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Reforms!

The government is insistent that we need reforms. They quote cancer death rates to prove this, cancer death rates which have now been debunked. They talk about making the NHS a world leader in health - when it already is. Lies upon lies upon lies to justify a bill which is poorly set out, doomed to fail and will maybe pave the way for privatisation of the NHS.

But this is not what concerns me the most, what concerns me is what happens when you talk to average man or woman on the street and ask them what they think.

They will tell you they support the bill, because they like the word reform, and then they will tell you why they want reform. It always comes from a very personal perspective, something like "My Mum was in hospital for 4 weeks, took them that long to find a nursing home, while she was in she got a urine infection which the doctors ignored and got bed sores because the nurses couldn't be bothered to roll her. We need to change this system."

And I agree, we need to improve nursing numbers, we need to improve access to social care and we need a decent and coherent structure for getting doctors trained and have them the ability to stay on the same ward for more than 2 days at the time so they know the patients, or at the very least know what speciality they are training under.

Private companies bidding for your health and GPs commissioning services will not change any of this.

It will lead to a disorganised and disjointed system. The reason social care takes so long to organise is because it is done through private providers and is not integrated with health care. All HSCB will do is fragment this service further.

You think commissioning healthcare will get more nurses in? In my opinion unlikely, commissioning often means going to the lowest bidder, and what is a companies most expensive asset? Its staff, no more nurses for you then as they cost money.

Training will suffer, I've talked before about how I feel letting 49% of beds go to private companies will end. Training is a shambles as it is, this will only worsen the case. Why else are a quarter of doctors each year jumping ship?

http://www.remedyuk.org/index.php/RemedyUK-News/Why-are-so-many-doctors-leaving-medicine.html

Don't let this bill through, changes are needed, but this bill and its reforms are not.

#HSCB #Health #reforms #reform #doctor #nurse

How the conservatives are doing?

I thought a fun thing to do with my spare time - Happy Valentine's day! - would be to see how good old Mr Cameron is doing compared to his 2010 ideas pledge.

2010: Power for patients to choose any healthcare provider that meets NHS standards, within NHS prices

2012: Not happened yet, I would be interested to know how good old Mr Lansley expects to gets GPs to commision healthcare but then let patients choose whoever they want, sounds tricky to me.

2010: Decentralise power, getting rid of target-led culture and publishing healthcare providers' results. Introducing payment by results system for GPs and other health services [England only]

2012: Lots of targets have gone, lots have simply been rearranged. Take A+E for example, the four hour wait still exists but has allowances for breaches have slipped from 98% to 95%, not the getting rid of we were promised.

2010: Patients put in charge of decisions about their care, including control of their health records [England only]

2012: I had to giggle a bit at this one, it has been fulfilled as long as all patients in the country opted to have their records sold to private companies. Oh they didn't? In that case not so hot Mr Cameron.

2010: Doctors and nurses to get more decision-making powers. Independent NHS board to allocate resources and provide commissioning guidelines. Power for GPs to commission local health services [England only]

2012: Has not happened yet and we are hoping that it won't happen at all! Monitor and the HSCB are starting to have problems, big problems, and if they fail another key health pledge from the election will go.

Source for election pledges: http://news.bbc.co.uk/1/hi/uk_politics/election_2010/8617433.stm

I read the manifesto but this seemed like an easier summary to me!

49%

Let's just call it half, Ok?

The government wants to allow hospitals to have half their beds allocated to private clients, this will allow hospitals to make money along with private comapnies, apparently.

Now I won't lie, I am going from the tabloid version of all this but assuming this all to be true it doesn't half annoy me.

Leaving aside for a moment the whole "NHS is becoming private" line of argument I would like to have a little rant from a doctor's point of view.

I have come across private in patients during my time working under various consultants and to be honest they are a pain in the backside, for as soon as a patient becomes private the become a customer who if not pandered to can take their custom else where, they therefore require more time to be spent on them, they require more tests and they expect all this done quicker. The system I have seen for dealing with patients like this involve your bog standard NHS doctor and nurse having to work extra hard, for no extra money or recognition so that a consultant/hospital can make a bigger buck. Often to the detriment of NHS patients.

You can't simply open up NHS beds to private patients and expect NHS paid nurses, doctors, OTs, Physios, HCAs etc. etc. to be happy about it. It creates a two tier system of entitlement which is exactly the opposite of what the NHS is about. I don't like it, not one little bit!

Prime ministers question time.

Did anyone see it today?

Probably not, most people were at work, but in a post night stoop I followed it, David continues to defend his reforms - of which I am not a fan. Ed does his best to attack them - mixed success.

But my favourite bit of the whole show was at the end, when in order to attack the NHS in Wales which is under Labour control Mr Cameron pointed out how well the NHS in England is doing, the system he says need urgent reform... Which hasn't yet been reformed!

I felt like I was watching a man shoot himself in the foot, can't say I was sorry though.

http://www.bbc.co.uk/programmes/b006nldz - for those who missed the comedy.

#HSCB primeminister irony

Selling our secrets?

The BBC of whom I generally read the most of have this story up on their front page today http://www.bbc.co.uk/news/uk-16021240

It is a story which says quite correctly that the government could if it so wished sell anonymised patient data to healthcare companies.

Shall we have a look at what is really going on? On December 1st 2011 a new government quango was set up - the Health Research Authority (HRA) Their remit - in a typical quango style - was to take over some previous quango's job, and start stealing other bits of work from other quangos therefore not really changing much at all but justifying themselves in the process.

The National research ethics service has now come under the umbrella term and the medicine and healthcare regulatory agency and National institute or research are to work closely with this new "authority"

What was the point of all this? Well, possibly to give someone a headache understanding all these TLAs, but more likely and according to the HRA website they wish to stream line the process by which people apply to do research (not a bad thing) and also approve access to anonymised patient date (Woooh Jimmy!)

This in itself doesn't seem like the end of the world, the NHS does have a lot of data, especially in the community where GPs nicely sort it and present it in order to get QoF points for their prizes however one does have to remain sceptical because:

What does anonymised data really mean? To me it would be no identifiable information at all, including age, address/area or name but some of this is essential to research.

Will GPs, hospital doctors or patients be able to refuse their data being used?

The most worrying thing for me is:

"The Government intends to transfer other functions to the HRA and legislate to establish the HRA as a non-departmental public body"

What further functions are going to be added, and what will research eventually mean? Will private companies be able to access data to research how best to tender their services when/if the health and social care bill come around?

I don't know, but I do worry about what the government is willing to sell/give away to the public sector. If you want me I will be sat in the corner with a tinfoil hat

#nhs #data #confidential #patient safety #private

For reasons I have not yet discussed (much) the health and social care bill is a bad idea, if you've got a minute please sign the petition and we'll see if we can get the bill debated in, not steam rolled through parliament.

Crazy idea I know - democracy? What's that?

#Petitions #democaracy #cynacism

This blogging thing takes some getting used to, bear with me while changes are made, then undone, then redone, the referred to a consulting firm who will tell me it is all fine, charge me £500 and then laugh when it fails - I call this the NHS model!

Interesting times

If you're involved in health in the UK you are no doubt aware of the interesting times we are going through.

The continuing changes the NHS is going through and the new challenges it faces are unending and sadly not in the good way.

I've had my interests sparked but recent events, the health and social care bill for example. A poorly drafted piece of legislation, which is already being implemented poorly and hasn't even been signed into law yet!

The pension fiasco which will be felt by every member of the public sector but on which the BMA - my union - has seemed incredibly quiet on.

Finally the almost criminal under staffing and under resourcing of our hospitals at the expense of patient care.

I have kept my head under the parapet, and been very quiet on all these things. My colleagues don't want to talk about them, not because we're hush hush or unaware of what is going on, but because we're too junior and too powerless to change anything.

Today however, I read something that just tipped me over the edge, a very brave - or very foolish depending upon which side of the fence you stand - orthopaedic surgeon's resignation letter got published ( http://www.scribd.com/doc/74391321/Resignation-letter ). He says some fairly harsh things, about management and about the failings of private providers and then says "I can no longer stand idly by when patients are at best having their human rights breached".

These are damning words indeed, and I think representative of far more than orthopaedics at Barts.

What has spurred me on to start speaking my anonymised mind is not that these events are happening but instead how little attention they receive, if one were to look round the major papers or watch the news tonight there is no mention of this story - Where a surgeon who has worked at a hospital for 30+ years accuses his employer of criminal standards, in fact the BBC who according the guardian helped unearth this letter don't have a single story about it.

I don't expect to change the world, but I hope to start unravelling some wool from in front of people's eyes.

#health #nhs #standards #surgeon #resign #letter #care #human rights

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