Does the Coalition have any idea what NHS reforms to put in place?

Cameron has tossed a bombshell into the NHS

reform ring, without any clear-cut idea of what

the Coalition’s reform strategy is going to achieve.


There has been lots of talk about the need to save money,

but anyone trawling through NHS reform proposals will find glaring examples of where these are actually going to cost money.

Negotiating the slippery NHS reforms

Delivering his ideas for NHS reform to the House of Commons, Cameron was questioned  by Ed Milliband:

“Patients want to know something ………. how long will they have to wait for treatment?”

All Cameron could come up with was  “We want to see waiting times and waiting lists come down”.

No promises of definite action there, just a wishy-washy half-hearted phrase that meant nothing.

Cameron’s advisors must have seen this question coming – so why no robust response?  Only his ineffectual reply, and anyone who follows Whitehall-speak knows this means ‘we haven’t a clue’.  Which rather sums up all the proposals, jaw jaw, counter-proposals and rhetoric that is coming out after the White Paper proposals.

Then, if you looked and listened carefully, came the bombshell.  Instead of listing what was going to be saved, and possible savings, there was a statement that the overall costs of the reforms is estimated at £1.4 billion.

Now tell me if I am wrong, but I thought the idea was to SAVE money – not to spend it?

We all know the NHS needs radical reform, and last May almost everyone agreed.  But for a party that has had 13 years in opposition to come up with a thoughtful solution to the NHS’s problems, all I can think of is Cameron’s team were playing on their Blackberries without any thought about what they were actually going to do when they came to power.

GPs rule

With the average GP’s earning £106,000 p.a. (Telegraph), the public are fast losing their affection for them.  Once, everyone would praise the family doctor; today – how many actually have a ‘family doctor’ ?  Most of us have become used to being seen under a lottery system, and may never have seen the doctor with whom we have a ten-minute appointment.

Under the new system, we are going to have to cram even more questions into our woefully-brief alloted time, whilst the GP juggles figures over cost of treatment we will need.  Perhaps we will even be fobbed off with ‘wait and see’, when we want to get on and find out what is wrong with us.  Currently it is bad enough waiting for tests – what is going to happen when GPs have decided on how much they are going to spend each month on ‘commissioning’ tests and other services – and the budget has been spent?

And already this is happening.  Last month I needed the all-important referral letter to get to see a certain Consultant over my problems with drug side effects.  I had been to see the ‘expert’ at our local hospital, whose knowledge of drug side effects wouldn’t even have covered a pin-head.  Presumably the NHS Practice would have already commissioned my appointment with this ‘expert’.

I am sitting in GP’s surgery, talking to a locum doctor whom I had never met before, who tries to tell me the ‘expert’ I saw is “a marvellous dermatologist”.  I point to the proof in a letter sitting in my file, but still he tries and tries to get me to go back to see this bully – was this because a repeat visit wouldn’t take up any more of the surgery’s budget?

Eventually I just sat there until I got my ‘Patient Choice’, but how many people would have given in?  Obviously it would have been cheaper for me to go back to the original ‘expert’ consultant than go to another hospital, further away, to see the person I wanted to see.

Appointments

Politicians love to talk about the ‘Broad Picture’.  But the public doesn’t want that, they want to know when they need something, it is easy to access.  But get down to basics, get those right, and the rest will follow.  As an example, they could start with the Appointments Line, and if this worked it would save a huge amount of money:

  • A letter arrives from The Appointments Line with no details – just saying it is a reminder for you to book.  Now, if you are a cancer patient you probably have lots of different appointments, and you rack your brain trying to find out which one you might have missed,  or did you turn up and the system didn’t mark you down?  So you waste yours, and the hospital’s time, phoning around to find what it’s all about
  • Then, to make the appointment you have to give a Password, but with Locums in our surgery, they don’t issue these
  • Then you are told to phone an 0345 number.  Now, over a year ago the Dept. Health were made to promise that they were going to get rid of the expensive 0870 and 0845 numbers.  Sneakily, they now give you an 0345 number which is just as expensive, but how many know this?   Every O345 number HAS to have an 01 or 02 ‘basic’ number.  These don’t cost anything to access under many telephone deals, so why does the NHS insist on using an expensive (to the patient)  0345 number?

I don’t know if I hold the record, but recently I received 14 letters about an appointment.  6 cancelled my appointment, 8 confirmed the date and time.   If that isn’t wasting money which the NHS could save….!!!

Local Clinics

And there are plans to set up ‘local’ clinics – but where is money coming from if NHS needs to save?  As Michael commented yesterday, “I don’t want all this talk by doctors of setting up clinics locally.  If I am having anything done, I want this carried out in a hospital environment, so that if something goes wrong, help is there”.

Where is Patient Centred Care?

The Insulin Dependent Diabetes Trust (IDDT) questions whether ‘Patients Really Are At The ‘Centre Of Care’  after asking Andrew Lansley, for his help.

In June IDDT highlighted the effect that withdrawal of a certain insulin and injection device would have on 90,000 patients; the pressure that only 6 months’ notice would put on NHS staff,  increased costs etc.  What happened?  Jenny Hirst, Co-Chair of IDDT comments, “We were surprised that Mr Lansley’s response showed so little understanding of the effect that this withdrawal would have on patients and on the NHS. He showed an unwillingness to take any action on behalf of patients, especially the most vulnerable groups – those with visual impairment and manual dexterity problems who, as a result of this withdrawal would lose the injection device that enabled them to self-inject and maintain their independence.”

Even the cautious King’s Fund are unhappy, considering the reform proposals were a good move but warning that changes were at risk from “a combination of the funding squeezer and the speed and scale of reforms”.

Cameron doesn’t seem to have learnt much – in 2009 he damned Dan Hannan, the MEP who had spoken out on Fox TV in the USA about the troubles facing the NHS (America was voting on going over to a similar system).  Then Cameron was saying the NHS was fine.  It has taken him just over a year to do an about turn – but now he is Prime Minister it is time to stop the politics and get on and govern.

And next time any of the Government needs A &E, would they please do a ‘Mary Portas’, put on a wig, and go as a ‘mystery shopper’?  They would see a very different side to the NHS than the super-duper ‘come this way’ VIP care they are given “because of security”.

Where is Matron?

Oh dear, common sense seems to have long gone when it comes to managing a hospital.  So many people are saying, “bring back Matron”.  She’d know how to put Lansley and all the policiticans in their place, would know exactly how much ‘her’ hospital was being over-charged by private contractors for second-rate service, would sack the paper-pushing Administrators, and  ‘get things done’ rather that write another report.

If anyone wants someone to carry a banner asking for the return of Matron – I’d love to help!!

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3 thoughts on “Does the Coalition have any idea what NHS reforms to put in place?

  1. Michael Cure January 20, 2011 at 11:24 pm Reply

    Your comments are succinct and entirely spot on.
    It is no good for anyone in any field to say ” I think we should save £20
    billion pounds and bring our service up to par in line with other European nations ” without spelling out very clearly what measures are to be taken in order to bring about the necessary changes.
    It is tantamount to saying ” I would love to win a gold medal in fencing ” and not commenting further, when in fact one should be saying ” I want to win a gold medal in fencing, and in order to do so, here are the ten steps I intend to take in order to bring that about “.
    Anything less is totally and utterly meaningless waffle.

  2. ade balogun January 23, 2011 at 2:37 am Reply

    you are a good sport.
    i love the way you write your articles.
    i believe david cameron is just like the old conservatives.
    everything is cuts, cuts, cuts and very soon, we might be cutting our limbs, arms, eyes, ears and eyes to balance the country’s deficit.
    for how long is this cuts going to be for? 10,20,30,or 100years?
    the thing is to get the spongey, lazy people off their arses to do some work.
    too many fit people are on the dole, or incapacity benefits whilst cancer patients are denied benefits as they are too honest and truthful about their illness and are told to go on to jobseekers allowance.
    Why jobseekers allowance when they are undergoing treatments?
    Also prime minister must ensure tax evaders are fined heavily to pay the growing deficits?
    Thank you
    ADE

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