Nurses for Reform Blog

This is a truly shocking report released yesterday by the NHS Ombudsman, detailing an investigation in to the systematic neglect of elderly patients by the NHS.

I also find it terrible that at the end of this Daily Telegraph article Nigel Crisp, Head of the NHS Confederation, states that he wants the 10 cases that the Ombudsman investigated put in to perspective.  The perspective is that only 10 cases were investigated, the NHS Ombudsman stated that they considered the neglect to be more widespread and that elderly patients with relatively little political voice are being left to die in the most appalling circumstances by a system that will continue to fail them unless radically and speedily reformed.

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!

This is a truly appalling story, the NHS continues to starve many thousands of patients in it’s care every year.  However, what makes this worse is that it is not a new story. I have written before on the appalling state of patient nutrition in NHS hospitals.

This is what happens when nurses become managers, filling forms to enable the Secretary of State for Health look good at the dispatch box,  while patient care is left to untrained staff.

When I had an operation in the private sector a couple of years ago I met many nurses working there who had taken a pay cut by leaving the NHS and had done so because the private hospitals gave them the opportunity to concentrate on caring for patients, i.e. nursing, rather than paperwork.

With yesterday’s publication of the government’s White Paper on public health, nannyish Tories are seeking to mobilise the full machinery of ‘municipal socialism’.

I choose my words carefully. The conservative party has always had deeply authoritarian and nannyish tendencies.  Rarely trusting in personal responsibility and the freedom of individuals to chose to do the right things in such areas as personal lifestyle choices, Conservatives have always been champions of big government across so-called ‘public health’.  What makes this White Paper so worrying is the Conservative Party’s mobilisation of municipal socialism.

Properly conceived, municipal socialism as a movement dates back to the 1870’s, when politicians such as Joseph Chamberlain sought to have local government take gas and water supplies in to public ownership not to mention the politicisation such areas as parks and sanitation.  In a quest to bring tax funded services ever closer to the lives of people, municipal socialism and local government are particularly powerful tools in the hands of social engineers.

While this White Paper talks loosely about local decisions, local people, and tries to deport the gentile atmospherics of “nudging” people to do what the political class currently believe to be the right thing, the measures it contains amount to a tyrannical busy-bodies charter.

For at it’s heart the terrifying prospect it contains is the conjuncture of puritanical Tory nannyism with the bloated machinery of local municipality.  Not only will this initially carry a price tag of £4 billion but in the long-term it’s outpourings will attempt to gain a stranglehold on so many of our remaining pleasures.

Surely we are getting to the stage when the government has to realise that the NHS has had enough chances of survival in its current state. This report that has been launched over the weekend demonstrates that NHS Trusts are persistently failing their patients with fatal results.

It is time for the coalition government to act.  NHS provided care does not work.  All NHS hospitals must be returned to the independent sector.   The NHS can then be a funding organisation that contracts with these hospitals and if treatment and care is not provided to acceptable standards then contracts must be removed and failing hospitals allowed to be closed or taken over by more successful trusts.

This is the only way forward for state funded healthcare in the UK and the sooner that the government acts to stop the rot in this failing system the better.

This is a shocking but unfortunately not surprising report about the way in which the UKs elderly population are being failed by the NHS.

Our elderly generation is the one that was promised all healthcare from Cradle to Grave, and it is certainly having its journey to the latter hastened in appalling circumstances.

What is truly awful though is the lack of upset that this story has caused. No government ministers have been calling for enquiries or promising to get to the bottom of this. Andrew Lansley, the Secretary of State for Health, has made no comment that I can find, this story has been allowed to die and the UKs elderly population will continue to pay the price of a National Health Service that is not fit for purpose and that requires urgent and radical reform.

Last Friday I spoke at the 2010 European Resource Bank, organised by the Taxpayers Alliance.

This is my speech.

I would like to begin by thanking Matthew Elliott and the staff of the Taypayers Alliance for inviting me to speak at this year’s European Resource Bank, and also to congratulate them on its success.

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I am the Director of Nurses for Reform.

I am also a Senior Nurse with more than 25 years experience working in both the NHS and the UK’s private healthcare sector.

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In addressing the subject of this session “Campaigning for healthcare reform” I would like to make several key points.

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In its campaigning, Nurses for Reform aims to influence opinion formers – academics, journalists and politicians – who in turn inform and influence the voting public.

This is done by placing articles in the press.

Media interviews.

Blogs.

Speeches.

And by networking at events like this one today.

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As a libertarian organisation, for NFR healthcare will only truly respond to consumers and customers, ageing or otherwise, when we get the state out of medicine.

When Margaret Thatcher was prime minister she privatized telephones.

Back then, no-one had ever heard of the mobile.

But look at the glories of where we have got to today.

The market is a process of discovery.

And NFR wants to unleash its potential across health and medicine.

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Today, sadly, there is no country in the world that has a great healthcare system, because there is no system in the world that is built on a genuine free market.

People talk of state and private medicine.

They talk of state and private healthcare sectors.

Yet, all these systems rely on professions that themselves rest on monopoly legislative favour.

In this country, to be a doctor you have to be registered with the General Medical Council.

To be a nurse, you have to be registered with the Nursing and Midwifery Council.

These are the underlying monopolies that we find in all countries.

These are the state monopolies that stifle training.

That lower standards.

That undermine innovation…

…This is the statism that kills people and that means our all healthcare systems cannot be as good as we want them to be.

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When it comes to America, not to mention other countries, Nurses for Reform is clear.

Demonopolise the professions.

Open up the whole system so people can voluntarily co-operate and coordinate better.

Deregulate insurance.

Move away from an imposed, employer based system.

Bring down barriers to entry.

Scrap the pseudo-science of State Sposored Health Technology Assessments.

I could go on…

In America, as in all other countries, we have got to stop the communism!

If the people in this room really are really serious about wanting good and glorious healthcare in the 21^st century, then we have to be clear ourselves what it will means to talk about a genuine, free market.

Thank you.