Nurses for Reform Blog

Here is a great blog by Tom Clougherty of the Adam Smith Institute assessing the implications of the Government’s Health and Social Care Bill.

After several years of discreet campaigning and going on from NFR’s meeting with David Cameron at the end of 2009, I am reassured by the Health and Social Care Bill to be launched today.

The idea that all NHS hospitals should be given independent foundation status is a good one, the idea that at any time NHS patients can chose to go private and that the NHS will pay providing the service is cheaper than the state, takes us a reasonable way along the road that NFR wants.  However, the government still needs to go much further to create a private market in provision that will favour the poorest in our society and not simply the rich, which is what we have had for more than sixty years.

Following on from what I have said previously, no only should there be incentives for trade unions to provide their own not-for-profit healthcare schemes but the government has to press ahead with ending national collective pay bargaining for doctors, nurses and other professionals.

Finally, NHS Foundation Trusts should also be given the freedom to launch their own community top-up schemes.  As well as people receiving NHS funded services, people loyal to their local hospitals should be empowered to take out additional health insurance, the profits of which go to their local hospital thereby avoiding any fat cats in the city.

David Cameron is absolutely right when he states ahead of the launch of today’s Health and Social Care white paper that we cannot afford not to reform the NHS.  However, the question that really worries me is that when push comes to shove will he really have the courage to do it?

The NHS is in a dire state with stories hitting the press almost every day about patient neglect and poorly delivered services and as the UK’s financial situation gets worse it is time for the Government to have the courage of their convictions to push through the reforms that are necessary.

We are already seeing vested interest groups such as the NHS Confederation and the Unions condemning the reforms and, as inflation gets worse and interest rates rise, I am sure we will hear voices from Unison and the RCN calling for higher public sector pay rises that will put even more pressure on an NHS that, by the nature of the system, cannot cope.

For Nurses for Reform the following is a list of reforms that David Cameron must push through to give the UK at truly world class healthcare system:

• In the post-bureaucratic age the Secretary of State for Health must no longer have any say over when or where hospitals are built, opened or closed.
• Following the planned changes in education, local planning laws must be reformed so as to enable a much greater diversity of – and investment in – independent provision.
• The planned Independent NHS Board should oversee the return of all UK hospitals to diverse forms of independent ownership (for-profit and not-for-profit).
• Health censorship must be outlawed and patients must be empowered with greater access to information. In this context hospitals, doctors and other health professionals including pharmaceutical suppliers should be free to advertise and build trusted brands. Only by allowing reputations to be built openly, bottom-up will the government be able to realise a lighter touch in regulation.
• To encourage openness, diversity and greater opportunity for staff, employers and patients, an incoming Conservative administration must also adopt the principle of subsidiarity when it comes to human resource management. Hospitals, care homes and all other health facilities should be able to set pay and conditions for staff as they think appropriate and take the lead in all medical and health training. National collective pay bargaining and professional monopolies should be abandoned in favour of a more post-bureaucratic approach.

By putting these key initiatives in place not only will there be a vast improvement in the provision of healthcare but, these changes will enable further micro-political changes to health funding. Overall, these reforms are necessary so that healthcare is pushed through the beneficial reforms that we now enjoy in so many other areas of our daily lives.

Although not going far enough, this is a good start.

Yesterday afternoon I was on LBC Radio discussing the private provision of public services.

I pointed out that for the NHS has had more than 60 years to get the provision of healthcare right and that it is failing at every turn with almost daily stories of neglect and mismanagement.

I put forward the NFR view that all provision of care for NHS patients should be in the private sector, that no hospital or clinic should be owned or run by the NHS and that the NHS should be recast as a funding organisation only.

This article exposing the extortionate amount of overtime payments consultant doctors have managed to “negotiate” from the NHS is truly appalling.  It is bad enough that it appears that these doctors manage their workload so inefficiently that they are then paid overtime to sort out the problems, but the most galling thing is that it clearly shows that politicians have not learned the lessons of history.

When the NHS was founded the Consultants we non-cooperative until Nye Bevan did a deal in which he claimed to have “stuffed their mouths with gold” , today’s story demonstrates that the politicians are still stuffing the medical profession with gold and there is little evidence that this is going to change anytime soon.

Now that we are all back at work I would like to wish all of my readers a very Happy New Year!

Unsurprisingly, 2011 begins with yet more stories of how the NHS is failing its customers.  Yet again the elderly and those with chronic illnesses are bearing the brunt of the failure as the stories here and here demonstrate.

2011 marks the centenary of Lloyd George’s National Insurance Act (more of which over the coming months). Surely, 100 years on with stories like these becoming an almost daily occurrence, it time for the government to admit that state interference in health and social care is not working!