different” and that the “old, closed, state monopoly is dead.” The white paper was originally due to be published last autumn, but has been repeatedly delayed. The drive towards a range of independent providers is likely to be seen by public sector unions as a move towards the privatisation of key public services.
Uncomfortable conversations about rationed operations are likely to become a more regular part of doctors’ work in the next few years, as the squeeze on NHS funding becomes more intense. Although the coalition promised to ringfence NHS funding, government spending on healthcare will remain flat until 2015, at a time when demand on the service is rising. The NHS was already committed to finding £20bn worth of savings (or “productivity improvements”) by 2015 and, as a result, all parts of the NHS are under pressure to reduce costs. Imposing tighter limits on certain procedures, such as gastric bands, is one way money will be saved.
This week, the Guardian reported that waiting lists for tests and treatment are already beginning to rise all over the country, and staff at Heartlands know that they are entering a period of financial austerity. The Heart of England Trust, which embraces three hospitals across Birmingham (including Heartlands), has agreed to shave 4% from its £600m annual budget – equivalent to £24m – every year until 2015, and expects to cut 1,600 posts out of the total headcount of around 10,000.
For the moment the full force of the impending squeeze on costs has yet to be felt, erupting only occasionally in unexpected rationing. Dr Taheri says he describes himself as “a fairly mild-mannered, calm person”, but he is increasingly angry about the new restrictions on treatment. “About 30% of the patients need things that we’re not able to get them. This is going to be the challenge, to explain to patients that we can’t do things,” he says.
PATIENTS’ lives will be put at risk by fire brigade cutbacks, the region’s hospitals chief has warned.
Under new plans, firefighters will no longer automatically turn out to the region’s main hospitals when an alarm sounds.
Humberside Fire And Rescue Service currently sends two fire engines to Hull Royal Infirmary and Castle Hill Hospital when an alarm goes off.
But now, fire officials are considering only dispatching crews if hospital staff confirm there is a blaze.
Phil Morley, chief executive of Hull And East Yorkshire Hospitals NHS Trust, said: “If the changes are made, I have told them they have to accept accountability for any patient death from a fire.
“It would be unbelievable, unacceptable and wholly inadequate.
“In the interests of patient safety, we should be a priority if an alarm goes off. It is acting quickly that saves lives.”
The Fire Brigades Union (FBU) claimed the new system will be like “playing Russian Roulette with hospital staff, patients’ and firefighters’ lives”.
PRIVATE firms and charities will be able to demand the right to run almost every public service – from schools and day centres, to libraries and leisure centres – under radical government plans unveiled yesterday.
An Ombudsman will rule on whether companies and voluntary groups have been
“unfairly precluded” from tendering for contracts currently held by local authorities, for example.
The idea is modelled on the plans to allow “any willing provider” to run NHS services, in legislation that triggered a storm of protest that forced David Cameron to retreat.
Unveiling the flagship “Open Public Services” White Paper, David Cameron vowed the Government was “releasing the grip of state control and putting power in people’s hands”.
But ministers were put on the back foot by confidential documents that showed civil servants had warned the plans would only work if existing, unsuccessful services – such as schools and hospitals – were allowed to collapse.
The number of people facing “long waits” for hospital treatment in England is rising, NHS figures show.
Under the NHS Constitution, patients have a right to be seen in 18 weeks.
But there are currently 236,155 on the waiting list who have waited longer than that – a rise of 8.5% in a year, according to official data. Nearly half have waited more than six months.
The government said there could be valid medical or personal reasons for long waits.
However, doctors blamed the rise on the squeeze in budgets that is increasingly being seen in the health service.
The most common treatments people are facing long waits for is in orthopaedics, which includes operations such as knee and hip replacements.
Peter Kay, president of the British Orthopaedic Association and a former adviser to the Department of Health, said the sheer numbers waiting longer than 18 weeks meant it was unlikely to be solely for personal or medical reasons.
He said the focus of hospitals was now slipping and patients were being left waiting for too long.
And he added: “One of the issues with 18 weeks is that once you have missed the boat there is less incentive to get the patient treated. They get left on the list for longer than they otherwise would.”
About 200 staff at a Leicester hospital say they are concerned missing overtime payments are due to their NHS trust’s troubled financial position.
Union Unison said 200 staff at the Leicester Royal Infirmary had not received pay for extra shifts and overtime this month.
The University Hospitals of Leicester NHS Trust has an overspend of £7m, three months into the financial year.
In a statement, the trust said payments would be processed in a week’s time.
“All staff have received their basic pay for June, but additional payments are dealt with separately, and a small number of those payments go through a supplementary run which occurs in the week following payday,” the statement said.
But Adrian Morgan, area organiser for Unison in Leicestershire, said staff had been told different things when querying the missing payments.
“A couple of people have phoned payroll and asked why they haven’t got their enhanced payments and they were told the signature on the overtime sheet isn’t legible or acceptable any more but these are from managers that have signed forms for years and years.
“It is very conflicting information,” he said.
Mr Morgan said staff were beginning to suspect the trust was hanging on to payments “to try to garner some interest”.
NHS managers have accused Health Secretary, Andrew Lansley, of failing to support them in their efforts to save money and lead the reform of the health service.
After a 20-minute speech to the NHS Confederation’s annual conference in Manchester last Thursday, Lansley was asked to be more vocal in his support for NHS leaders, helping to raise their profile in the media.
A young man in the audience, who only started working in NHS management two years ago, said: “I have quickly recognised the role that leaders play and the absolute benefits they bring. I do not, therefore, understand why I have to go home and convince my friends and family of the pivotal role we all play. Can you not do more to make clear the difference between bureaucracy and essential leadership – in the public arena and through the press – so that I do not have to go home and convince people myself?”