Petition to save the NHS

[shadow_boxer]

I'd prefer to go on the tangible evidence we already have - which is that where we already have forms of GP commissioning.

For example, unbeknown to most people, two years ago there was a full transfer of PCT to GP commissioning in Cumbria, which resulted successes: lower costs, better care.

http://www.guardian.co.uk/healthcar...h-gp-commissioning-michael-dixon-nhs-alliance



I'm all for pragmatism, but this argument that SOMETHING BAD MIGHT HAPPEN1!!!!1 is largely based on conjecture and is not a reason for not reforming.

http://www.guardian.co.uk/society/2011/jul/05/nhs-hospital-reforms-needed

That's all well and good about Cumbria but now imagine 250+ CCGs across the country. This is my concern, how are smaller communities going to cope? The commissioning group will only be as good as the local GPs and managers. Might be fine for large cities but I'd be concerned that this so called "post code lottery" we hear about in the media may be exaggerated even further. I'm all for GPs to work with local managers but data shows that the level of primary care services are directly correlate to outcome. Giving too many GPs this extra job just won't work, what makes the Government think that a GP will be better at managing and provisioning healthcare than a dedicated manager whilst also doing his/her surgery?!

Also, Dr Michael Dixon (chairman, NHS Alliance) is a well known advocate of the Bill. Not exactly an unbiased article.

 

[Hatter The Mad]

This is my concern, how are smaller communities going to cope? The commissioning group will only be as good as the local GPs and managers.

Well, let's see? They didn't know how it would scale when the NHS was created, did they? But it evolved, including some trial and error.

Why are you so afraid?

Giving too many GPs this extra job just won't work

Why won't it? Back it up with something.

Also, Dr Michael Dixon (chairman, NHS Alliance) is a well known advocate of the Bill. Not exactly an unbiased article.

So it is wrong to be an advocate based on something tangible? That's like saying "Oh, he's an advocate of eating. Of course he's going to review this food highly".

 

[anything I don't mind]

This is why we should remove the right to vote from public sector workers, a major flaw in democracy and socialism and a massive conflict of interest.

 

[shadow_boxer]

Why are you so afraid?

My main concern is regarding levels of accessibility to primary care. There are currently three times the number of hospital speciality doctors than GPs and occasional difficulty in getting an appointment with a GP is pretty well documented. The general consensus among the majority of GPs is that being involved in the current number of proposed CCGs (roughly 250) would take a lot of resources away from surgeries when they could otherwise be seeing patients.

I do agree there needs to be reform but not in the way this Bill is proposing, or at least in it's current form. I believe the number of commissioning groups needs to be much small and manageable with more centralised governing and provisioning of healthcare. I do recognise your point about Cumbria and it is obviously an evolving process that will take time but if I think if we have too many individual CCGs we won't be making the best use of GPs as the front line in the NHS. There needs to be compromise on both sides.

 

[waxapple]

Thank **** the NHS is devolved in Scotland!

Should probably refrain from signing that as it's nothing to do with Scotland right?

 

[Hatter The Mad]

I believe the number of commissioning groups needs to be much small and manageable with more centralised governing and provisioning of healthcare

Do you not think that most of the problems we have in the NHS now (when it comes to waste and the 'big paint brush' problem) is due to supersized PCTs and over-centralised management of healthcare?

Won't there be substantial benefits in having people more in tune with the needs of a particular community/smaller collection of the population, buying healthcare on their behalf according to demand?

 

[shadow_boxer]

Do you not think that most of the problems we have in the NHS now (when it comes to waste and the 'big paint brush' problem) is due to supersized PCTs and over-centralised management of healthcare?

I do think it is one aspect of the problems but I can't see how decentralising it into very small CCGs will help? Also, it isn't something which need legislation and a new policy IMO. There does need to be some degree of local management but the Bill I think takes it too far to one extreme. The emphasis is right down on the GP where as it I think it'd be most effective at some sort of region level. I think in reality if it does go through, we'd see just a many "managers" etc just at a local level. I can see GP surgeries/groups of surgeries perhaps more likely employing low level local inexperienced managers to help. I don't think it solves the initial problem but just shifts locally.

 

[Hatter The Mad]

shadow_boxer, I see what you're getting at. I disagree with it... but so what.

The bit I do mind is that you still (and no one has, really) provided anything tangible to back up their fears about this bill causing the NHS to collapse, the world ending, the rapture etc.

The only practical, tangible "Yep, they made change X and that seems to have done Y" that relate to the aims and spirit of this bill have ended up working and delivering positive results.

I concede that this bill is open-ended and contains a lot of unknowns and it COULD go wrong. Of course it could - that's the point of it; it provides freedoms. But all present indications are that it probably won't go wrong.

 

[Hatter The Mad]

All I am asking for is for someone who says "It's all going to go wrong, it'll bloat the NHS with even more managers, money will be wasted due to GP's inexperience" to show me where that already happens when GPs have been given power of procurement and more freedoms to manage local health delivery.

You wouldn't think that's much to ask, but it seems it is.

Instead people just find Dr. Misc or Mr. Opposition Random to voice their conjecture and articulate what is essentially the product of their imaginations.

 

[shadow_boxer]

Various other PCTs have also dedicated large proportions of their healthcare procurement, for example in NHS Stoke-On-Trent, 80% of the budget is controlled by a local GP consortium, it's not only Cumbria.

A study carried out by Nuffield Trust into local provisioning of healthcare in the US,

Nuffield Trust is an authoritative and independent source of evidence-based research and policy analysis for improving health care in the UK. We conduct cutting edge research and influential analysis, inform and generate debate, support leaders, and examine international best practice

The Nuffield Trust report concludes that there are clear risks of introducing GP commissioning when the government has placed such a strong emphasis on reducing management costs, and when proposals to develop more extensive co-operation between primary and secondary care remain under-developed.

Report lead author Ruth Thorlby, Nuffield Trust Senior Fellow, said: ‘The message from the US is unequivocal – many English GP consortia will really struggle unless there is a relentless focus on securing and sustaining high-quality leadership and substantial investment in management that can work with key stakeholders and develop strategic commissioning plans that drive innovation and change. More effective collaboration between local clinicians is also crucial.

It also praises the work that can be done and what it can achieve but it mustn't be rushed. Primary care must be give time to adapt.

Nuffield Trust report on US experience of GP commissioning

Here's an article for anyone wishing to see why the BMA and the vast majority of it's members are opposing the NHS Bill.

http://www.bma.org.uk/images/nhsreformbriefingbmaopposesbilldec2011_tcm41-210946.pdf

 

[StonedPenguin]

NHS needs a total reform.

Sign this instead please. Thankyou!

 

[stockhausen]

Cameron has called a meeting on Monday to discuss changes to the NHS.

Amongst the bodies that have NOT been invited are the:

• British Medical Association
• Royal College of Nursing
• Royal College of general Practitioners

Number 10 has refused to reveal who has actually been invited to the PR event. However, I have absolutely no doubt that Cameron's proposals will be welcomed by all who have been invited to attend

 

[Dolph]

Cameron has called a meeting on Monday to discuss changes to the NHS.

Amongst the bodies that have NOT been invited are the:

• British Medical Association
• Royal College of Nursing
• Royal College of general Practitioners

Number 10 has refused to reveal who has actually been invited to the PR event. However, I have absolutely no doubt that Cameron's proposals will be welcomed by all who have been invited to attend

Exactly why should the vested interests more concerned with their members happiness than saving peoples lives be invited?

should we sacrifice lives to keep trade unions happy?

 

[Dickyb0b]

There useless anyway and so are hospitals, the country is screwed up to much now i am afraid, even if you're dieing from a heart attack you are going to be just left to die k.

 

[MrMoonX]

Cameron has called a meeting on Monday to discuss changes to the NHS.

Amongst the bodies that have NOT been invited are the:

• British Medical Association
• Royal College of Nursing
• Royal College of general Practitioners

Number 10 has refused to reveal who has actually been invited to the PR event. However, I have absolutely no doubt that Cameron's proposals will be welcomed by all who have been invited to attend

wonder how many private medical providers have been invited :roll eyes:

/me waits for dolph to come wading in with his tory anti NHS BS

 

[MrMoonX]

Exactly why should the vested interests more concerned with their members happiness than saving peoples lives be invited?

should we sacrifice lives to keep trade unions happy?

guess i spoke to soon

cos the tories haven't invited a load of private companies to help pick the bones of the NHS for private profit much

 

[scorza]

Exactly why should the vested interests more concerned with their members happiness than saving peoples lives be invited?

should we sacrifice lives to keep trade unions happy?

Because organisations comprised of, and representing medical professionals know a thing or two about the way healthcare is provided in this country? All the evidence is that more lives will be lost as a result of implementing Lansley's changes.

It's incredibly disingenuous of you to dismiss the BMA, RCN and RCGP as trade unions. They're all professional bodies, two of which were set up with a Royal Charter. They're about much more than representing their members (which isn't a bad thing in itself anyway).

 

[Strife212]

Exactly why should the vested interests more concerned with their members happiness than saving peoples lives be invited?

should we sacrifice lives to keep trade unions happy?

 

[mrochester]

Nearly all community services have passed over to the relevant provider from PCT's last year, a separate change recently implemented in the NHS so there is no reason why providers cannot expand on this without the health bill.

From my experience, this has been a fairly messy change. The level of prescriber accountability is scarily absent in some areas of the country. One NHS Trust who took on responsibility for a group of non-medical prescribers last year didn't even have telephone numbers or contact details for their staff. I have precisely zero confidence that they even know what they're non-medical prescribers are doing or what level of patient care is being offered. TCS was already a big enough mess, this is only going to get a lot worse if we proceed down this path.

 

[Extra77]

From my experience, this has been a fairly messy change. The level of prescriber accountability is scarily absent in some areas of the country. One NHS Trust who took on responsibility for a group of non-medical prescribers last year didn't even have telephone numbers or contact details for their staff. I have precisely zero confidence that they even know what they're non-medical prescribers are doing or what level of patient care is being offered. TCS was already a big enough mess, this is only going to get a lot worse if we proceed down this path.

In LaLa we trust !!! I can see things getting worse with any willing provider...