The NHS is just fine?

Baroness Murphy

When there’s a big bill coming up, like the Health and Social Care Bill, progressing in stately fashion through its committee stages in the Commons at the moment, there are numerous briefings and meetings organised to hear the views of the various groups of ‘stakeholders’ who may be affected by the bill. Baroness Thornton, an opposition spokesman on health and former government spokesman in the Lords, has organised a series of meetings for peers from all sides of the House about the HSCBill.  Perhaps not surprisingly we have heard more from those who don’t like the Bill than those who do!

Yesterday afternoon we had presentations from three Presidents of medical Royal Colleges- Mr John Black from the Surgeons, Sir Richard Thompson from the Physicians and Dr Clare Gerada from the GPs. The main message they gave us was that there is nothing much wrong with the NHS as it is, it simply needs more money. The surgeons were less worried about the Bill than the others, perhaps because they are more used to changes but the others didn’t have a good word for it.  Lord Warner pointed out that there had been a 30% uplift in funding in the past 15 years that had made some improvements but had done little to improve productivity nor outcomes. Productivity is difficult to measure in many specialities (but not that difficult) and international comparisons of outcomes are dodgy because of the problem of comparing apples and oranges from data collected in different ways. BUT again, it’s not too difficult to make comparisons about stroke outcomes, cancer survival rates, rates of cardiac treatment and many other rates where we do not do well enough yet.

Given the recent Ombudsman’s report about the quality of care for older people, which everyone acknowledges is poor/ disgraceful in many NHS hospitals, and the lack of improvement we have seen with massive investment, I find the idea that the NHS does not need to change difficult to accept.  Could it be that doctors have a vested interest in maintaining the status quo?  (A doctor speaks!)

19 comments for “The NHS is just fine?

  1. Lord Blagger
    22/03/2011 at 10:32 am

    The main message they gave us was that there is nothing much wrong with the NHS as it is, it simply needs more money.

    20,000 deaths where the NHS contributes a year? Nothing much wrong? You’re deluded.

    My local hospital starved a patient to death. We wouldn’t have known if he hadn’t left notes that were found later.

    It needs more money. It’s had vast amounts thrown at it, and it hasn’t improved in proportion.

    There is no money. The government is overspending by 30%. That’s the size of the cuts.

    To protect health care, we should start by axing the Lords. There is no need for an expensive retirement home for failed politicians.

  2. MilesJSD
    milesjsd
    22/03/2011 at 1:07 pm

    As long since stated, including by a number of clear-thinking British governance-level people, the National Health Service has actually never been a Health & Long-Term Wellbeing-Building service;

    it was in 1948 and has remained always an Illnesses, Medications & Hospitals service.

    I believe it has been successful, and since the previous New-Labour’s ‘five-year-plan’ of reforms were implemented has been showing further marked improvements.

    But –
    ————–
    That the British Medical Association’s motives overall were underminingly-suspect became evident to the public-mind when they (the BMA not to be confused with the BHMA) smothered the UN Declaration of Primary Health Care (NB as majorly distinct from primary Illnesses and primary Medical treatment)by sweeping it all under their longstanding monopoly of “health” named Primary Medical Care.

    The UN Declaration was clear, that a new and major focus had to be established upon Health Maintenance & Longterm Wellbeing Building, quite distinctly from the extant essential illnesses & hospitals services (which in Britain had long before been called the national Health service despite their one-sided (albeit very welcome and successful) foci upon illnesses, medications, and hospitals.

    That the Commons and the Lords allowed the BMA ( the Doctors’ British Medical Association)to sweep this British-Peoples’ immediate and long-term Health and Wellbeing Building, intended by both spirit and letter of the UN Declaration, under the monopolistic medical mat of Primary Medical Care is not a mere conflation-mistake, it is complicity and thinly-veiled malfeasance (bad-government).

    So –
    ————
    Instead of spending more big-taxpayers-monies on privatising and against-the-grain revolutionarily-reorganising the present reasonably-successful national illnesses & hospitals service, Parliaments should be urgently founding a National Wellbeing-Building Service, and with that should be legislating for the National Illnessess Service (“NHS”) to focus more exclusively upon just that, Illnesses, Medications, Hospitals, and Epidemics;

    and let the old-NHS leave the major- thrust of Present Health Maintenance and Longterm Wellbeing Building to that new service.

    That way increases in Health & Wellbeing must surely lead to substantial decreases in Illnesses and hospitalisations;

    And also at last fulfil the spirit and intention of the 1978 UN WHO Declaration of Primary Health Care.

    —————-
    1307T22Mar11.JSDM.

  3. maude elwes
    22/03/2011 at 2:11 pm

    The NHS is in chaos. And it is not due to the lack of money.

    It has lost its way organizationally. What needs looking at and changing radically is the management and the role of government intervention. It should be taken out of politics altogether.

    The money thrown at it under Blair and his crew did nothing to raise the standards, it lowered them in fact. Money became the mantra rather than patient care. We need people running it who have a basic principle of care and caring.

    The failings of these hospitals and GP surgeries are well known. The spotlight is on constantly, but, in general the warnings are ignored.

    Who have you got doing this job? What is their background? What have they achieved? What is their motive? What is their vision?

    Handing over to GP’s is ludicrous. Have you visited GP surgeries within a mile of the Palace of Westminster and taken a look at some of the madmen you have running these things? The entire basis of their work week has little or nothing to do with the welfare or health of their patients. In fact, as is the British ethos regarding any business, the customer is a nuisance. Without those people everything would run like clockwork.

    Add to that the enormous foreign contingent who can’t speak English, have no concept of what the NHS means and its duty of care, and voila, you can see a definite indication of sub standard practice.

    How is it the Europeans can run a health service. And don’t come back with the people pay for insurance. The insurance is not the principle of how it is run. And even with the insurance, it cost less there than here and yet the care is superior.

    Anyone who has been treated in Germany, France, Spain, Portugal, Switzerland, or any of the main European countries will tell you the service they receive is far superior to ours.

    What is it they do that we can’t? And if we can’t, why is that?

    It’s because the objective is no longer the principle of service and responsibility. The emphasis is the dreaded, global. And that means pass the buck, pretend you are doing something, and wait until the heat passes. And if a good heart blows the whistle, sack him/her, run them out of town, or, better still, try to jail them. This is the usual British answer.

    Being a patient in this country is taking a chance. Playing a lottery line or placing your chip on red.

    And the fault is of consecutive governments who use it as a vote puller.

    Education is likewise I may add.

    • MilesJSD
      milesjsd
      22/03/2011 at 8:21 pm

      It was not the new-labour (Blair) government’s NHS Plan and Budgeting that was wrong, it was the blind-minded and amnesial destructivism from many addictively self-interested, fatly-incomed, professionally-black-hatted cliques and comfortably-off middle-class communities.

      The ‘Blair NHS Plan’ needed some ‘five-years’, to reach all of its of goals;
      its self-seeking enemies wanted it delivered and all done within ‘five minutes’ !

      Those blind and but aggressively-impatient and destructive relative-few, including much of the Media who fanned the flames of sabotage, insisted in big-results within only five months of the Plan’s implementation; some including many within the NHS itself screaming for the whole Reform to be accomplished within a mere five weeks of its announcement;

      and Crowds and The Public being targetted by such dishonest, strong-sensationalism and de Bono black-hat-ism, tend very much to ‘parrot’ it.
      ————
      I wouldn’t have expected minds such as Maude’s to have been sucked in by the same series of blindnesses-of-heart and enthymemeries-of-mind as was the Media, the fat-cat-few, and the then floundering Conservative Opposition.
      ==============
      2021T22Mar11.JSDM.

      • maude elwes
        23/03/2011 at 2:17 pm

        Dear Miles, Trust me on this one, it’s experience not the media. I am not a media woman. Progressively and horrendously it has become unworkable. From point of entry to time of exit. This does not mean there are not really dedicated people in bunches, but, they are thwarted by those who want to play the game rather than support the field.

        However, I follow your point and respect your view.

        It should not be a political football and that is why they use it in the way the do. Remove that and you will get what you ask for. A more relevant pace of change.

  4. Carl.H
    22/03/2011 at 5:54 pm

    I haven’t looked into this to any degree so my knowledge on the Bill is flimsy.

    We are never going to achieve an NHS that is perfect, there will always be errors and imperfect service to a degree. There will never be enough finance.

    At present it is far from perfect and although treatments and prognosis is better than in previous times some basic elements such as hygeine are being allowed to degrade. The public view seems to be that there are far too many managers, not involved directly in health care, and far too few staff especially at the lower end, the public face.

    In Trusts we have seen many services outsourced, catering, cleaning etc., these have not been seen as a success by the public. There have been many incidents I have heard of blood and filth on wards and in emergency departments as well as a lack of resources such as beds for care. Most staff appear to do an amazing job in my opinion so it appears there are not enough, hence why managers are blamed. They are noted as having high salaries, long lunches and little compassion.

    Switching the management of finances to GP’s appears to be a desperate bid by someone unaware of how surgeries now operate. Most surgeries are multiple doctor surgeries run by a practice manager not the GP’s who know they have little experience in management as they did not train for that side. The rumoured concept of GP’s being paid more for spending less is a recipe for with holding treatment until too late.

    When one attends a surgery a doctor will best guess your symptoms and if not rectified will ask you to return in a given period or he will refer you to a specialist. The fact of the matter is that given the purse that doctor will err on the side of finance and should NOT be put into that position. GP’s should not in anyway hold the purse strings, it is unethical and most are incapable, being untrained in that position.

    The current situation although imperfect seems far more tennable than that which is proposed. Yes alterations do need to be made and a balance between management and workforce financially needs to be sought but at best will remain imperfect.

    It is extremely difficult in terms of league tables by Nation to get a real grip on the value of our service, there are many variables. I am sure a central service looking at these Nations purporting to do better could find why.

    I do not know that there is panacea, I doubt it, but GP’s buying Hosptal Services is a large step to privatisation. A step Mr.Clegg’s party said they will not take, although Mr.Clegg himself side stepped the issue quite well as it is not full privatisation. It is however privatisation. The Government pay the doctor a certain amount per patient, he buys services as he feels necessary, however the less he buys the more he earns.

    The system will be open to abuse, the friend the doctor plays golf with gets a consultant appointment quicker and so forth. Some doctors will become adept at with holding treatment to save cash, others find they go broke. It is not a position for doctor nor patient, it is the first step back to the 1800’s where the best was only available to the rich.

    There are services such as mental health services doctors maybe loathe to provide should a price tag be put on them. One of the best ways a GP serves the community is seeing people as people, as individual characters if they take over finance of the NHS I do not believe this will be the case. Patients will become a profit or loss sheet and although this maybe the case in large specialist hospitals it should never ever be the case with a community GP.

  5. ZAROVE
    22/03/2011 at 6:56 pm

    So much for all that Critiism of how the Americans arent compassionate and the Health Care services here are twrible.

    I shoudl not that peopel dont starve in Hospitals Here.

    I think the NHS is dreadfully innefficient.

    • maude elwes
      23/03/2011 at 2:58 pm

      Zarove: People there in your country, the USA, don’t get in to hospital if they don’t have health cover and 40 million people in the US don’t have cover of any kind.

      The poor SOB’s that do, when their insurance runs out, get thrown out, literally onto the street. Some are often taken to the street by ambulance and left there.

      http://www.youtube.com/watch?v=jUV66P5Lr6Q

      http://www.youtube.com/watch?v=chrnZtiaVgo

      • Lord Blagger
        30/03/2011 at 10:13 pm

        http://www.guardian.co.uk/society/2008/jan/18/health

        More than 17,000 people receiving treatment in the UK have died unnecessarily because of the inadequacies of the NHS, it is claimed today.

        ============

        The NHS itself puts the figure at 20,000 plus, killed.

        No figures published for those that are maimed.

        And now the government wants to prevent those who have been injured from getting redress.

        In reality the real problem is the monopoly in the legal profession when it comes to compensation for getting it wrong.

        The NHS won’t improve so long as insurance, regulation and supply are combined,.

  6. Gareth Howell
    22/03/2011 at 7:19 pm

    Is there an internal market in organ donation?

    The NHS is for all intents and purposes, a monopoly, so it is easy to say that there is not much wrong.

    I wonder what the similarities and differences are between the Sickness services of other European countries and ours are?

    Merely being able to observe different services somewhere else does not make it any less a monopoly.

    The NHS cannot for example provide Cosmetic surgery by definition, in any true sense of the word. ‘Cosmetic’ means ‘disfiguring’.
    Private medicine can and does provide surgery which enhances the individual’s appearance, but where would the NHS be if that were provided by them?

    The case is Dental surgery. The NHS dentist
    leaves off at a point where most private dental practicioners, would begin to have a real and lasting effect on the appearance of the patient,usually at a young age. He has no choice. He is an NHS dentist.

    Where would we be if he did not?

  7. Twm O'r Nant
    23/03/2011 at 1:58 pm

    The NHS is just fine?

    Reports that 30% of disease is Doctor and surgeon induced may be exaggerated.

    One acquaintance of mine was a “terminal surgeon” and it often makes me wonder how much Death itself, is doctor and surgeon induced.

    A good deal, especially if you get in to the habit of going near them with every pain.

    Death is after all relief of pain, and pain, and the relief of it, is the Doctor’s principal stock in trade.

  8. Matt
    23/03/2011 at 5:23 pm

    “The NHS is just fine?”

    Indeed it is. See Ben Goldacre’s (author of ‘Bad Science’) rebuttals on the manner, succinctly summed up with the conclusion that “there’s no need to hide behind a cloak of scientific authority, murmuring the word “evidence” into microphones. If your reforms are a matter of ideology, legacy, whim and faith, then, like many of your predecessors, you could simply say so, and leave “evidence” to people who mean it.”

    What I think is interesting to note is that general practitioners are private entities. Ergo, the plans put NHS funding into private hands. I wonder how GPs are going to cope with managing funding for their areas … perhaps by subcontracting to insurance companies?

    Why look at the bottom of that slippery slope there, Medicare in the UK, my oh my!

    • maude elwes
      30/03/2011 at 3:00 pm

      Another book that is a must read on this subject is: How We Treat The Sick: Neglect and Abuse In our Health Services by Michael Mandelstam, Jessica Kingsley Publishers.

      He advises that when someone you love goes to hospital, keep records and take pics. Complain and complain and never let up until you get justice.

      As TWM O’rr Nantr Nant writes. Dr Death may very well be correct. Many suffer from HIV and we are not allowed to know. So, like dentists, if they operate and come in contact with your blood, you are vulnerable. Of course there are passonablesonable’ illnesses.

      Only when those carrying out the abuse are made truly accountable will there be anything close to change. And if you want this change you have to be brave enough to face it up front.

      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071615/

      • MilesJSD
        milesjsd
        30/03/2011 at 9:09 pm

        Thank you, maude.

        Not only in the Hospitals-domain is there the additional Mind-functional weakness that has failed to budget not just Money but human Time, Energy, Things, Places, to true scientific, technological, and human-developmental ‘chunking-up, -down, and sideways’, NLP-wise, of the Tasks and Problems therein of managing Illnesses, Medications, Hospitals, Patients, and yes, Knowledge and Skills.

        The well-known historical-precedent of the dirty-needle is the operating-blades of medical-surgeons who openly sharpened their scalpels on the soles of their expensive leather-shoes, and without washing, immediately before incising the (hapless) patient-victim.

        I mean, the fault, the sin, the ‘crime’ even, is compounded in all kinds of professions, workplaces, and lifestyles,
        by professional-‘security’, ‘rights’, and ‘ethics’ that contain breaches of Morality (under which pure-umbrella they derive and ply their businesses)
        sufficient to put at risk the wellbeing and the very lives of clients, and the Public outside of the professions.

        Further, how often do you hear the research-report showing that Doctors have entered the medical profession primarily for one of three basic personal-social reasons
        (1) for the Love of People;
        (2) for the Love of Power (over other powerfuls such as Lawyers, Police, Criminals, Government-lawmakers and official;
        (3) for the Love of Money;

        and putting those three in reverse order you have the percentages of doctors under each heading,
        the last I heard (from Australia) being
        (“) primarily
        50% for the Money,
        40% for the Power, and only
        10% to help People(“).

        ——–

        As John Donne shares with us in
        A HYMN TO GOD THE FATHER.
        “I.
        Wilt Thou forgive that sin where I begun,
        Which was my sin, though it were done before?
        Wilt Thou forgive that sin, through which I run,
        And do run still, though still I do deplore?
        When Thou hast done, Thou hast not done,
        For I have more.

        II.
        Wilt Thou forgive that sin which I have won
        Others to sin, and made my sin their door?
        Wilt Thou forgive that sin which I did shun
        A year or two, but wallowed in a score?
        When Thou hast done, Thou hast not done,
        For I have more.

        III.
        I have a sin of fear, that when I have spun
        My last thread, I shall perish on the shore ;
        But swear by Thyself, that at my death Thy Son
        Shall shine as he shines now, and heretofore;
        And having done that, Thou hast done ;
        I fear no more. ”
        ——————
        But beware!
        the last line of the same John Donne’s similarly titled ‘Hymn to God, my God, in my Sickness.’

        “Therefore that He may raise up, the Lord throws down”.

        – – – we might have to set a fourth reason for people entering the Illnesses and Hospitals professions, whether the latter Organisation continue self-aggrandising in the great-whitewash-guise of “National Health Service” or be more truthfully-titled;

        nd that would have to be – – –
        (4) ( “I came into the Medical Service” – ) in order to play God.

        ========xxxxx=======
        2209W30Mar11.JSDM.

  9. ZAROVE
    23/03/2011 at 6:58 pm

    Maude- You are insane.

    The reason I say this is because in America its against the Law for Emergency Rooms to turn people away. No America does not let people die who are uninsured.

  10. Twm O'r Nant
    25/03/2011 at 6:14 pm

    Everybody seems to think that the NHS is not fine but representatives in Parliament are drilled (presumably by the relevant committees of examination not being up to the job) in to thinking that everything is perfect and that the public should be persuaded of it.

    In the recent discussion of the impotence of
    Parliamentary select and (standing) Bill(?) committees, the one that stand out like sore thumbs as being NO DAMNED GOOD are the select committees on Health and sickness.

    When I did my meanderings between the various committee chambers in the 90s, they were certainly the least effective.

    “Isn’t the NHS wonderful?” makes you feel sick doesn’t it? like Leonard Cohen’s song,
    “Where none were sick and none were well”

    In the limbo of disease…. and NHS hospital!

    Get a second opinion, and pay for it!

  11. MilesJSD
    milesjsd
    25/03/2011 at 7:48 pm

    I apologise for this 620 words submission;
    but some civilisational-advance drums need to be continually rat-a-tat-tatted.

    All of the comments so far in this NHS domain bear experiential truth and factuality – much alas! being largely ignored, and much being largely falsified, by reactionaries.
    ———————
    But Maude Elwes rightly calls upon our experience(s) of a Matter, in this case the historical, current, and future performance of the “NHS”.

    There are different “fields” within this NHS confuddle;
    and Maude points to the “political one” whilst I am pointing to the
    “Primary Medical Care” one, a blatant misnomer for “Primary Health Care”, by the BMA in its more cunningly-concealed “football” and “privatised-ball-park2 game-plannings.

    In this they prevented the spirit and practical-word of the 1978 UN Declaration of Primary Health Care
    (note that that UN ‘Health’ was intended to be Generic and widespread throughout all Nations, and to include access for every individual, distinctly for long-term ‘Wellbeing’ building as well as for day-today Health-maintenance, both to be DISTINCTLY different from day-to-day doctors’-surgeries for Illnesses, Medications, and Hospitalisations (which nonetheless were called on to continue in 100% strength against Illnesses, Diseases, and Epidemics, but as a Medical Service NOT as a Health-&- Wellbeing-Building one).

    i.e. the new primary or basic health-building was to be in a real sense ‘civilisationally-generic’;

    NOT based exclusively upon Illness-Diagnoses, Medications, and Hospitalisations;

    NOT based mainly upon the Medical Sector and its big-boss the BMA.

    Now, Primary Health equates with basic self-care or, as I am not afraid to neologise, with holistic-self-health-ing which latter naturally includes self-healing –

    (Baroness Murphy might like to take or make a neologisational note there, by the way) –

    such self-health-ing being based upon non-medical, best good-health maintenance, in a larger “Shire” of “fields” dedicated and budgeted to the Long-term Wellbeing-Building of every individual;

    and this, the UN expressly made clear, needs to be by a cooperative-strategy majorly including other sectors, not just the BMA, Medical, Clinical, Local GP Surgery, Nursing-services and Pharmacologies, for the Treatment of Illnesses, Prescription of Medications, and Hospitalisation of ‘life-threatened’ patients;

    it was to be for health-building, not merely illness-curing.
    Full stop. End of Chapter, And end of great Document (UN WHO Declaration of Primary Health Care).

    But what did the BMA do ?
    and I suspect in one fell swoop largely cause the Parliaments and the British Public of that day to become complicit-with ?

    It imprisoned the whole UN Declaration under its longstanding and essentially monopolistic “Primary Medical Care” practices and reactionisms.
    ————

    That is just one of the “games” and “footballs” that has been and still is being cleverly-hidden and swung-across upon both the People and the Parliaments, by the BMA, and by similar Captains-of-Industry having the super-powers and riches to be able to manipulate both BMA and the Parliaments, in such Big and Strategic Matters.
    ————-
    I respect Maude for not being taken-in by the resulting decades-dragging-on Media-hypes;

    And I do call for clarity when using such terms as “change”, “progress”, “together” (the new Con – Lib slogan “We’re All In This (Disaster and Belt-Tightening) Together”)…

    and so on ad nauseam to “Ethnic Cleansing” euphemistically supplanting the on-the-ground reality which is Ethnic-Persecution.

    And because we English have a world-wide, and therewith a Human-Race-Survival, responsibility to present truth in clear and clean English; we need to be focally-discussing and democratically-demonstrating such matters.

    We can not do this whilst our civilisation’s lifesupports themselves are being falsified and, as Maude’s similes make quick snapshots of, are being sensationally kicked around like footballs in a mere game upon a mere privilegocracy’s private-pitch, and not in the proper democratic “playing-field” at all.
    ————
    That is what I am striving to convey in the comments I put forward.

    ———————-
    1948F25Mar11.JSDM.

  12. MilesJSD
    milesjsd
    27/03/2011 at 10:59 pm

    Briefer but possibly more practically-helpful to the Ageing and their genuine-carers and advocates than my above 620 word submission:

    have a little read through an unlikely-titled new-progress non-fiction book for the better health and enjoyment of one’s own life, that has been overlooked since 1988, especially for the repressed-aged:

    “Somatics: re-awakening the mind’s control of movement, flexibility, and health” by Thomas Hanna PhD founder of the field of Somatics

    “Practical and easy to use, ‘Somatics’ is the essential guide to reversing the effects of ageing – or staving them off before they even begin”.
    ============
    2359Sn27Mar11.JSDM (thriving octogenarian).

Comments are closed.