The Three Amigos: listening to worries over NHS reform
Am at The Three Amigos production in a Surrey Hospital launching the government listening process on NHS reforms.
The PM, DPM and Health Secretary are side by side…
(Listening hard? Nick Clegg, David Cameron and Andrew Lansley in Camberley, Surrey)
It’s very important David Cameron keeps Andrew Lansley onside – he has given him enormous responsibility with a charge, the NHS, he says is sacred. It would look like a colossal failure of judgment by Mr Cameron himself.
But the DPM has a big problem in his Lib Dem backyard. He acknowledged this morning that a pause in the middle of a bill was “a bit unusual” and said it was understandable people wanted accountability for GPs.
Andrew Lansley watched Nick Clegg like a hawk while he spoke and seemed to relieved to hear no ratcheting up of the rhetoric, something the Lib Dem leader has been felt to have done in some earlier interviews.
I suggested to David Cameron in the Q and A session that a “pause for thought” should probably happen before you start a massive reform like this – surgeons don’t pause for consultation halfway through major surgery. He said that was the wrong metaphor because this was evolutionary change not radical surgery.
Prof Steve Field who will head the government’s pause for re-think on NHS reforms just told me that he “can’t see how we can do it (the reforms) with just GPs on their own …. (there) needs to be clinical involvement, more meaningful patient involvement…” The Health Secretary says the same thing but it’s not clear how involved these non-GPs will be … Andrew Lansley says they will be “involved” in commissioning decisions.
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As the man said when asked for directions ‘If i were you, I wouldn’t start from here’
Clegg promises they are not privatising the NHS – but he also promised to oppose an increase in tuition fees – but they’ve admitted that GPs won’t have to handle the business side – ‘they will hire people to do that.’
So waiting in the wings are a number of companies ready to fulfil that role. And how long before they start finding ways to make the whole thing more ‘efficient’ and ‘profitable’ by hiving off parts of it to private insurance schemes?
Impossible? it happened with my NHS dentist who found he couldn’t give the ‘standard of service you deserve’ on the NHS. I now have to pay £32 a month just to keep my dentist (and there are no NHS dentists available)
And those of us of a certain age can remember the stigma of kids who had NHS glasses (identifiable by their cheap frames). I’d love to have my lenses and even frames paid for by the NHS now.
If it can happen with teeth and eyes, it can happen with other bits of us and that is the way it seems to be heading.
Is it cost effective for three of the top paid people in the government to go on this listening spree together, especially when we know it won’t really make any difference to their dogma?
Why not split up and listen to three times as many people, then report back to each other? Or don’t they trust each other to tell the truth?
While on cost effectiveness, MPs recently successfully lobbeyed for more of them to be paid for overnight accommodation because parliament sits so late they can’t get home.
Instead of that, why don’t they stop working to university terms? If parliament sat all the year round except for say three weeks in the summer and a week at Christmas/New Year (a bit like the rest of the working population) they could get the same amount of work done without sitting late into the night. Even more of them could get home.
Of course it would screw up those who work for other people during the day and bowl up at the commons just to vote but to hell with them.
I could , but I won’t because it is unethical, give at least 12 recent scenarios where a pause for thought and liasonship between staff with minds engaged in solving problems rather than either wanting to take glory or blame and shame for similar glory would have been in the best interests of all concerned. Competition where patient care is concerned has opened a hornets nest of lies and unscrupulous behaviour.
The more powerful the person at fault or at least blamed , if indeed there is a fault, will have more powerful protection or a harder fall.
This isn’t patient care .. it is competition. What we need is working together in a spirit of cooperation to serve the publics interest.
The three Amigos, as the tone and allusion goes , need to know that 2 beans , 1 bean ,a bean and a half and half a bean make 5 beans and experience does not make a has been.
Thank you, Sam and Margaret. I agree.
Has anyone asked GPs whether they want to do this? I remember something similar under Margaret Thatcher and our local GP surgery didn’t want anything to do with it. I find Cameron’s words somewhat disturbing ”I believe passionately in our NHS and I make no apologies about this.”
What DOES he mean?
And these wonderful Private Companies that we not be held accountable-Or Transparent. I actually like my taxes going to the NHS, I have HAD 1 life saving operation and many other minor ones over my lifetime, and to think a company is going take over and then give a dam about the patient is misguided. The patients will just become another unit of PRODUCTION!! Never Mind the Politics and LIES fed to us by the TORIES & CO…..
A lot of emotion is being generated by the fear of so-called ‘privatisation’ – but the NHS is already largely privatised.
Your ‘local hero’ GP is not an employee of the NHS – he or she is a self-employed (or partnership) contractor – the local GP ‘Surgery Business’ charges money to the NHS for the service it provides based on an agreed formula. The GP (or GPs) then run their independent business unit and, at the end of the year, share out the ‘profits’. That’s privatisation, and it’s been at the core of the NHS since 1948. So what is everyone getting so emotional about ?
The Three Amigos have missed a trick in not emphasising this aspect to demonstrate that private elements are wholly compatible with the concept of the NHS at any point.
They should also bang the drum about there being no change to the principle of ‘free at the point of delivery’. That’s the public’s real hot-button.
Once these two aspects are nailed, the true source of all the fake emotion could be revealed – it is the huge vested interests of feather-bedded employment which are stirring it all up, and it looks like the Coalition is not bright, or confident, enough to address this…
I qualified as a nurse in 1970.I worked in the NHS in a variety of settings until I retired in 2008 as a community hospital manager.I am increasingly now a patient. I agree with every word that Mudplugger says. Any government must stand up to “the huge vested interests of feathered-bedded employment”. These changes are vital for the interests of PATIENTS.But I fear that that political cowardice will win again.
According to a repoert in the Guardian Cameron ‘claimed the changes were already working, with 3,000 fewer managers and 2,500 more doctors in place.’
I think he can take credit for putting 3000 people out of work but unless he has found a way of training doctors in a year, surely the credit for the extra doctors goes to the previous administration and system?
I agree with Mudplugger. There is a huge amount of hot air being expended suggesting that sinsiter and unscrupulous beings will come along and destroy the NHS for profit. This is conspiracy theorising and is not very helpful.
The coalition have an amazing inability to communicate some simple realities. One of these is that the NHS has become bloated and wildly wasteful of resources.
I have been unfortunate enough to have more than enough first hand experience of the NHS and I would say that in many ways it is absolutely world class, just as in many ways it is very badly run. What I think the coalition is trying to do is to cut the waste and mismanagement to redirect resources to front line medicine where they are badly needed. They are just hopeless at communicating that.
mudplugger. to condense your blog. basicaly
the health service is privatised in all but name
and staff, it is not totaly free at the point of
delivery we pay national insurance, the main reason it is not totaly, privatised by now. and
why the three amigos? are pressing all the wrong buttons