An unhealthy debate

Baroness Murphy

Andrew Lansley’s  Commons statement on the Government’s decision to pause and think further on the Health and Social Care Bill was read in our Chamber by Earl Howe this evening, a sensible decision given the political noise. Lady Thornton doesn’t like it, very few people like it. I may prove to be the only person in Parliament who does like it! It’s very peculiar. There isn’t a key policy in the Health and Social Care Bill which wasn’t first introduced by the Labour party when in Government (and the NHS was equally oppositional then too). And it turned out when Lord Owen delivered his ‘exocet’ that he’d got completely the wrong end of the stick about the competition policy, simply misread it. There’s an awful lot of misreading going on. Ah, politics.

Could it be that the vested interests in the NHS have a serious interest in ensuring that nothing much changes? The exam question is what policies will best ensure the NHS is sustainable in the longer term as described in the NHS Constitution, fit for the purpose of addressing long term conditions and improving quality of care and improving its poor productivity. Cost effective answers on a postcard please.

8 comments for “An unhealthy debate

  1. Lord Blagger
    04/04/2011 at 9:54 pm

    The exam question is what policies will best ensure the NHS is sustainable in the longer term as described in the NHS Constitution, fit for the purpose of addressing long term conditions and improving quality of care and improving its poor productivity.

    Abolish it.

    There are far better systems of universal health care.

    1. Mandatory insurance. Hence universal coverage.

    2. Mixed models for the care. Not for profit, for profit, charities, even union run.

    3. Government regulates.

    For an example of a good system, see Switzerland and large parts of Europe where this is the model, and it works.

  2. MilesJSD
    milesjsd
    05/04/2011 at 12:15 am

    The purpose of the term “Care”, in the National Illnesses, Epidemics, Medications, and Hospitals Service’s underpinning-practicum and overarching-morality greater-context, should be

    to fully support the surviving good-health-habits and sustainworthy-wellbeing-lifestyling efforts of the Person now become a Patient, whilst in the focally-medical sense Treating their Illness/Injury.

    0115T05Apr11.JSDM.

  3. Gareth Howell
    05/04/2011 at 7:10 am

    productivity. Cost effective answers on a postcard please.

    What is the NHS product that keeps it in business and thriving?

    Relief from Pain, sickness, and death? Now the latter would be something.

  4. Carl.H
    05/04/2011 at 8:36 am

    Let’s make no mistake what is planned is privatisation. GP consortiums, an extra layer of costs, being allowed to decide if they buy NHS services or the likes of BUPA.

    Now in my experience, the same surgeons and Doctors work for both the NHS and BUPA, it will be a battle of costs. And whilst the NHS will be burdened with those cases that are more expensive and long term, the ones BUPA say no to, the private industry will be able to pick and choose.

    The NHS should neither be about targets or competition. GPs are not the people to decide the best form of treatment for serious illness. I ask the noble Baroness, as an expert, would she allow a GP to decide the best way to treat mental illness in a geriatric ?

    We have spoken of postcode lottery’s in terms of treatment before, well exactly how will this system help ? A patient unable to get what THEY WANT from one consortium of GPs surely will move to another ?

    NHS trusts will still need to be run, they will still need the management but now they will need salespeople. GP consortiums will need setting up correctly, time and money. We are simply adding another layer of bureaucracy, accountants and costs.

    Whenever you open a service up to competition there will be an inevitable drop in standards as costs are driven down. Low prices are not a measure of effectiveness. One of the often mention thoughts on quango’s are that these bodies are ineffective and have no teeth, this Government has seen that and yet here it is trying to implement Ofhealth or Monitor.

    This bill is dangerous to your health and can lead to Cancer of the NHS.

  5. Teithiwr
    05/04/2011 at 9:17 am

    It doesn’t seem to have been mentioned in this post or previous posts on the subject but my understanding is that the Health and Social Care Bill under discussion relates only to proposed changes to the NHS in England and not the NHS in Scotland, Wales or Northern Ireland. Although the Westminster Parliament is becomingly increasingly irrelevant to daily lives of citizens in 3 of the 4 nations that make up the UK, it would be useful if those posting could clarify when the issues they raise are not relevant to Scotland, Wales or Northern Ireland.

    • Gareth Howell
      06/04/2011 at 7:59 pm

      relevant to Scotland, Wales or Northern Ireland.

      If those regionsEUspeak, nationsUKspeak, have their own legislatures, presumably judgements and proceedings about the NHS in those regions/nations are made by them.

      If decisions about the NHS are made in London for the whole of the UK, they would be delegated to those regions for approval, since/if they are legislatures in their own right.

  6. maude elwes
    05/04/2011 at 4:39 pm

    Earl Howe audio:

    http://www.kingsfund.org.uk/multimedia/lord_howe_on_the.html

    A lot was vague. In fact, from my point of view, there was no real explanation on the method they are planning to use to set this in motion. How are they expecting GP’s to handle the vast administration being passed to them from PCT’s? Each GP has around 6,000 patients. The enormous amount of additional work for a regular practice, not including the surgery hours, would be phenomenal. How is this going to be accounted for?

    The best GP surgery you can visit, I believe (they do most of the tests in house and the patient/GP ratio is excellent) but, it is fee paying, and run by, Robert Lefever, at the PROMIS unit of Primary Care. However, he always complained he had to give up NHS work because of the bureaucracy. The paper work made it impossible to stay focused on what was important, which is the patient and their needs.

    http://www.totalhealth.co.uk/clinical-experts/dr-robert-lefever

    He would be an excellent source of reference.

  7. Twm O'r Nant
    07/04/2011 at 6:43 pm

    increasingly irrelevant to daily lives of citizens in 3 of the 4 nations that make up the UK, 5m people out of 60m one twelfth of the population? Or 3m if it does not include Scotland.; one twentieth of the population.

    However the delegation of responsibility to these regions would be exactly the same as to any other English region, say the Wessex region, or the North Eastern region, except that it would be inspected and reviewed by the “regional” or “national” assemblies of those countries.

    Fortunately there are not seven or eight “National” assemblies, or nations(!) in England too; they are merely called Regions!

    Delegation to the regions of England would be a direct responsibility of civil service Health Department in Whitehall.

    In my view even this is regrettable and not in the best interest of economy. The English regions should have their own “expanded county council” style assemblies, but this was turned away by an idiotic referendum in one of the regions in about 2002.

    The county councils are moving towards greater integration as regions; the district councils are now appointing a JOINT Chief executives for two districts of a county, which can only be good, and economical.

    When counties appoint a chief executive between counties I shall really be cheering from the roof top.

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