The Health Reforms Explained.

[cherrypie]

Saw this article in the Daily Fail. Not too bad for the Fail as it does explain the Health Reforms in a way that can be understood.
http://www.dailymail.co.uk/health/a...health-revolution-What-family-needs-know.html

It says at the end of the article that the things it will not do,

1...Cut waiting times.

2...End Postcode lotteries.

3...Improve nursing.

4...Tackle poor out of hours care.

(These 4 things are something that we all want .)

 

[AJLang]

What worries me is the reliance on GPs. Despite me going to the GP three times about my stomach problems she never referred me for any tests, just gave me some tablets. Fortunately I had my annual diabetic review with the hospital consultant. If it wasn't for him I wouldn't have been diagnosed with severe gastroparesis or referred to the diabetes gastroparesis specialistin the next county. My GP also doesn't agree with the amount of gastroparesis medication that the specialist prescribes - but when I try to reduce it I have a very, very poor quality of life.

 

[Northerner]

I agree Amanda. There seems to be some belief by Ransley et al. that GPs are the best people to decide on treatments - not if they are not good GPs, and as we know there are quite a few of them around. I think the following section sums up my main worries:

The main argument against giving GPs control of the money is that while they?re skilled at looking after patients in the community, few have the proven financial and planning skills to manage the business of commissioning services.
The expectation is that GPs will end up employing outside companies to arrange contracts for their patients? treatment.
?Our worry is this will mean that GPs will end up rubber-stamping decisions made by vast management companies who have little actual insight about patients and their needs,? says Dr Clare Gerada, chair of the Royal College of General Practitioners.
There is also concern that GPs, under pressure to stick to tight budgets, will make decisions based on their balance sheet rather than what you, the patient, need.
Another concern is about potential conflicts of interest when GPs commission services from organisations they part-own.
The commissioning groups will, for example, be allowed to own cataract clinics, so could in theory commission their own clinic to provide their patients with treatment.
Meanwhile, rather than cutting bureaucracy, it is feared that the new NHS Commissioning Board will end up as yet another top-heavy layer of management.

Strange how, with the police, the argument was to reduce bureaucracy for fronline staff (the coppers) by removing administrative tasks from their purview - yet these reforms suggest handing it over (or, as stated, probably to huge management companies)

 

[Ellie Jones]

What two fact's about the health care reform that isn't being mentioned..

Since the conception of the NHS there has always been a Safeguard on the Stature Books (the law) that protects the fundament's of NHS provision for all. Not only is the NHS answerable to the Government, but any major changes to it's provision of Service has to become part of the Stature Book via an act of parliament... Hence the reform Bill, and Government can enforce the NHS to comply with such things as NICE etc.

Once the Reform Bill goes through, this Safeguard will be removed, the NHS won't be answerable to the Government, changes to provision won't need an Act of Parliament to implement the change. Nor will the Government be able to enforce the NHS to do something..

Hence why this is a back door into privetation and 2 tier health care.. The NHS will be able to do what it likes, charge what it likes for treatment etc..

The other thing not mentioned in discussions..

At the moment NICE oversee's best clinical practice, ensures a fairer access to drugs and treatments.. But the intention in 2014 or after the Reform bill has been passed.. Changes will take place with NICE changing rules, it will still provide best clinical practice, still oversee what drugs and treatments available on the NHS.

But it will lose the legal clout to enforce the NHS to provide these drugs and Treatments to patients. As in 2014 a new system will be coming in 'Value-Based Pricing' where it will be GP's who will determine whether or not the drug or treatment will be funded😱


So if we think we got problems with test strip restrictions, getting various medications and insulin pumps now, what's going to happen when GP's start deciding whether a pump is value for money, we as patients will have nowhere to go, MP's won't be able to do anything, no good campaigning to NICE or even the Government has none of these will have the clout legal or otherwise to change anything...

 

[ypauly]

I have actually read these changes in depth, while choice with your GP is good and is supposed to end the postcode lottery choice of GP isn't so good as you will still need to be in the catchment area. So if you have a bad GP...............

There are many good things, and now the competition element is being watered down it should be better, but I can't help but feel the usual winners i.e doctors,politicians and lawyers will be the winners again,and patients will see no major change/improvement.

 

[Ellie Jones]

Paul I wish I had some of your belief's...

The whole pretext of the reform is reducing costs, increasing standards by creating competition... Similar theory used with our utilities sector and look what's happened there😱

Better still look at what happened to our dental NHS service😱

I do agree that the NHS does need reforming and costs need to come down...

But this can be achieved without putting our health service at risk, just need to restructure it, cut out the excessive management structure as the whole organisation is top heavy with too many overpaid chief and not enough Indian's... And one hell of a lot of people who don't know what they are doing, such as putting simple clauses into software development contracts, such as time penalties, and you pay for the finished product at the agreed amount on completion!

Too many highly and overpaid people have cost the NSH some very serious money that wouldn't be tolerated within a private sector company..

The reform bill is a very big mistake, and sadly people will pay with their lives.

 

[Northerner]

What I would like to know is why, if the ideas were so good in the first place, have they had to make so many changes because of huge opposition? Did they anticipate the reactions and include an element of concessions they could make when the furore started so it looked as though the govt were listening? And why does such a huge reform have to be made so quickly, at precisely the time that the country and NHS can least afford it? It's always appeared to me that this government is so eager to implement as many huge reforms across the board because a) they've been champing at the bit to put all their unproven theories into practice, and b) they are worried that if they don't get enough done quickly enough their ambitions might be reversed by a future government. Sadly, the main opposition in the Commons appears to be ineffective

 

[FM001]

The whole Reforms Bill is a mess and in true Cameron style he will not scrap it and admit defeat🙄 The NHS and what it provides is dear to everyone's heart and meddling in it will cost them dearly at the next election.

 

[mcdonagh47]

The whole Reforms Bill is a mess and in true Cameron style he will not scrap it and admit defeat🙄 The NHS and what it provides is dear to everyone's heart and meddling in it will cost them dearly at the next election.

I don't know why they keep calling it "Reform" - aren't reforms supposed to make things better? Why not the "Health Vandalism Bill" ?

 

[mcdonagh47]

Sadly, the main opposition in the Commons appears to be ineffective

Disagree there - Andy Burnham, Shadow Health Chap, seems to have won all the arguments.

There seem to be some major flaws in the plans.
1. They want to cut down bureaucracy by abolishing 300 PCTs and replacing them by 9000 GP Consortia ..... Er ...right. It sounds like Mrs T's abolition of the Metropolitan County Councils,allegedly to reduce bureaucracy ... In Greater Manchester County the County Council was abolished and succeeded by ten or so unaccountable Committees fulfilling its functions.

2. The fundamental issue is the Conflict of Interest ... The more GPs save on treatments (bang go strips and pumps) the more they can put in their own pocket. Its going to lead to GPs earning a Million a year and diabetics struggling for services and having to pay for the normal checks.

 

[Robster65]

Are the GP consortia going to be, effectively, private companies bidding for the right to provide a healthcare service?

Or will they still be employed by the NHS, but with a bigger budget and a free hand to buy in services?

I presume there'll be nothing stopping them doing a deal with a large health provider (say BUPA) along with the wining and dining that accompanies such deals, and shippign everything over to them while they just sit by the pool 5 days a week and 'manage' things.

Rob

 

[mcdonagh47]

Are the GP consortia going to be, effectively, private companies bidding for the right to provide a healthcare service?

Or will they still be employed by the NHS, but with a bigger budget and a free hand to buy in services?

I presume there'll be nothing stopping them doing a deal with a large health provider (say BUPA) along with the wining and dining that accompanies such deals, and shippign everything over to them while they just sit by the pool 5 days a week and 'manage' things.

Rob

Its all basically uncertain but I can't see many GP Consortia wanting expensive Diabetics on their books.
On the other hand there might be scope for some GP Groups in big cities specialising in Diabetes.

 

[Northerner]

Disagree there - Andy Burnham, Shadow Health Chap, seems to have won all the arguments.
...

Yes, I agree there as an individual, but really I meant The Opposition, with Milliband in charge. If Burnham had won all the arguments the Tories and Lib Dems would be voting against it too!

 

[Robster65]

That would make sense. And a selective interpretation of reports and studies that enable them to save cash.

I wonder also how the relationship between consultant/DSN and GP is going to change. At present the GP has to prescribe what DSN dictates.

When GP is payign for DSN's services, will GP tell DSN they're no longer required and find another one who doesn't insist on spending their budget?🙄

Rob

 

[Northerner]

That would make sense. And a selective interpretation of reports and studies that enable them to save cash.

I wonder also how the relationship between consultant/DSN and GP is going to change. At present the GP has to prescribe what DSN dictates.

When GP is payign for DSN's services, will GP tell DSN they're no longer required and find another one who doesn't insist on spending their budget?🙄

Rob

I suppose there is going to be some sort of evidence required that they are actually improving patient outcomes...as long as it's not set as low as the QOF target of around 50% for diabetes

 

[Freddie99]

If they want to improve the NHS have it run along the same lines as the BBC - protected funding and run by people who know what they are doing instead of a bunch of politicians whose last A&E visit was as a drunken student. I mean have it run by doctors and nurses for doctors and nurses and all health professionals to achieve the best for the patient as opposed to the bank balance.
Improving nursing? We have within the UK a body of highly qualified and highly capable nurses that are let down by the system within which they work. It is a case of too many chiefs and not enough Indians complicated by ream upon ream of paper work which could be reduced, standardised across the nation and written by the nurses instead of the lawyers. Oh, and sisters/charge nurses who get their hands dirty please. At the end of the day we want to care, one of the reasons why we are nurses. That said we are let down and our employers set us up to fail through a variety of means.

 

[mcdonagh47]

That would make sense. And a selective interpretation of reports and studies that enable them to save cash.

I wonder also how the relationship between consultant/DSN and GP is going to change. At present the GP has to prescribe what DSN dictates.

When GP is payign for DSN's services, will GP tell DSN they're no longer required and find another one who doesn't insist on spending their budget?🙄

Rob

The position of Diabetic Specialist Nurses (DSN) is a worry. They mainly seem to be employed by Hospital Clinics and PCTs at the moment. I can't see many GP Consortia being willing to fork out 40,000 a year for DSN.

 

[FM001]

Disagree there - Andy Burnham, Shadow Health Chap, seems to have won all the arguments.

Said some time ago on here that Burnham would make a good leader of the opposition, Miliband is weak and next to useless when under question and during prime-ministers question time.

 

[mcdonagh47]

Yes, I agree there as an individual, but really I meant The Opposition, with Milliband in charge. If Burnham had won all the arguments the Tories and Lib Dems would be voting against it too!

LOL There's a big difference between winning the argument and winning the vote in that Madhouse, especially when they are all whipped to death. The poor Lib Dems are being held hostage.

 

[FM001]

That would make sense. And a selective interpretation of reports and studies that enable them to save cash.

I wonder also how the relationship between consultant/DSN and GP is going to change. At present the GP has to prescribe what DSN dictates.

When GP is payign for DSN's services, will GP tell DSN they're no longer required and find another one who doesn't insist on spending their budget?🙄

Rob

That is a concern we all should have.