Psst! The NHS is starting a funding revolution – but don’t tell anyone!

As far as the main stream media have been concerned, things have been very quiet at the Department of Health recently, so this prompted me to have a dig around to find out what our erstwhile health team have been up to.

Interestingly, Lord Darzi, one of the Health Ministers, is initiating a little publicised project called Personal Health Budgets (PHB), a new way of funding NHS care for chronically ill patients.  I first wrote about this here in January, but this week the Trusts undertaking the pilot schemes have been announced.

My criticisms of this project remain the same, while I applaud this initiative, I do not think that it goes far enough.  My view is that if projects like this are to really work, patients must be able to purchase care from the private sector as well as the NHS.

As part of my digging around I telephoned the PHB office.  Here while asking one question, “Will patients be able to purchase care from the private sector?”, I was passed around to speak to a number of people within the department.  The general gist of the replies I got was that the guidelines have not been developed yet, most of their experience is in social care not health so they are not sure what will be decided for health care and finally, they are not sure what will happen if patients become acutely ill because patients do not have the experience or knowledge to make such ‘difficult’ decisions! (or to put it bluntly, patients are not trusted to make decisions because the bureaucrats might not like the outcomes!).

This leads me to suspect that yet again an enlightened project will be derailed a bureaucracy that really doesn’t want patients to behave like customers.

 

Nothing New from the Royal College

Given the perilous times that we live in with the current economic climate, so ably discussed in this new Institute of Economic Affairs publication, there was a fantastic opportunity for the Royal Collect of Nursing at their congress this week to lead the way in setting the agenda for healthcare during the recovery period given that it is generally accepted that there will have to be sweeping public sector cuts.

However, it seems to me that this was barely mentioned at congress.  There were a couple of debates that seemed to conclude that financial considerations should not sully the waters of patient care, but the RCN once again demonstrated that they have no teeth!

Now is the time for them to lead the way, to recognise that the NHS has never worked, with billions of pounds pumped in to it in recent years patient care and outcomes have got worse and the system is in demise.

Come on RCN ’smell the coffee’ as they say, embrace the market and lead the way in demanding a better way of providing health care in the UK.

 

What are the Royal College of Nursing thinking?

I will be writing more on the Royal College of Nursing tomorrow, but in the mean time I just had to link to this.  At a time when the NHS is falling down around our ears do the RCN really think that discussing the implementation of a national uniform is a priority?

 

Choose and Book

It seems that Government sources are using Nurses for Reform to defend some of their policies.  In responding to an attack on choose and book by some in the medical profession they cited a blog entry of mine to demonstrate that NFR are in support of the system.

 

Lessons Obama needs to learn from NICE

Today I have had this paper published by the Heritage Foundation.  It is part of their briefing paper series and details the history of Health Technology Assessment, the mistakes made by the UK with NICE and some of the systems used in other European countries.

 

More NHS Rationing by waiting…

My mother needs an operation on her knee and is, unfortunately, at the mercy of the NHS.  After quite a bit of waiting, lots of letters and so many telephone calls that she has lost count, she managed to get an appointment with an Orthopaedic Consultant, an MRI scan and another consultation.

Although the consultant confirmed that she will more than likely require surgery, he wanted her to have some physiotherapy first.  That is when the entire situation turned in to a farce!  Again, numerous letters and telephone calls have been required and she is at last on the, wait for it…,  waiting list for physiotherapy.  The real joke is that the waiting list for physiotherapy is so long that her appointment to see the consultant to assess its value is scheduled for early March, before she is actually due to start the physio!

You really couldn’t make it up could you?

 

More joined up thinking from the NHS!

This report on some suggestions for the NHS to combat “climate change” (let’s leave arguments about that for another day!) beggars belief.

To pick up on just two points.   When we know that, according to the Malnutrition Advisory Council, between 40 and 60% of patients in NHS hospitals are suffering from some degree of malnutrition, why on earth are the Government proposing to remove meat from NHS menus?

Secondly, as many clinicians will know, vast amounts of time and money have been spent by NHS Trusts and PCTs in recent years implementing new decontamination guidance and the promotion of single use equipment to reduce the incidence of Healthcare Acquired Infection (HAI).  Now in the interests of “saving the planet” we are supposed to put lives at risk by going back to sterilising re-usables.

This is just another example of inconsistent nonsense from the Government.

 

Why we must choose Choose and Book

This is an interesting comment from a Consultant Surgeon on the subject of the NHS system Choose and Book.

While readers of this blog will know that I am a fierce critic of the NHS, I do think that Choose and Book is a system that is great for the patient and their families.  The importance of Choose and Book is twofold, not only does it it begin to make the patient feel and act like a customer, it also makes doctors pull their socks up!  No longer will they get patients referred to them just because they are there at the local hospital, they will have to demonstrate for example, how good they are and how low their infection rate is. However, I am sure that Consultants who do not like the system will go out of their way to sabotage it.

As in the BBC article some NHS Consultants do not like this and tend to use patronising phrases, such as;

How many patients know enough about the health service to make a really informed choice?

Not many, is the answer.  However, not many of us know about the workings of the internal combustion engine, but that does not stop us from doing our research, talking to our friends and reading magazines such as Which to enable us to make an informed choice about buying a car.

This will happen with healthcare too.  There is already information out there such as the work done by Dr Foster and people will still be discussing their referrals with their GPs.

So Nurses for Reform says embrace Chose and Book and remember that your choice of hospital is not restricted to the NHS, you can go to the independent sector too with your NHS funding.

 

Re-inventing the Wheel

It really makes me wonder how low standards of NHS care have dropped when I see reports like this.  I was an operating theatre sister at a large London teaching hospital in the 1990’s and it was part of my job to make sure that these checks like theses were undertake and that the patient journey through our department went smoothly and safely.

What has happened to clinical care if this has to be introduced by the Government and the WHO as some wonderful new practice?

 

Shameful

This very sad report in today’s Daily Mail speaks for itself.  Sadly, it is one of an ever increasing number of stories about the failures of the NHS.