Forum topic: Coming to the defence of the NHS
Coming to the defence of the NHS
Basil Clarke
15 Feb 2017 20:00 #2748
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In recent weeks scarcely a day has gone by without new and very disturbing information about the crisis in the National Health Service. Ever longer waiting times in A&E departments, postponement of non-emergency operations, skilled surgeons having to waste their precious time waiting for beds to become available, hospital doctors buckling under stress, and so on - it seems that the tremendous improvements that we saw in the first decade of this century have all been overturned.
All around the country people are coming together to form local NHS defence groups. Here in Enfield a group calling itself Defend Enfield NHS (DeNHS) was set up last year. This weekend it will be holding its first public meeting (10am on Saturday 18th February at the New Crown in Southgate).
Ahead of the meeting DeNHS has issued a document setting out its concerns and the steps it is taking to defend the NHS in Enfield.
Far from being a ‘money pit’, NHS funding is now reduced to 8.5% of Gross Domestic Product (GDP) compared with France’s 10.9% and Germany’s 11% GDP health spends. They face the same challenges as the UK - ageing populations, obesity, smoking and long term conditions like diabetes.
Every year more services are contracted out, with 40% of contracts going to the private sector in 2015. £250 billionhas been spent on using the private sector to build new hospitals, often locking the NHS into long-term loan repayments at high rates of interest, instead of spending the money on patient care. Far from boosting efficiency, the requirement for NHS commissioners to buy in services on a competitive basis adds in an extra layer of bureaucracy and is very expensive for both purchaser and provider. It is estimated that every year £4.5 billion is wasted in this way - enough to pay for either ten specialist hospitals; 174,798 extra nurses; 42,413 extra GPs. Meanwhile there are 25,000 nursing vacancies and the pay freeze has seen the value of NHS salaries reduce by 14%.
Local people still remember how Highlands Hospital was closed in 1993 and the closure of the accident and emergency department at Chase Farm Hospital in 2013 without providing suitably enhanced services to compensate.
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Coming to the defence of the NHS
Basil Clarke
15 Feb 2017 20:41 #2749
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If you're not convinced that the NHS is in mortal danger, here are some links from reliable, non-radical sources that might make you change your mind.
First off, an hour-long expert debate on the Radio 4 programme Inside Health, entitled NHS Special: What needs to give? The programme entitled Why hernias, hands and varicose veins might not be treated on the NHS is also a must-listen.
http://www.bbc.co.uk/programmes/b019dl1b/episodes/player
Then some of the articles from the first two days of a week-long investigation into the state of the NHS in the i newspaper. There are another three days to go yet...
The Great NHS Gamble: What we have investigated and why it is important to you
https://inews.co.uk/essentials/news/health/great-nhs-gamble-investigated-important/
STPs: How they will shake up the NHS and what they mean for you
https://inews.co.uk/explainers/great-nhs-gamble-stps-mean/
NHS crisis: 19 hospitals face axe as doctors accuse Government of deliberate underfunding
https://inews.co.uk/nhs/nhs-crisis-19-hospitals-face-axe-as-doctors-accuse-government-of-deliberate-underfunding/
A&E doctor writes: I don’t have the capacity to be caring – it’s soul -destroying
https://inews.co.uk/opinion/comment/nhs-crisis-working-ae-i-dont-capacity-caring-soul-destroying/
I gave away a kidney because I love the NHS – now I fear privatisation
https://inews.co.uk/essentials/news/great-nhs-gamble-i-gave-kidney-nhs-not-i-made-sacrifice/
How £18m of taxpayers’ money was spent on private consultants to plan NHS cuts
https://inews.co.uk/essentials/news/health/great-nhs-gamble-17m-public-funds-spent-private-consultants-save-health-service-money/
The full list of the 24 A&E units marked for closure
https://inews.co.uk/nhs/full-list-24-aes-marked-closure/
NHS crisis revealed: 24 A&E units marked for closure or downgrading
https://inews.co.uk/nhs/nhs-crisis-revealed-overhaul-means-dozens-of-ae-units-face-closure/
How to speak NHS manager: Decoding the jargon that obscures the cuts
https://inews.co.uk/nhs/great-nhs-gamble-cquins-dr-first-triage-jargon-obscures-plans-reshape-health-service/
The cuts and changes planned for your local NHS
https://inews.co.uk/nhs/cuts-changes-local-nhs-planning/
The Great NHS Gamble: What we have investigated and why it is important to you
https://inews.co.uk/essentials/news/health/great-nhs-gamble-investigated-important/
First off, an hour-long expert debate on the Radio 4 programme Inside Health, entitled NHS Special: What needs to give? The programme entitled Why hernias, hands and varicose veins might not be treated on the NHS is also a must-listen.
http://www.bbc.co.uk/programmes/b019dl1b/episodes/player
Then some of the articles from the first two days of a week-long investigation into the state of the NHS in the i newspaper. There are another three days to go yet...
The Great NHS Gamble: What we have investigated and why it is important to you
https://inews.co.uk/essentials/news/health/great-nhs-gamble-investigated-important/
STPs: How they will shake up the NHS and what they mean for you
https://inews.co.uk/explainers/great-nhs-gamble-stps-mean/
NHS crisis: 19 hospitals face axe as doctors accuse Government of deliberate underfunding
https://inews.co.uk/nhs/nhs-crisis-19-hospitals-face-axe-as-doctors-accuse-government-of-deliberate-underfunding/
A&E doctor writes: I don’t have the capacity to be caring – it’s soul -destroying
https://inews.co.uk/opinion/comment/nhs-crisis-working-ae-i-dont-capacity-caring-soul-destroying/
I gave away a kidney because I love the NHS – now I fear privatisation
https://inews.co.uk/essentials/news/great-nhs-gamble-i-gave-kidney-nhs-not-i-made-sacrifice/
How £18m of taxpayers’ money was spent on private consultants to plan NHS cuts
https://inews.co.uk/essentials/news/health/great-nhs-gamble-17m-public-funds-spent-private-consultants-save-health-service-money/
The full list of the 24 A&E units marked for closure
https://inews.co.uk/nhs/full-list-24-aes-marked-closure/
NHS crisis revealed: 24 A&E units marked for closure or downgrading
https://inews.co.uk/nhs/nhs-crisis-revealed-overhaul-means-dozens-of-ae-units-face-closure/
How to speak NHS manager: Decoding the jargon that obscures the cuts
https://inews.co.uk/nhs/great-nhs-gamble-cquins-dr-first-triage-jargon-obscures-plans-reshape-health-service/
The cuts and changes planned for your local NHS
https://inews.co.uk/nhs/cuts-changes-local-nhs-planning/
The Great NHS Gamble: What we have investigated and why it is important to you
https://inews.co.uk/essentials/news/health/great-nhs-gamble-investigated-important/
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The NHS crisis - facts and figures
Basil Clarke
15 Feb 2017 22:24 #2751
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More evidence of the NHS crisis. "STPs", referred to below, are the sustainability and transformation plans that are currently being drawn up, with the twin aims of improving NHS services while simultaneously cutting costs significantly.
Dr Marlowe's concluding remarks:
Amongst all this gloom remember the NHS was declared the best healthcare system in 2014, by an international panel of experts and led by an American charity, who rated its care superior to countries which spend far more on health. The same study castigated healthcare provision in the US as the worst of the 11 countries it looked at, despite spending the most, as many patients in need are denied care because they do not have health insurance, it is also the poorest at saving the lives of people who fall ill. Published in 2014 this report was produced by the Commonwealth Fund, an internationally respected Washington-based foundation. They examined an array of evidence about performance in 11 countries, including detailed data from patients, doctors and the World Health Organisation. "The United Kingdom ranked first overall, scoring highest on quality, access and efficiency"
As chair of the BMA London Regional Council, Gary Marlowe recently presented a synopsis on the variants creating the current situation in the health and social care environment:
- 2014/15 spend on NHS £135 billion = 7.3% GDP. By 2020/21 this will decrease to 6.6% amongst lowest of any OECD country
- We have fewer beds, 2.8 per 1000 pop than almost all OECD (Germany 8.3, Poland 6.6) in 2011 and STP plans are to decrease this between 5 and 20%
- We have fewer doctors, around 2.8 per 1000 than most of Europe (only Slovenia, Romania and Poland have less)
- Current spend per head per year in England = £ 20657, lower than other European country
- The Five Year Forward View estimates a funding gap of £30 billion per annum by 2020/21. To close the gap the government have proposed £10 billion extra funds and £22 billion efficiency savings. However, when the Health Select Committee (Chaired by a Conservative MP) examined the figures, for current year its actually £4.5 billion
- The important fact to hold on to is the eye watering £22 billion “efficiency” savings = cuts.
- Hospital deficits grew form £859 million in 14/15 to £2.54 billion in 15/16. PFI is a significant contributor to the deficits (eg Barts Hospitals Trusts, the biggest PFI in the UK, pays approx. £2 million a week in interest payments)
- The 4 hour A&E target is now only 88.4% (target was 95%)
- Delayed discharges are >25% up from last year
- Number of emergency admissions have gone up by 2.9% (this at a time when all efforts are being made to keep people out of hospital) suggesting that it’s the truly ill who are attending A&E
- STPs in theory are an excellent idea but a “must do” is to operate within the “system control total” i.e. they have to save money. They appear to be completely subservient to the financial imperatives
- Public Health and preventative policies will only show dividends decades down the road.
- Much of the STPs are predicated on shifting work out of hospital to primary care. However, primary care is on its knees with low morale, high vacancies and a retirement time-bomb. NHS spend on primary care in 05/06 was 10.4% of the total, decreased to 8.1% in 14/15 and now around 6%. This is while providing 90% of patient contacts.
- A solution that is often touted is increasing skill mix using Health Care Assistants, Pharmacists and Physician Assistants. The evidence is that this improves quality of care but does not save money or replace medical professionals. It in fact might turn out to be more expensive.
- In the 2015 Spending Review there was a 20% cut to non-ring-fenced Health spend. This included education with a loss of nursing bursaries just when we are desperately short of nurses (vacancies have increased by 60% and applications for training posts have fallen by 20%)
- Last year £13 billion of health care was purchased from private providers, an increase of 76% from 2010. On the other hand NHS receipts from private earnings increased by 30% to £558 million (the beginning of a truly 2 tiered system within our own NHS hospitals)
Dr Marlowe's concluding remarks:
Amongst all this gloom remember the NHS was declared the best healthcare system in 2014, by an international panel of experts and led by an American charity, who rated its care superior to countries which spend far more on health. The same study castigated healthcare provision in the US as the worst of the 11 countries it looked at, despite spending the most, as many patients in need are denied care because they do not have health insurance, it is also the poorest at saving the lives of people who fall ill. Published in 2014 this report was produced by the Commonwealth Fund, an internationally respected Washington-based foundation. They examined an array of evidence about performance in 11 countries, including detailed data from patients, doctors and the World Health Organisation. "The United Kingdom ranked first overall, scoring highest on quality, access and efficiency"
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Coming to the defence of the NHS
Chrystalla Georgiou
16 Feb 2017 16:23 #2761
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Its very upsetting to know that the NHS is being badly treated, human life is just not valued. Politicians publicly praise the NHS and privately they deprive it of necessary funds. Cruel.
It not the country that is rich but the Government, to me its not the same thing.
It not the country that is rich but the Government, to me its not the same thing.
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Coming to the defence of the NHS
Basil Clarke
16 Feb 2017 18:16 #2766
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The Sustainability & Transformation Plans (STPs) have some very good ideas for improving health and social care - but transformation can't be done on the cheap. Trying to transform and simultaneously make big savings is either madness or the whole thing is designed to fail, at which point the government can say "We tried to fix the NHS, but couldn't, which proves that universal health care free at the point of delivery is no longer viable."
For more, from the people who understand the NHS - the doctors, see https://www.bma.org.uk/news/2017/february/nhs-needs-9-5-to-transform?imgdoctors=
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Coming to the defence of the NHS
Bill Linton
17 Feb 2017 19:02 #2769
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I fear everything points to the latter conclusion. This government is heading hell-for-leather towards the privatisation of the NHS. They keep saying they're not, but actions speak louder than words. Services are cherry-picked and sold off - I think I heard that 10% of the NHS budget is spent on the bidding process for all that! Private providers would have to be incredibly more efficient than the nationalised service to make up for that, as well as provide a return to their shareholders. What results in practice is money-saving by staff cuts, and hence a worse service. No wonder the staff are in despair.
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Coming to the defence of the NHS
Darren Edgar
02 Mar 2017 12:31 #2844
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The NHS is thoroughly abused and will eventually die unless free POS is removed (even partially).
Almost lost part of my leg last summer due to Dr incompetence at North Mids, main reason I'm healthy & walking now is being able to get treatment under my private medical insurance cover.
Almost lost part of my leg last summer due to Dr incompetence at North Mids, main reason I'm healthy & walking now is being able to get treatment under my private medical insurance cover.
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Coming to the defence of the NHS
Bill Linton
02 Mar 2017 14:05 #2848
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You may have just been unlucky in your doctor, David. Every profession has its share of incompetents, and also competents who have off days. The general impression people seem to have of the NHS is of dedicated and caring professionals doing a good job, but snowed under with mounting volumes of work to be done on a shrinking (or not expanding fast enough) budget.
If we lose 'free at the point of provision' we're heading for the American model where only the rich can afford to get ill. I saw a tweet the other day with a hospital bill for a 6 days stay (with op) coming to more than $50,000: pic.twitter.com/bchsXEITwf
Likewise when the NHS started in 1948, doctors' surgeries were packed out with people with diseases and injuries they'd suffered from for years and could only now afford to get treated. Let's not go back to that pre-1948 situation.
If we lose 'free at the point of provision' we're heading for the American model where only the rich can afford to get ill. I saw a tweet the other day with a hospital bill for a 6 days stay (with op) coming to more than $50,000: pic.twitter.com/bchsXEITwf
Likewise when the NHS started in 1948, doctors' surgeries were packed out with people with diseases and injuries they'd suffered from for years and could only now afford to get treated. Let's not go back to that pre-1948 situation.
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