Nurses for Reform Blog

I have recently had to renew my daughter’s BUPA health insurance, while doing this I came across some very interesting information.

While discussing payment and cover options I was astounded to find out that if I wanted my daughter to have the option of using the private pay bed units in NHS hospitals I would have to pay considerably more than if she was to use only private hospitals.  This is because the NHS apparently makes no attempt to be competitive to attract business, they blindly charge far higher prices than the private sector and ultimately drive away business.

David Cameron and Andrew Lansley are right, the NHS should be opened up to competition and the sooner this happens the better.  I have no problem with the NHS using pay beds to generate income, what I do have a problem with is being ripped off!

The recent announcements that the government is creating more Academies and Free Schools is really good news for education in the UK.  However, it really is a shame that the same reforms are not being applied to the UK’s hospitals.

While NFR would agree that the development of GP Consortia are a good idea and should be pursued, the government’s healthcare reforms must be as bold and exciting as those in education.

NFR would like to see all NHS hospitals being returned to the independent sector, being run by a multitude of for and not-for-profit suppliers.  While the healthcare unions are busy protecting their own vested interests it is becoming increasingly apparent that patients and consumers of healthcare just want good quality and value for money.  It is time that the government and the unions realised this and started setting hospitals free to deliver this.

This really is great news.  Dr Peter Carter, of the Royal College of Nursing, is finally beginning to listen to Nurses for Reform and to really understand the NHS reforms.

His understanding that failing hospitals should close is a major step forward.  Sadly, he still seems to think that healthcare provision should still be managed top down by central government rather than develop via market mechanisms, but this  is definitely a start!

On Tuesday afternoon I was interviewed on the BBC’s Three Counties drivetime show to discuss the progress of the Coalition Government’s healthcare reforms.

The points that I made were:

1. The core of these healthcare reforms have always and will always build upon the key reforms of Tony Blair in the early 1990’s.  Through the concordat with the private hospitals, the introduction of Independent Treatment Centres (ITCs) and the desire to have Independent Foundation Trusts and Public Private Partnerships it was Tony Blair and the last Labour Government that brought to an end the counter productive war between the NHS and the independent healthcare sector.

2. No-one in the coalition government has ever proposed an American-style healthcare system.  Clearly, what David Cameron and Nick Clegg want is to deliver a more open, innovative and diverse NHS that fully uses all expertise and resources available whether NHS, mutual, charitable or for profit.

3. NFR is critical of the tories as for too long they did not explain what they were attempting to achieve for the NHS and this led to Unison and the BMA scare mongering.  I think that we should be greatful to Nick Clegg for having forced Andrew Lansley to better communicate the reforming messages in a non-threatening way.

4. While NFR would like to see a more radical and market oriented approach that is even more patient focused, we are confident that NHS provision will become ever more independent.

5. NFR also sees these reforms as an opportunity to increase efficiency and competition in the independent sector and are delighted that the government plans to remove the cap on NHS pay beds.

6. In time NFR would like to see the following changes made to the NHS:

• Hospitals and healthcare professionals being allowed to advertise their services to enable the establishment of trusted brands.
• All NHS hospitals to be returned to the Independent sector. No NHS funded patient should have to be treated in a state owned or run hospital
• Planning laws must be changed to make it easier to build new hospitals and clinics.
• The government must abolish collective pay bargaining.  Pay must be negotiated at local levels.

7. Finally, NFR believes that Andrew Lansley’s NHS reforms have never been revolutionary, they have been evolutionary building on the work of Tony Blair.  As the unions were wrong to scare monger that his reforms were privatisation in the 1990s, they are wrong to cry wolf now.  NFR wants an honest and open debate, we want to see the end of vested interest groups such as Unison and the BMA misleading the public.  Because these reforms are patient focussed they must be supported.

This is a very insightful article from Janet Daley in the Telegraph.

She pretty much sums up my view that David Cameron spent a considerable amount of time this week announcing that there will be little or no changes to the NHS reforms proposed by the coalition government.

When you examine the detail of his speech you find that there is really not much there.  He stated that the NHS will not be changed in to an American-style system.  That’s fine, but I don’t think that they intended to do that anyway.

He also stated that the NHS will continue to be free at the point of delivery.  Again, no change.  Another key point seemed to be the insistence that the NHS remain a universal service.  As far as I can tell this just means that the government will remain the main funder of NHS care for the forseeable future.  However, over time I think we will see more and more people choosing to make top-up payments for various treatment and care options.

The government is aware that if the healthcare provision in the UK does not change very soon there will be even more of a disaster than we have at the moment.  While in my view the proposed reforms do not go far enough, if they do not go through there will be even more stories such as this as the NHS fails to cope.

Something that has really annoyed me during the debate about the forthcoming UK healthcare reforms is that when there is talk about the independent sector providing care for NHS funded patients, the independent sector is accused of cherry picking.  It is stated that the nice, clean and profitable work will be chosen leaving the NHS to pick up the more expensive, difficult and less popular work.

Well, I think it is time to be honest about this and in my opinion no healthcare organisation cherry picks like the NHS does.  When the NHS was established in the 1940s end of life hospice care was left out of the nationalisation as the NHS did not want to be involved in this expensive and unpopular work that ended in all of the patients dying.  The happy result of this is that without state interference the UK has a thriving, high quality hospice movement.

As time moves on and the NHS cannot afford to carry on as it has in the past, the cherry picking continues with NICE deciding what drugs the NHS will and will not give people, with infertility care rarely funded by the NHS, with much mental health and elderly care provided by the independent sector, with more and more surgical procedures being classed as cosmetic rather than plastic surgery so that the NHS can wiggle out of providing the, and even less dental procedures being available to NHS patients.

This is all very different to that founding promise of the NHS that all Medical, Dental and Nursing care would be free to everyone, rich or poor!

This morning I was interviewed on LBC Radio with a GP from the BMA discussing the speech that David Cameron’s made yesterday on the NHS Reforms.

I made several points;

First, David Cameron talked about keeping the values and ethos of the NHS and these reforms are true to that promise as they do not falter from the founding promise that the NHS will be free at the point of use.

Second, David Cameron stated yesterday that these reforms are little new and as such they are an evolution not a revolution.   They follow on from the work of Tony Blair’s labour government.  Indeed, it was under Labour that from 2000 onwards NHS funded patients could receive surgery, treatment and critical care in the independent sector with 250,000 NHS patients per year entering independent sector hospitals.

Finally, the GP stated that healthcare is not like the high street, that bad hospitals cannot be closed down like bad shops.  Well, I would argue that they should be.  NFR wants to see failing hospitals taken over by successful organisations or social entrepreneurs so that we no longer hear stories of the elderly dying for lack of water in UK hospitals.

This letter today in The Daily Telegraph is a great move forward from the medical profession in support of Andrew Lansley’s NHS Reforms.

Not only do the GPs support the reforms but they point out the most important part of them, the benefits to the patients.  For Nurses for Reform this is the most important reason for the reforms.  That patients can work together with their family doctors to chose how and where their healthcare is delivered.

Another article in the Telegraph questions that the GP’s letter does not mention the use of the private sector for healthcare provision.  Could this possibly be because GPs and patients do not mind who owns the hospital in which their care is delivered?  What is important to them is that the care they receive is good quality, value for money and that they do not contract healthcare associated infections or become malnourished during their hospital stay.

Putting to one side the dire financial situation this country is in, I do still find it amazing that despite continued evidence that the NHS is failing the British people the trade unions continue to bury their heads in the sand.  While the rest of us, our family and friends are finding out on a daily basis that the NHS cannot and will not live up to the promises of the 1940s the unions are now threatening to make matters worse by going on strike.

What also interests me is that  for all their complaining and protesting I cannot find any evidence that Unison can suggest alternative ways of reforming the NHS.  They go on and on about fairness and equality but there is not one jot of a suggestion of how they would do things.   Maybe Dave Prentis knows the way to the pot of gold at the end of the rainbow that will solve all our problems, but in the real world the truth is that it will continue to be the elderly and the most vulnerable in society that suffer from the strike action proposed by Mr Prentis and his members.

Earlier this morning I was interviewed on LBC Radio with Peter Carter from the Royal College of Nursing I was pleased that I was able to convey many of the points that I wanted.

Briefly, I warned the RCN against going on strike.  To wander up a Scargillesque blind alley at this time of such national financial pressure would be fool hardy.  That said, if they do strike and I were in the government I would press ahead and seek to abolish National and Regional Collective Pay Bargaining.

Again, adamant that all UK hospitals should be placed in the independent sector so as to drive up quality NFR made the case that away from the whines of sectional trade unions real patient interests require some blue skies thinking