Monday, June 30, 2008

Quality ranking key to NHS funds

Patients' rating of the quality of their NHS care will affect hospitals' and GPs' 

funding in England in the future, ministers have announced.

Information on service quality is also set to be displayed on "dashboards" in hospitals, GP surgeries and on the web.

For example, quality-linked funding could make up between £7-9m of the average district general hospital's budget of around £250m within a few years.



Friday, June 27, 2008

The NHS will be 60 on the 5th July...............

Will it be a Happy Birthday ?

The NHS was born on 5th July 1948 and was the “child” of Nye Bevan and at the time a sorely needed service to the Welfare state.

Much has evolved over her 60 years and most of the , some say unwelcome, changes have happened since the 1980's, mostly due to more administration and targets and less to do with patients. Many NHS staff and supporters think that these changes are merely political interference and the NHS being used as a political pawn.

That aside there have been many new surgery techniques, drugs and working practices adopted and there have been many Department of Health enforced changes to staff roles in the 60 years.

So all is looking rosy for the elderly lady then?

It was not until the 1980's when the then Thatcher government managed to get is hands on the NHS did we see the foundations of the current NHS problems start and the beginning of Targets and G.P fund holders and these were also accompanied by some staff changes, at that time some staff posts were ended such as Matron's and not much fuss was made.

Mrs Thatcher used the targets to beat the opposition in Parliament for some years with the “we can run the NNS better than you” message. Meanwhile she was planning to Privatise the NHS by the back-door, under the noses of the Patients who were wrapped up in their tax cuts, high interest rates (17%) and getting a job (3 million unemployed).

She did begin privatisation by introducing the Compulsory Competitive Tendering system which affected both the NHS and Local government, as can bee seen even today we are still suffering from this legacy, some Councils still have contract Bin men and many NHS hospital’s have Contract cleaners. This idea was sold to the people on the basis that it would be cheaper and would promote efficiencies, in reality we know the results, MRSA and other superbugs due to shortcuts and poor cleaning methods and also it isn't cheaper either in the long run, How much has it cost the Taxpayer for the recent “Deep Clean” exercise? And why were the cleaning companies not penalised and forced to pay up for the bill from their unearned profits they have already banked?.

This system has allowed certain companies to get in the door of the NHS to milk the NHS finances, putting profits before patients and nothing more.

When the Labour party won in 1997, many thought that Mr Blair would be the saviour of the NHS and he did have a good start by injecting more funding into the NHS.

But and there is a big BUT............ The Labour party and indeed Mr Blair himself wanted to follow some of the Thatcher principles and he used the Target culture against the Conservative opposition and he made sure there were over 200 more targets to meet.

The effect of this has been more data collection and the increased investment in the NHS has been wasted on more Administration and Management, rather than to Patient care to satisfy this unending greed for statistics to enable more political clout in parliament and for nothing more.

There have been many new treatments and drugs pioneered and with the imbalance of the weighted head per capita funding a “postcode lottery” has been introduced so that many patients cannot benefit from these treatments. This imbalance is nothing short of criminal and should be addressed as should future projections for the ageing population.

There have been many reorganisations at the Strategic Health and Primary Care levels and these have seen on the Strategic Health area redundancy payments from the 2006 reshuffle, which amounted to £80m yes £80m, what a waste of NHS funds.

Another idea that the Thatcher government introduced in the 1980's was the Private Finance Initiative, when they were in power it was just an idea and on the face of it, it does appear to satisfy the requirement to build new Hospital's but when it is assessed fully it is another waste of NHS cash.

A local example is the Treatment Centre at Hinchingbrooke Hospital, super building, modern, clean and easy to access, the original costs were set as £19m but rose to £22m, this will in fact lead to a final cost over the 30 year contract to the building alone costing £93m yet alone the extra “soft fm” costs of domestics and porters on top. This is just but one example and there are many more across the NHS.

What Next?

The Government have now got a marketisation agenda for England and this is not aimed directly at the Secondary sector (Hospital's) as many are of Foundation Status, but at Primary care level, the level most of us use.

Your G.P, community services and your healthcare is at risk from this attack, with these plans the “son of PFI”, LiFT, will surge forward and linked to the Darzi report, which sees the new Polyclinic scenario; where there are many G.P's and other services are provided in a “one stop shop”.

Some provided by private healthcare companies such a Virgin (What they know about Healthcare is beyond me, they are well known as company who see an opportunity and then take it and then when the profits are not as projected they pull out – like they did in the Power provider and Music shop sectors) .

These centres will probably work in certain areas where there are few G.P's and in a city environment but when in rural areas it will be to the detriment of patients.

There is a current campaign going on locally to Save Papworth Surgery, it is threatened with closure and the people of Papworth, home to the famous Heart hospital will have to travel 8 miles to see a G.P, that is outrageous.

Lord Darzi would do well visit Cuba where they have effective Polyclinics and they also have G.P's working in the system too, and see how that model works.

There are also other areas where the private sector try to ease their way into the NHS, Support Services, by this I mean Sterile services and Pathology labs and the like, locally again there was proposed a “network” of NHS trusts to have a Private company run a “centralised” Sterile service in Thrapston to serve some local trusts with decontaminating surgical instruments, this has now been shelved as Trusts pulled out of the process one by one, you only have to look at the current transport costs and other cost factors to see why.

As for Pathology, there was a proposal in 2007 to have ALL of Cambridgeshire's community blood tests done at Newmarket in Suffolk by a Horse Racing lab, a company was going to be set up of which Addenbrookes in Cambridge would have had a large interest, this would have led to increased blood test turnaround times(from hours to result to days to results), with extra traffic on the roads and now with increased transport costs an increase in the tariff collected would have already been passed onto the G.P's and PCT's. Not cost effective at all and again to the detriment of patients.

This is a big issue with letting Private companies in on the NHS, they as has been proved before with cleaning contracts, only there for PROFIT, they do not care for Patients one iota.

There are some Government ministers and the CBI who claim that the Independent Treatment Centres provide value to the NHS, when in fact they cherry pick easy procedures which give maximum profit and it is well known that for 10 procedures done in an ISTC, 11 are performed for the same cost in the NHS. The other complicated cases are left for the NHS to mop up.

Lets be brutally honest, look at the mess the railways are in, the contract cleaning and other privatised services they are not run efficiently or are cost effective, just a means to satisfy a shareholder profit and blow the service they provide to us the “customer”.

To monitor the performance of these companies it is left to Public companies to have their own system to check on their contractors, again another necessary financial burden.

If the Government get their way here the NHS will be like the Royal Mail, it will bankrupt itself. It will left be that the NHS will only having funding for the complicated procedures and Private companies who the rest of the work, this will result increased costs for the NHS and boom....bust and yes this will happen if they are allowed to get away with it.

The final part of this issue is the latest Government idea, to Franchise out “Failing Hospital's”. They haven't yet said what the definition of a failing hospital is, but on the day of their announcement saw fit to use Hinchingbrooke Hospital as an example.

Naturally the terminology “Failing Hospital” seems unkind as Hinchingbrooke are in the UK's Top 40 hospitals and in the Top 5 for Patient care, so why are they considered to be failing? I understand that naturally, Hinchingbrooke are unhappy about this unfortunate terminology.

It would appear, for Hinchingbrooke that it has been categorised as Failing because of the Labour government caused, Historic debt. The government is solely to blame for this due to the way their policy and strategy changes they have implemented along with their constant reorganisation of the NHS since 2000 which has caused hardship for All District General Hospital's in the UK and given the Foundation Trusts more freedom to go for a market based environment should they choose to.

Now to make sure that the NHS continues to provide free healthcare and be sustainable too, we need to remove necessary targets, remove Private involvement, stop PFI, fund it equally across the UK and argue the case for this valuable Public service

Nye Bevan said 60 years ago “ The NHS will only survive while there are people willing to fight for it”, this is not just a Trade Union issue, not just a Local councillor issue, not just a Politicians issue it is a Citizenship issue, one we ALL need to embrace and fight for this service before they take it away from US, it's OUR NHS...........leave it alone and in public hands

Friday, June 06, 2008

SHA statement regarding Hinchingbrooke

Well our friends at the SHA, in a statement to Radio Cambridgeshire
claim that the replacement of the Hinchingbrooke Trust board
was agreed at last years PCT consultation...................



We believe that the Government should also revisit their
statement and clarify a "failing" hospital..............

Hinchingbrooke is a Top 40 hospital in the the UK in
the Top 5 for patient satisfaction and under the patient
choice system more people including former senior
staff members are using this wonderful facility............
The fight goes on to keep this Hospital in the NHS and not
farmed off to a.n other to try and pay off the government
induced historic debt................

Please read "Caught in the Crossfire" it shows clearly
how Hinchingbrooke was "bullied" into it's current financial
situation by Government policy changes.................

The NHS is a month away from being 60 and its founder said

"The NHS will only survive for as long as people fight for it."

and by golly we will fight for it.................

Wednesday, June 04, 2008

New Government Plans

We said this would 2006
The government have now a crazy plan to allow private companies and or Foundation Trusts to take over "failing" Hospitals and run them...........

So with Hinchingbrooke, where will they go?

Is it a failing hospital?............well it's in the Top, No then

MRSA a, no problem there then

Finance................yes a Historical debt that needs to be sorted out......but, 

WHO CAUSED IT.........................The Government, the very ones who want to sort out
the failing hospitals, how about sorting the failing government policies?

We say leave Hinchingbrooke alone and let them carry on with their current board and
organisation and negotiate a way to sort out the debt