Nurses for Reform Blog

This story about filthy and dangerous NHS hospitals has really gained momentum over the weekend. What is really bad news for the government is that not only is this is not a one off rogue trust, but that many of our hospitals are in this state and the problem has only been accurately identified by the private sector in the form of Dr Foster.  

For me it is not surprising that the Care Quality Commission (CQC) managed to rate many of these Trusts as “good” and then for Dr Foster to obtain more accurate results.  I have recently been in discussion with a number of colleagues about the CQC and the general opinion of them is that they are disorganised, incoherent and generally do not have a clue what they are doing.  In fact when some nurses that I know asked them for an opinion they were unable to give any helpful or coherent advice.

I am sure that this story and the others like it that will follow will bring calls from interest groups for more regulation.  This is the wrong way to solve this problem.  There are two courses of action that must now be taken as a matter of urgency.

First, the NHS has shown that it is now failing to provide clean, safe care with monotonous regularity.  All healthcare provision in the UK must be returned to the independent sector as a matter of urgency.

Second, the CQC has demonstrated that it is incapable of making accurate assessments of the state of our hospitals so why not abolish it immediately and let the public rely on more respected and reliable brands such as Dr Foster and Which to inform then of the true state of healthcare provision.

The only way forward is for less regulation from government and more market forces and self regulation.

Over the weekend the American Senate voted to debate the most recent version of President Obama’s healthcare bill.  Amid discussion of various Senators being bought off to support the bill with promises of increased federal funding for their States there are some very real issues here for the American people.

Many commentators point out that the cost of implementing Obamacare has been grossly underestimated and predict that rather than the promised cost of around $850 billon the final figure is more likely to be over $2.5 trillion over the first 10 years.  This money can only come from the American tax payer and I am willing to bet that if this bill is passed the estimated costs will only rise as implementation gets closer.

The Heritage Foundation in this excellent article point out what they consider to be the five main flaws of the Healthcare bill and conclude with a quote from the Dean of the Harvard medical school from an article in the Wall Street Journal:

So the majority of our representatives may congratulate themselves on reducing the number of uninsured, while quietly understanding this can only be the first step of a multiyear process to more drastically change the organization and funding of health care in America. I have met many people for whom this strategy is conscious and explicit.

We should not be making public policy in such a crucial area by keeping the electorate ignorant of the actual road ahead.

In 1948 the British Government promised the people of the UK that ALL Medical, Dental and Nursing Care would be free, yet this week the Government agency the National Institute for Health and Clinical Excellence (NICE) has decided that you will be left to die if your medical condition is considered to be too expensive to treat.

If this is not a stark enough warning that Government should not be involved in healthcare I don’t know what is.

Here are two stories that should make the Government and the NHS hang their heads in shame.  Despite the billions of pounds that have been poured in to the NHS under New Labour some of the most vulnerable members of society are being failed time and time again.  Not only do half of Alzheimer’s patients leave NHS hospitals in a worse state than they entered them but care in NHS hospitals for them is so bad that a third of their carers have to complain and a greater number think that they should have.

Surely we have seen enough of these horror stories for even the most die-hard NHS supporter to realise that the system is failing.  With the cuts in public spending that are inevitably coming our way there is an historic opportunity to put things right.  It is too late for the Government, who I am sure will make some empty promises in today’s Queen’s Speech, but the Conservative party must take notice of the suffering reported in these all too frequent stories.  It is time for the NHS to stop subjecting people to this substandard care.  All NHS hospitals must be returned to the independent sector where the language of price drives quality of care.  The NHS has had sixty years to try to prove its worth.  It has failed continually, now it is time for the market to demonstrate its superior qualities.

This is just madness from the Government and the Royal College of Nursing.  It is the belief of Nurses for Reform that this is another example of ludicrous government induced qualification inflation. In further nationalising the labour market on the front line of patient care, ministers and the Royal College of Nursing will simply end up sucking in tens of thousands more ancillary workers and lowering standards on wards still further. Nurses for Reform wants a vibrant and diverse labour market that will push standards up. Instead of imposing a uniformity of centrally planned rules, that is why NFR campaigns for open markets in nurse training as well as an end to national collective pay bargaining.

During my recent trip to the USA I made a short film for the Heritage Foundation titled “How Government Run Healthcare Works”.  Here is the link.

Yet again the Medical profession has the Government where it hurts!  To meet the key objective of getting a high proportion of the UK population vaccinated against pandemic (swine) flu, the Department of Health is having to pay off the General Practitioners

This is no different to the 1948 battle to establish the National Health Service.  When the medical profession in the shape of the British Medical Association (BMA) threatened to derail the process, the then Health Minister Aneurin Bevan claimed that to get the doctors on side he had had to “stuff their mouths with gold”

NFR believes that it is time that the medical profession stopped holding their patients to ransom and using the NHS to broker these special payments for work.  The time has come for doctors to be truly independent and for them to bid in a competitive market for work such as this.  While the government remains the sole funder of the vaccination programme’s and indeed most other healthcare, it must stop being blackmailed by the medical profession and open up all healthcare provision to competitive tender, therefore getting a much better deal for the taxpayer.

Last week NFR had a very successful evening speaking at the Oxford Libertarian Society.  Sharing the stage with Shane Frith of Progressive Vision, we discussed the “Alternatives to Government Run Healthcare”.  The evening was videoed and when the link is available I will put it up on this blog.  In the mean time here are a couple of photographs of the evening.

I am off to Oxford University tonight to speak to the Oxford Libertarian Society.  I will be giving a joint talk with Shane Frith, Director of Progressive Vision.  This is how we have been billed:

Alternatives to Government-Run Healthcare’

The ubiquitous assumption in British political discourse is that state control of healthcare is a necessary policy to ensure universal access to high quality care, free from profit-motivated decision making. Our speakers challenge this assumption, arguing that evidence from voluntary schemes around the world present a compelling case for rejecting the deference to state-run systems of healthcare. Arguing from her experience as a senior nurse in the NHS, Helen Evans will tackle the reform of healthcare provision, criticising the rationing and bureacracy of NICE, and the special interests served by the state’s position as a monopolist in healthcare. 

This is a great analysis of the healthcare bill presented to the US Congress last week by Speaker Pelosi.  Grace-Marie Turner of the Galen Institute explains all that is wrong with it and why it breaks promises that President Obama made to the American people.

Breaking Promises

How can President Obama possibly endorse the bill that Speaker Pelosi unveiled to such great fanfare on Thursday? The House bill breaks major promises he has made to the American people about his goals for health reform. To name just a few:

Cost: The president has assured us that health reform would lower health costs. But the House bill would bend the federal cost curve UP, not down, according to the Congressional Budget Office’s preliminary analysis.

And only by using budget gimmicks were House leaders able to get the reported cost to $894 billion over 10 years, just barely under the president’s somehow magic $900 billion number. But that’s not the real cost. Robert Pear of The New York Times reports today, “By the most commonly used yardstick, the bill would cost $1.05 trillion over 10 years, roughly $150 billion more than President Obama had said he wanted to spend on the legislation.”

So the real cost will be over $1 trillion — and that doesn’t include the “Doc Fix.” The Speaker had the audacity to introduce that bill separately so the $245 billion price tag wouldn’t get counted in the total cost of the bill. Senate Majority Leader Harry Reid tried that trick last week, and went down in flames. Can the AMA possibly still stay on board with the House bill, since its deal has now been broken?

And health insurance premiums will soar, especially for younger families because the insurance regulations in the House bill allow only a 2 to 1 premium variation between the youngest and healthiest policy holders and the oldest and sickest.

And this doesn’t even count the huge economic distortions, cost-shifting, and new taxes that surely will be passed along to consumers.

Middle-class taxes: The president promised no tax increases on the middle class, but they surely will be paying the lion’s share of the $500 billion in new taxes to finance the bill. Americans for Tax Reform posted a listing of the new taxes in the House bill which violate the president’s pledge.

And add to that the estimated $33 billion in taxes the CBO says will be collected from individuals who don’t buy the expensive, government-mandated health insurance.

Keeping health insurance: A coalition of major business groups late Thursday sent a letter to Speaker Pelosi and Republican Leader John Boehner saying the House bill falls short of the bipartisan goal of controlling costs and could jeopardize group health insurance provided by employers to 160 million workers.

These are people who should know because they represent the companies that provide health coverage to the majority of Americans: The American Benefits Council, Business Roundtable, Corporate Health Care Coalition, the ERISA Industry Committee, National Association of Manufacturers, National Association of Wholesaler-Distributors, National Business Group on Health, National Coalition on Benefits, National Retail Federation and U.S. Chamber of Commerce.

No savings from the public plan: CBO concludes that the government insurance option would typically charge higher premiums than private plans available in the new Health Insurance Exchange. “That surprising conclusion raises doubts about Democratic promises that a government-run insurance plan would provide a lower-cost alternative to consumers,” Politico reports. And it adds, “At the same time, it calls into question Republican charges that the plan amounts to government takeover of health insurance — because only 6 million people would enroll in the plan, according to the CBO.”

The 400,000-word House health reform bill is absolutely astonishing in the level of government intrusion it would shove into the lives of every American, every business, and every health care professional. I won’t bore you here with the legislative jargon, but pick a page, any page, and you will see what I mean. Here is a link to the bill and a much more reader-friendly section-by-section analysis. You will see that all power and control vests to the government.

Hitting small business hard: Don’t miss the new analysis by WellPoint that mined its own actuarial data to model the basics of the plan incorporated in the House bill, using data from 14 states where it runs Blue Cross plans.

In all 14, it found that the legislation would drive up premiums for small businesses and individuals. Young and healthy consumers would see the largest increases, with premiums more than tripling in some states.

The head of the National Federation of Independent Business, Dan Danner, said the huge cost of the health reform bill “will ultimately come out of small business owners’ pockets and prohibit them from growing, investing in their business and hiring new employees.”

The bill requires detailed recordkeeping on employee health insurance, imposes new taxes and new civil penalties for not complying with the barrage of new federal health insurance laws, and puts burdens on virtually every company to pay for this expensive insurance, in perpetuity. See my article, linked below, in Tuesday’s Wall Street Journal for a report on how this is (not) working in Massachusetts.

Lock out: Speaker Pelosi’s announcement of the House bill had all the trappings of a major campaign rally. The only problem was that the public was locked out. Big chain link fences surrounded the West Front of the Capitol — usually a very open, public space — to make sure only supporters of the bill were allowed in.

This is so symbolic of the whole process: The American people are being shut out of the debate. All congressional recesses have been cancelled since August to keep members away from their constituents as much as possible, doors are locked while negotiations over the bills are taking place (breaking another presidential promise of an open and public process), and now, the public was even shut out of the public space outside the Capitol for the announcement rally.

This legislation is going to have an impact on the economic and health care freedom of Americans for decades to come. It is beyond irresponsible for Congress to be on the verge of passing these bills with this kind of disregard for the will of the people.

Politico carried a full-page ad yesterday with the pictures of 36 former members of Congress defeated in the 1994 elections in the aftermath of HillaryCare. It could happen again unless members open up this process to heed the fears of their constituents about a government take-over of the health sector.

The Independent Women’s Forum conducted its own poll that found women want to make their own choices and decisions about their and their family’s health care and they do not want politicians intruding.