Tories and the Nhs changes.

[GreersElbow]

the NEW labour party was the least socialist party we had ............reason for my leaving the party

Apologies, I did entirely mean Blair's new labour.

And dingodan, no government involvement? There's very little involvement at the moment.

Your Austrian economical view on the markets is funny, here's a question for you. If Hayek, and Ludwig Von Mises economic and philosophy actually works, why has no country ever implemented the Austrian approach? Because it's utopian, no less or more utopian than Marxism.

If the markets were incredibly good, we'd be living in incredible wealth, with very little poverty, with everyone owning their own property, price stability, reasonable levels of inflation, oh....and no financial cock-ups because banks were to busy giving mortgages to anyone and everyone without evaluating their risk of default, then selling the mortgage to another bank...

 

[GreersElbow]

All those that say get rid of the NHS should reseach what was there before Labour after WW2 created it. The Tories never wanted it, Churchill spoke against it, you bascially only got treatment if you paid and most couldn't afford major treatment. Going back a little further, doctors only became more avaiable to the working class because the Goverment and the factory owners found that the health of the workers was so bad that the army and factories had trouble finding fit people. Like most things under the Tories it's a race to the bottom, pensions, wages, housing, etc. If you've got the money you'll ok, if not hard luck.

It was private and 3rd sector based, very high levels of illness.

The U.S style system is very similar. Only a few can get medicare or mediaid. The U.S system is actually inefficient, it's sluggish, because the insurance provider gets in the way and acts as a middle man. In the UK, you go to the doctor. Anyone to argue that state provision is slower should look at the Canadian NHS, based of ours, however more efficient.
HealthMatters: Which Country Has The Most Efficient Health Care System?


The Singaporean model is only that efficient because it's a city-state...

 

[Westdene Seagull]

The NHS needs to reform. You only need to sit in a hospital queue to see how inefficient the staff can be. My partner has been going to a doctor for a couple of years for a medical complaint. When he refers her to an NHS hospital it takes months to get an appointment - he recent gave in and referred her to a private hospital ( Goring Hall ) and the appointment was arranged within a week. All follow ups were arranged within days. If the NHS can't do it then GPs should be allowed to use private companies.

Let's also not forget the greedy tossers that are dentists who are bleeding the NHS dry with no requirement to actually provide NHS treatment to all that want / need it - absolute greedy bastards !

 

[dingodan]

So what is the role of Government then. Everything it does is about providing the state with services, whether that be healthcare or defence.



How can a free market system be humanitarian? Where are your arguments to back up this? If you took out the state medicare and medicaid the states and left if for a free for all (for those that can afford insurance) then you will have the poor dying where they fall. A free market does not guarantee the best service, that's just a blinkered Conservative ideology. Take the banks, your argument would be to completely remove regulations as that would be a true free market yet the current global financial position has been created because banks weren't regulated enough. No regulation would mean no protection for people's savings so you could lose everything because a bank has gambled and lost.

Another example against your argument is the way cleaning of hospitals was outsourced to private companies. Standards went down and there was a massive increase in hospial acquired infections such as MRSA and C.diff. It is only in recent years that they have had to improve the cleaning and therefore reduce these infections.

The only thing an unregulated free market does is to lower standards to the detriment of the consumer and raise profit for the so called entrepreneu.

Most of what you have said here is wrong.

Government regulations in banking existed. It did nothing to prevent what happened. The strictest regulator is the market, if a bank makes irresponsible decisions and goes bust, it should go bust, not get bailed out.

Peoples savings should be protected I agree. But how are they destroyed? Don't you realize that people ARE loosing their savings because banks gambled and lost. You say "no regulation" would lead to this happening, but government intervention in the form of bailouts is, and will further, cause inflation. That is what threatens peoples savings and it comes from government, it would not happen under free market conditions. In a free market a bank cannot look to a lender of last resort, they suffer the consequences of their actions. This removes moral hazard, the bank is less likely to take irresponsible risks. It is the market that truly regulates and protects consumers and savers.

Standards have gone down massively in a lot of areas of hospital management, mainly as a result of bureaucracy and targets imposed by government. You cannot be arguing that outsourcing cleaning to a private company represents free market medicine. Who paid the contracts?

The free market and capitalism are based on the principles of liberty. A free market is humanitarian because it is the only system that does not require force. And as I have tried to explain it is also the only system which provides the best quality at the lowest cost with the best distribution. This is just economic law and historical fact. For all the good intentions of trying to make sure everyone has everything that they need, the government end up causing problems, undermining liberty, undermining economic forces and in so doing, they destroy the prosperity and abundance that they are trying to achieve.

EDIT: And the role of government in a free society is the protection of liberty. It has some other responsibilities, national defense, having a sound currency and having low taxes. But in essence the government should have a negative role, the people are supposed to be free.

 

[dingodan]

Duplicate post.

 

[RexCathedra]

Loverly. A slew of ex-ante assertions, each one with no evidence, and an equal-and-opposite assertion can be made for the left for each one. Exempli gratia

A free market is humanitarian because it is the only system that does not require force.

Presumes that coercion, when it's applied by other means -- intrusive corporations, grinding poverty, popular prejudice -- isn't actually 'real' coercion, but a something else.

And the role of government in a free society is the protection of liberty.

The law, as Anatole France reminds us, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread. Anatole France.

And so forth.

Trust a Yank with health issues -- the less your health-care delivery system system looks like ours, the better. If you must have a foreign model, copy France's.

 

[Drumstick]

For what is provided in monetry terms in it an incredible feat and the envy of many other NHS type systems. Making it fully local will not work on its own but in part it is what is needed and in part provided. Otherwise people will moan about a 'post code' lottery and why doesn't their area specialise in Trauma/Cancer/Elderly care etc. The NHS Improvement plan in 2004 did allow certain areas to become more set up for local needs (Brum has a massive Asain pop, Asians are more succeptable to Diabetes so in Brum you have specialised Diabetes care) but if you want another specialty you may be better of elsewhere, The NHS Improvement plan in 04 allowed you to be able to go to other areas for specialist treatments to remove the post code lottery.

It is not a perfect system but being one of the worlds largest work forces (1,600,000) behind only a few groups like the Chinease army etc it will always be a challange to have every member of staff making every patient delighted, But the majority (99%) try their damned hardest.

If these reforms go though I only see it as a BAD thing for the future of the NHS as it is slowly carved up. Cameron is holding a meeting today about the reforms and three big bodies anti it, The Royal College of Nursing, The Royal Colleg of GP's and the British medical association have not been invited, Says it all really.

Every employment body within the NHS is trying to stop these reforms from the Royal College of Paediatrics and Child Health to the British medical association.

Nurses rarely strike yet that happened the BMA has never had a strike yet will seemingly, This isn't about jobs/pay etc Nurses/Docters can work and get Visa's to any country in the world. A Nurse in fact can go to Oz and almost DOUBLE their pay.

This is about saving one of the last things that makes this country GREAT.

 

[vulture]

cameron and osbourne getting away with it due to labour having red ed

 

[RexCathedra]

A reading from the letter of St. Margaret to the Tories:

[1] Yea, verily I say unto you, everything that is, may be bought, and sold.
[2] And that which may not be bought or sold, is not.
[3] All that is private is better than each that is public, for that which is public, is not.
[4] Know ye that so long as one of us, somewhere, is covered by a collective-bargaining agreement, none of us can truly be free.

Here endeth the lesson.

 

[Drumstick]

The NHS needs to reform. You only need to sit in a hospital queue to see how inefficient the staff can be. My partner has been going to a doctor for a couple of years for a medical complaint. When he refers her to an NHS hospital it takes months to get an appointment - he recent gave in and referred her to a private hospital ( Goring Hall ) and the appointment was arranged within a week. All follow ups were arranged within days. If the NHS can't do it then GPs should be allowed to use private companies.

Let's also not forget the greedy tossers that are dentists who are bleeding the NHS dry with no requirement to actually provide NHS treatment to all that want / need it - absolute greedy bastards !

Much of what you've said is correct it does need tweeking, the red tape removing etc.

In a perfect world there would be less non clinical staff, and more front line staff but that won't happen for a long time. Que's are improving but the whole time we have old hospitals (A large part of the RSCH is PRE Florance Knightengale) and not enough front line staff hands are tied.

I'm pleased your getting the help you need from the private hospital I really am, Not everyone can go down that route though and often if the private hospitals make a mistake the patient is taken to a NHS hospital to be fixed up.

 

[Westdene Seagull]

Much of what you've said is correct it does need tweeking, the red tape removing etc.

In a perfect world there would be less non clinical staff, and more front line staff but that won't happen for a long time. Que's are improving but the whole time we have old hospitals (A large part of the RSCH is PRE Florance Knightengale) and not enough front line staff hands are tied.

I'm pleased your getting the help you need from the private hospital I really am, Not everyone can go down that route though and often if the private hospitals make a mistake the patient is taken to a NHS hospital to be fixed up.

I agree with almost everything you've posted and I'm a great supporter of the NHS BUT it infuriates me when I see actions by NHS staff that could really be more efficient and a COMPLETE lack of information when there are delays.

A good example was when my now ex-wife was pregnant with our first son. We chose to go to the Princess Royal in Haywards Heath ( a plus for the NHS allowing us to choose ) for both the pre-birth checks and the birth. For the pre-birth checks you sat in a communal area and were then called into about six rooms in turn. What was frustrating was that in some cases this meant a member of staff just moving from one room to the next - you saw EXACTLY the same nurse but in a different room. For Gods sake - just do all the checks all in one room at the same time. Also, there was a lot of time wasted with staff chatting - you don't expect to wait in a supermarket queue while to cashiers chat / have a cup of tea etc etc so why is acceptable in an NHS hospital ?

NHS and private staff should be forced to swap jobs occasionally as, from my experience, private hospital staff are far more focused on the customer than NHS staff.

Personally, if I could stop paying the money I contribute to the NHS and use it for a private health care plan I think I would be much better off.

 

[dingodan]

Loverly. A slew of ex-ante assertions, each one with no evidence, and an equal-and-opposite assertion can be made for the left for each one. Exempli gratia



Presumes that coercion, when it's applied by other means -- intrusive corporations, grinding poverty, popular prejudice -- isn't actually 'real' coercion, but a something else.



The law, as Anatole France reminds us, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread. Anatole France.

And so forth.

Trust a Yank with health issues -- the less your health-care delivery system system looks like ours, the better. If you must have a foreign model, copy France's.

"Presumes that coercion, when it's applied by other means -- intrusive corporations, grinding poverty, popular prejudice -- isn't actually 'real' coercion, but a something else.

Your argument then is that government coercion is better than the coercion that would exist under free market conditions.

There is no coercion in a free market. The coercion that exists in our system today is in the form of plunder (taking our money) and monopoly (government controlled monopoly). In a free market you have neither plunder nor monopoly. You may well still have large more successful businesses, but in a free market this success is delivered by the consumer through voluntary action, not by government.

And the role of government in a free society is the protection of liberty.

"The law, as Anatole France reminds us, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread. Anatole France."

“It is not true that the legislator has absolute power over our persons and property. The existence of persons and property preceded the existence of the legislator, and his function is only to guarantee their safety.” ― Frédéric Bastiat, The Law

and in the context of this discussion:

“As long as it is admitted that the law may be diverted from its true purpose--that it may violate property instead of protecting it--then everyone will want to participate in making the law, either to protect himself against plunder or to use it for plunder.”

“Government is the great fiction, through which everybody endeavors to live at the expense of everybody else.”

― Frédéric Bastiat, The Law

Trust a Yank with health issues -- the less your health-care delivery system system looks like ours, the better. If you must have a foreign model, copy France's.

I'm not saying that the US system is a good system at all. The current US system is not a free market.

 

[drew]

Most of what you have said here is wrong.

Government regulations in banking existed. It did nothing to prevent what happened. The strictest regulator is the market, if a bank makes irresponsible decisions and goes bust, it should go bust, not get bailed out. So you think with no regulation the banks would sensibly regulate themselves with good business practice, much like the press!!!

Peoples savings should be protected I agree. But how are they destroyed? Don't you realize that people ARE loosing their savings because banks gambled and lost. You say "no regulation" would lead to this happening, but government intervention in the form of bailouts is, and will further, cause inflation. That is what threatens peoples savings and it comes from government, it would not happen under free market conditions. In a free market a bank cannot look to a lender of last resort, they suffer the consequences of their actions. This removes moral hazard, the bank is less likely to take irresponsible risks. It is the market that truly regulates and protects consumers and savers. You say a failing bank should be allowed to fail and with it, presumably, the deposits of savers, yet in the first line of your paragraph you say savings should be protected. How? Are you suggesting savers take out some form of insurance, the cost of which will come out of any interest they earn!

Standards have gone down massively in a lot of areas of hospital management, mainly as a result of bureaucracy and targets imposed by government. You cannot be arguing that outsourcing cleaning to a private company represents free market medicine It is not free market medicine, I never said it was. It is an example of where privatising an element of the health service backfired. Who paid the contracts? Contracts would have been based on the cheapest quote. Fact is, they're cheap for a reason. Tenders would have set out minimum service requirements bUT they're cheap for a reaosn. Ask anyone who has to run a hospital ward (I'm married to such a person) and the loss of control over cleaning and the reduction in quality of that service was a major factor in the spread of mrsa and other type infections.

The free market and capitalism are based on the principles of liberty. A free market is humanitarian because it is the only system that does not require force. I think therein lies the problem. We have different understandings for the meaning of the word 'humanitarian'.And as I have tried to explain it is also the only system which provides the best quality at the lowest cost with the best distribution. This is just economic law and historical fact. For all the good intentions of trying to make sure everyone has everything that they need, the government end up causing problems, undermining liberty, undermining economic forces and in so doing, they destroy the prosperity and abundance that they are trying to achieve.

EDIT: And the role of government in a free society is the protection of liberty. It has some other responsibilities, national defense, having a sound currency and having low taxes. But in essence the government should have a negative role, the people are supposed to be free.

I think you live on a different planet and probably spend too much time reading economic and political books rather than living in the real world. In a free market you allow failing businesses to fail and if you apply that to schools and hospitals then you affect the lives of individuals. If the Royal Sussex failed, a city would be without a massive provider of health service in the city. Where would people go whilst waiting for another operator to take over. Can cancer patients put their illness on hold while the 'business men' negotiate their profits, will those waiting dialysis 3 times a week hang a little bit longer so your 'humanitarian' free market can look after them, assuming of course that those patients can afford the bill. What about A & E or the Royal Alex? Bleeding to death and perhaps the ambulance will take you upto Redhill or even further. What's another half hour in the back of an ambulance when you life is at stake. Assuming of course you can afford the ambulance in the first place.

 

[beorhthelm]

The US has had government managed medicine for 40 years. Today in the UK, with the government involved in medicine, care is denied to people on the basis of cost.

not providing a particular course of treatment is not at all the same thing as not providing any treatment or care. I dont think you quite grasp what is available in US healthcare, sans insurance, you get nothing. they will literally turn you away dieing, or send you home with a bill if you get patched up for anything beyond immediate life saving. i've seen how they have charities fly in doctors from UK, South Africa, south American countries with supplies of glasses and prosthetics. imagine that in the UK or elsewhere in Europe?

The free market is the only true humanitarian system, that will ensure the best services, at the lowest cost, and with the best distribution.

patently, this is not true. see above. it doesnt even make sence, how can "free market" possibly ensure the best service or the lowest cost, when the two are often mutually exclusive. the "best" services will be expensive, because you are free to charge more, while others chose a cheaper lower quality service because they'd rather spend funds elsewhere (assuming they have the funds to have any choice). I believe free markets, im a capitialist, but one has to acknowledge their shortcomings.

The free market and capitalism are based on the principles of liberty. A free market is humanitarian because it is the only system that does not require force. And as I have tried to explain it is also the only system which provides the best quality at the lowest cost with the best distribution. This is just economic law and historical fact. ...
EDIT: And the role of government in a free society is the protection of liberty. It has some other responsibilities, national defense, having a sound currency and having low taxes. But in essence the government should have a negative role, the people are supposed to be free.

i know this will sound condesending and i think you mean well, but i dont think you understand alot of this, or havent thought about it very deeply. free markets are not "humanitarian" they dont care about any of the same issues, except maybe being non-discriminatory. your "fact" is nothing of the sort, or please show where in history the best has been equally distributed at low cost. its simply not possible, you have to compromise on at least one if not two of those criteria in any service.
As for the role of government, understand that is one ideal of government. many believe the state should control and determine alot more and that allows a free society (because they believe equality means or is equal to freedom). others would pointout the need for a military inherently indicates a non-free society. others might ask whats so great about a free-society, they'd rather be safe and have their basic needs met. literally speaking the point of government is to govern, to control and direct policy, and how it does this changes wildly. but this has nothing to do with NHS, except that in a society offering no government other than the points you raise, you would be in near anarchy, and healthcare would probably be down the list of priorities, behind sustenance, security and others.

 

[ChilternGull]

Before retiring a few years ago to run my own medico-legal training company I was a NHS CEO for a number of years so here is my guide to the proposed NHS changes.

On one level the government is carrying on the reforms started by the Thatcher government and continued by Blair and Brown. Namely splitting the buying (commissioning) and provider (hospitals and community services) functions. This has allowed the private sector to provide some NHS services but always in a very controlled and regulated way. The Blair govt used the private sector to clear a back log of joint replacement operations for example. Some specialist services are only provided in the private sector such as forensic pyschiatry.

However, the Cameron reforms go much further than ever envisaged before. The Bill currently before Parliament would allow the private sector to both commission and provide NHS services. For example a group of GPs (and I suspect many will) could tender their commissioning responsibilities to an insurance company or firm of management consultants. They in turn could tender services to other private sector organisations. There is a whole section of the Bill (Part 3) given over to European tendering requirements. So we could find Virgin Medical commissioning your health services which in turn are provided by a German health care company that has taken over your local hospital. You may think "so what" as long as I get the heathcare I need it does not matter who provides it? Well dwell on the following.

The Bill removes the legal requirement on the Secretary of State which has stood since 1946 to provide a free comprehensive health service at the point of need. So a GP could decided to start charging hypertensive patients for blood pressure checks or other services and just could simply decide not to purchase certain services and there is nothing you could do about it beyond either paying up or going to another private provider (and buying health insurance assuming you qualify). Currently decisions made about what healthcare to purchase on behalf of local populations are made by Primary Care Trusts. Anyone could go along to a Board meeting and see the relevant papers and listen to the decision making process. You would also have various rights and including legal ones to intervene if you wish to object to a commissioning decision. The Bill sweeps all this away.

The Bill, like a lot of modern legislation, is a framework and nobody knows how well it wll work in practice and in reality what changes, if any, GPs might make. I suspect some GPs will embrace the changes and others will move quite slowly. All the expert opinions I have read say the Bill opens the way to less transparency in decision making, reduction in NHS services and privatisation.

As I understand it the way the Bill is currently drafted opens up the way for GPs to set up their private companies to which they can refer their own patients thus paving the way for GPs to be paid twice for the same patient. Some would say this does not matter if opening the NHS to more competition brings greater efficiencies and effectiveness. Others argue that the NHS is currently one of the most effective and efficient healthcare systems in the world and certainly one of the few offering universal coverage. From my researches only some Scandinavian countries have better systems but they spend a greater percentage of their nation's income on health than we do.

At the last General Election Cameron said "no more top down NHS reorganisations"! I can tell you this is the biggest reorganisation since the NHS was founded in 1946 - I know I worked through all the previous ones! The arguement is that the Government has no mandate from the electorate for changes on this scale hence the degree of opposition in the House of Lords.

The Bill is opposed by most of the Royal Colleges, professional associations and trade unions. In fact the what limited support there is within the NHS is coming from the few organisations that have not balloted their members. The Drop the Bill petition on the 10 Downing Street website has over 140,000 signatures and has only be bettered by the campaign to release the Hillsboro documents. More signatures than petitions to bring back hanging, leave the EU and limit immigration.

So in simple terms the offer is that more competition will bring more services, better quality and lower costs. The counter arguement is that NHS needs integration and cooperation to improve and that privatisation will bring an unwelcome focus on the use of public money to make profits. There is concern that patients with long term complex needs will suffer as it much more difficult to price up and sell the bundle of services they need as they stretch across the health and social care divide and are difficult to forecast in in terms of time.

My personal view is that we are all shareholders in the NHS and should be asking more about what is being planned for our healthcare and should have a better final say in what changes in any come about. So why not ask your GP about local plans for the commissioning and provision of health services and how you might in the future influence the decision making process?