Privatise the NHS

[Park Life 70]

I still don't get why so many people who are completely dependent on their employers for any kind of healthcare and who must be aware of how vulnerable all jobs are can be so opposed to the public option - is it just dogmatic stupidity?

 

Special interests will block a public option in the U.S. till the there is some kind of revolution.

[ChezGiven 0]

I still don't get why so many people who are completely dependent on their employers for any kind of healthcare and who must be aware of how vulnerable all jobs are can be so opposed to the public option - is it just dogmatic stupidity?

 

Special interests will block a public option in the U.S. till the there is some kind of revolution.

 

If you spend $1000 of tax per capita on a public option or $1000 per capita on a private subsidy towards coverage offered on an insurance exchange, which is the more efficient?

 

Focus on the 'public option' is wrong since it makes the debate about how you fund something, rather than the 'outcomes' of the policy i.e. the increase in the number of people who will have access to healthcare.

[Park Life 70]

Cut out all this bollocks, just build hospitals and let people use them for free. Job done. Build one a month.

[NJS 3986]

I still don't get why so many people who are completely dependent on their employers for any kind of healthcare and who must be aware of how vulnerable all jobs are can be so opposed to the public option - is it just dogmatic stupidity?

 

Special interests will block a public option in the U.S. till the there is some kind of revolution.

 

If you spend $1000 of tax per capita on a public option or $1000 per capita on a private subsidy towards coverage offered on an insurance exchange, which is the more efficient?

 

Focus on the 'public option' is wrong since it makes the debate about how you fund something, rather than the 'outcomes' of the policy i.e. the increase in the number of people who will have access to healthcare.

 

But that still doesn't address what happens to someone who loses their job and them presumably has no healthcare (unless my understanding is wrong). Presumably providers won't provide care without premiums.

 

I could understand the dismissive attitude if there was an economic boom and everyone was "safe" but at the moment I don't get why there arses aren't twitching.

[ChezGiven 0]

I still don't get why so many people who are completely dependent on their employers for any kind of healthcare and who must be aware of how vulnerable all jobs are can be so opposed to the public option - is it just dogmatic stupidity?

 

Special interests will block a public option in the U.S. till the there is some kind of revolution.

 

If you spend $1000 of tax per capita on a public option or $1000 per capita on a private subsidy towards coverage offered on an insurance exchange, which is the more efficient?

 

Focus on the 'public option' is wrong since it makes the debate about how you fund something, rather than the 'outcomes' of the policy i.e. the increase in the number of people who will have access to healthcare.

 

But that still doesn't address what happens to someone who loses their job and them presumably has no healthcare (unless my understanding is wrong). Presumably providers won't provide care without premiums.

 

I could understand the dismissive attitude if there was an economic boom and everyone was "safe" but at the moment I don't get why there arses aren't twitching.

 

I think there is still concern for those who will fall between the cracks in the system. This legislation would fail John Rawls' difference principle (a political philosopher who dominates european social policy, even though he was a yank) as it does not improve the welfare of the least well off in the US. It does address some of the issues faced by the lower middle classes though.

 

As Sullivan pointed out in the Sunday Times, the big battle is getting legislation on the statute, once that is done, tweaking it to improve the faults will be relatively easy. There are some bold assumptions in the analysis, if employers dont behave the way they are predicted, then further legislation will be necessitated by the federal finances. If Obama gets a second term, these tweaks will be of the 'socialist' variety.

 

This is his strategy imo.

[ChezGiven 0]

http://www.guardian.co.uk/society/2010/jul...-paper-shake-up

 

The NHS faces its biggest shake-up for decades as ministers prepare to give family doctors control over £70bn of healthcare budget, and to roll out reforms that could give the private sector a greater role in health services.

 

Inevitable really.

[Happy Face 29]

Require doctors to keep data on their own performance and publish detailed evidence of hospital mortality rates.

 

Shipman would have loved that.

[Renton 17841]

This is madness.

 

I hate the Lib Dems more and more with each passing day.

[NJS 3986]

I "love" the way they sell their shit - "putting the power in the hands of those who know best" - how the fuck do GPS know how to run presumably multi-million pound businesses with no training or experience? - It's the same as letting parents run schools instead of LEAs - fucking madness.

 

The involvement of the private sector is their way of siphoning off ringfenced funding to their mates - fucking despicable.

[Renton 17841]

I "love" the way they sell their shit - "putting the power in the hands of those who know best" - how the fuck do GPS know how to run presumably multi-million pound businesses with no training or experience? - It's the same as letting parents run schools instead of LEAs - fucking madness.

 

The involvement of the private sector is their way of siphoning off ringfenced funding to their mates - fucking despicable.

 

My experience of GPs is that they have no managerial or appraisal competencies whatsoever, and most don't have the motivation to acquire these skills. Consequently, more managers will have to be employed at a local level. Also, if more managers aren't employed then time that could be spent doing clinical work will be used for management instead. A terrible use of resources.

 

One of the main reasons NICE was initially set up was to eliminate the postcode lottery. This will make it ten times worse, and poorer areas are bound to affected disproportionately.

 

Apart from any of this, the last thing the NHS needs at this time is yet another reorganisation back to the days of fund-holding for GPs. We've gone full circle, and when it is complete we'll do another one, ad infintum.

[NJS 3986]

I have a feeling it's their plan for it to be chaotic to excuse handing over surgeries to BUPA on a wholescale basis - probably with some kind of "the poor will be okay though" lie.

[Billy Castell 0]

This is madness.

 

I hate the Lib Dems more and more with each passing day.

 

So do I, and I have voted for them in each election I'm eligable. Won't vote for them anymore, as they're letting the Tories just do what they want in exchange for a referendum on voting reform. A referendum that the Tories will campaign against. The term 'sell out' doesn't begin to describe Clegg and co.

 

It's up to Labour now to get their act together, give a shit about the poor, and stop sucking off the worst kind of capitalist bastard who has made fortunes out of our financial implosion, and led us there in the first place. Hopefully they can cut out the management jargon and love of fudged privatised nonsense like PFI too.

[Tooj 17]

http://www.guardian.co.uk/society/2010/jul...-paper-shake-up

 

The NHS faces its biggest shake-up for decades as ministers prepare to give family doctors control over £70bn of healthcare budget, and to roll out reforms that could give the private sector a greater role in health services.

 

Inevitable really.

Aye. I've already had the briefing.

 

Basically private sector 'expertise' is where we should be looking.

 

In a nutshell - gain investment from the private sector so we can outsource to them.

[Park Life 70]

http://www.guardian.co.uk/society/2010/jul...-paper-shake-up

 

The NHS faces its biggest shake-up for decades as ministers prepare to give family doctors control over £70bn of healthcare budget, and to roll out reforms that could give the private sector a greater role in health services.

 

Inevitable really.

Aye. I've already had the briefing.

 

Basically private sector 'expertise' is where we should be looking.

 

In a nutshell - gain investment from the private sector so we can outsource to them.

 

Is that cheaper and better?

[Renton 17841]

Con Dems accused of ditching the two-week cancer pledge. Beeb.

 

Acting opposition leader Harriet Harman has accused the PM of lacking "the guts to admit" that cancer patients will no longer be guaranteed to see a specialist within two weeks.

After David Cameron refused to support the previous government's NHS target at question time on 14 July 2010, Ms Harman told MPs: "He's obviously ditching the guarantee for cancer patients, but he hasn't got the guts to admit it to the House."

She also called on the PM to reveal how much the government's planned overhaul of the NHS would cost in "extra upfront administration costs".

Ms Harman asked: "Does he stand by what he said just a few months ago on NHS reorganisation: 'the disruption is terrible; the demoralisation worse; and the waste of money inexcusable'?"

But Mr Cameron rejected the charge. "We are not reorganising the bureaucracy - we are scrapping the bureaucracy," he declared.

He added: "We are cutting £1bn of administration from the NHS. We're cutting administration costs by 45% over the next Parliament."

Mr Cameron told her: "We will only keep targets where they actually contribute to clinical outcomes."

The prime minister argued that the "new dividing line" in British politics separated the Labour party, which is "defending the bureaucracy of the NHS", and the coalition, which sought to focus on treatments.

[Park Life 70]

"Capitalism is failing due to it's inability to channel wealth back to the periphery". Geroge Soros. Financial investor.

[Meenzer 14083]

Glad you added that clarification. Would have never heard of him otherwise.

[Rob W 0]

after all this whining from the medical profession about unnecessary managers its going to be interesting to see how they manage the cash....................

 

probably big salaries all round "because of the increased responsibility"

Edited July 15, 2010 by Rob W

[Renton 17841]

after all this whining from the medical profession about unnecessary managers its going to be interesting to see how they manage the cash....................

 

probably big salaries all round "because of the increased responsibility"

 

Maybe, but more than likely they'll have to re-employ the managers from the PCTs and SHAs who will have just received large redundancy packages. It'll now be 500 consortia compared with about 150 PCTs it was, yet this is going to cut beaurocracy and save money?

[Billy Castell 0]

The NHS should never be privatised. Otherwise we'll be telling millions of people that their health is unimportant, and therefore they are unimportant. The USA has done that for many years, and their private system has cost them billions and had still left 40 million people unable to afford healthcare. If capitalism was fully introduced into healthcare, then doctors and hospitals would put the poor last in line, however serious their illness was. That is the nature of capitalism-screw things to your advantage and make money.

[Renton 17841]

The NHS should never be privatised. Otherwise we'll be telling millions of people that their health is unimportant, and therefore they are unimportant. The USA has done that for many years, and their private system has cost them billions and had still left 40 million people unable to afford healthcare. If capitalism was fully introduced into healthcare, then doctors and hospitals would put the poor last in line, however serious their illness was. That is the nature of capitalism-screw things to your advantage and make money.

 

Simplistic take but basically correct. Crucially, socialized healthcare systems are also much more efficient, so we all pay less. Despite what the ConDems would have you believe, the NHS is the most efficient healthcare system in the World and the second best overall. Beeb. For now that is.

[Renton 17841]

Thought I'd add in this BMJ article about the white paper. Couldn't agree more.

 

GPs have reasons not to be so cheerful over commissioning plans

Polly Toynbee, political and social commentator, the Guardian

 

polly.toynbee@guardian.co.uk

 

It is a mystery how the hundreds of proposed consortia are to work better than the current system

 

 

General practitioners are the masters now, running the whole shebang with £80bn to spend as they please. Some enthusiasts can’t wait. But many wise GPs will look this gift horse in the mouth with considerable circumspection. How exactly are they to do it?

 

Divided into 500-600 consortia, GPs will do all the purchasing that the abolished primary care trusts did with 45% less cash for management costs. They will do it alongside the day job they chose—general practice, not NHS management. Once 303 primary care trusts did the job, but the shortage of finance directors and chief executives forced their reduction down to 150. Now all PCTs and the 10 special health authorities are to be abolished, with their staff cast to the four winds. In yet another game of NHS managers’ musical chairs, how will they be spread thin across 500 GP consortia? As happens with each turbulent reorganisation, many of the best will walk away. Civitas—a government friendly think-tank—warns that this great disruption will yet again set back NHS progress by one to three years.

 

Observers agree that PCTs, supposed to be turbo drivers of the internal NHS market, were often the weak link in the chain: top managers preferred the glamour of running hospitals to the pen pushing bureaucracy of PCT purchasing offices. Nonetheless, those same NHS observers were this week shocked at the idea that the entire cadre of commissioners would be fired, and GPs left to set up completely new entities. In times of plenty, money might rescue disasters along the way—but this happens as a massive £20bn of "efficiency savings" is to be cut from the service, with management costs nearly halved and the NHS about to enter a period of greater stringency than it has ever known, according to the Institute for Fiscal Studies. Forget "ring fenced" and "protected," this will be a tighter squeeze than those crises that precipitated Margaret Thatcher and Tony Blair into their radical reforms. The cost of much social care will also be piled on to GP commissioners. The mystery is how these hundreds of consortia are to work better, needing many more staff on much less money? The Nuffield Trust suggests that the consortia will cost £1.2bn more, a conservative estimate.

 

Another reason for GPs to pause: if they think they can commission whatever local hospitals and services they choose, they should think again. The prime duty of Monitor, the independent regulator of NHS foundation trusts, will be to act as an economic regulator, ensuring a level playing field in a competitive marketplace. That means EU laws apply and every tender must be fairly open to all bidders from home and abroad, contestable in court if bidders feel discriminated against. GPs will not be allowed to favour services and providers they already know and trust. Once the Pandora’s box of the market is open, the lid can never be put back on. This will not be the familiar NHS but a random and shifting collection of best bidders from all over the world. Powerful US companies may well begin with loss-leading bids that would be hard to prove unfair. If some GP consortia don’t want to put in the management time, these companies will bid to do the consortia’s purchasing too, so then who runs the NHS?

 

Another reason for GPs to worry: a consortium will have power to run the GP practices in its zone with a rod of iron. Managing its budget will depend on GPs’ spending behaviour and those who "overspend" will not be tolerated. GPs will not have the same independence. Consortia will have "powerful incentives" to hit their commissioning targets, so you can bet every GP will feel that incentive on their back as never before. Good, perhaps, if all have to perform as well as the best—bad if all have to prescribe the cheapest of everything, regardless.

 

A deeper ethical dilemma should grip GPs as they consider how all this changes their role as intermediaries between patient and NHS rationing. Whose side are they on—the patient’s, the state’s, or their own bank balances’? Once they hold the budget each patient becomes a unit of rationing or possibly a business prospect, if GPs set up their own treatment centres. True, GPs are already small businesses, but their business is conducted through contracts with the government, at which they have been clever on Labour’s watch. This has intervened very little in their direct relationship with their patients. But now a patient would be right to wonder if a doctor’s decision is guided by how much money the practice has left that year for hospital or expensive drug treatments. If a GP recommends consultant X or drug Y, is it the cheapest or the best? Certainly good doctors should always have concern for the always limited resources of the NHS—but it spells the end of trust if a patient ever suspects a personal financial incentive to offer the cheapest.

 

Right now the power to say no rests with GPs. So when the BMA negotiates the new GP contract, politicians should remember the doctors have the upper hand. The BMA would be right to refuse anything that risks breaking the trust between patient and doctor or breaking the non-commercial spirit of the much loved NHS.

 

Cite this as: BMJ 2010;341:c3839

[Kid Dynamite 5941]

Both my parents are NHS managers and may be getting made redundant over this after 50 years between them in the job. Both of them are wondering why they stuck to their values for so long and turned down so many jobs in private healthcare only to be shit upon from a great height.

[peasepud 59]

Both my parents are NHS managers and may be getting made redundant over this after 50 years between them in the job. Both of them are wondering why they stuck to their values for so long and turned down so many jobs in private healthcare only to be shit upon from a great height.

 

Cue CT with a "you cant make an omlette without cracking eggs" or Rob to spout on about how there's far too many like your parents sitting around at the taxpayers expense.

[Kid Dynamite 5941]

Well I can attest to the fact that they both put in 60hour weeks, so there isn't much sitting around