Nurses for Reform Blog

This irrelevant scaremongering nonsense is what we have come to expect from the Royal College of Nursing. It is designed to lead to the public to believe that 100,000 nursing jobs will be lost completely due to the Government spending cuts and healthcare reforms.

However, what is not taken in to account are the jobs for nurses that will be transferred to the private sector.  With reference to my previous post, I would suggest that we may see increased demand for nurses to work in many different healthcare settings.  As for the accusation that less nurses would be trained, surely the time has come for the state to lose its monopoly on nurse training and for us to see a plethora of new entrants to the nurse education market.

I am really pleased to see that David Cameron and Andrew Lansley are continuing to push ahead with their plans for NHS reform.

The realities of how the private sector will work with the NHS are now being explained and, in truth, they are just an extension of what has been before.

I remember when opticians were first allowed to see patients/customers in high street shops instead of NHS facilities.  There was a brouhaha about whether quality would be maintained.  Now none of us think of going to the NHS for our glasses or contact lenses.  Whether we go to SpecSavers, the internet any other of the competing brands, the people who have their eye care free at the point of delivery continue to do so and the rest of us get good quality eye care, a huge choice of frames and, most importantly, great value for money.

When I think back to the 1970s when children who wore NHS glasses were stuck with two choices for frames (horrible pink or blue plastic!) that always broke and were repaired with a sticking plaster, I am so pleased that that is now a distant memory. What I want to see in the near future is the evolution of other NHS services so that NHS customers can receive their healthcare in places that are convenient to them.  Where they don’t have to wait in overcrowded waiting rooms to be seen by doctors who behave as if the patients are an inconvenience and yes, if small, inefficient and poorly functioning NHS facilities are forced to close or are taken over by better performing providers this can only be for the good of the patient.

According to the UK press, this morning Prime Minister David Cameron will announce that many public services, including hospitals, will be run by independent companies, charities and mutual organisations.

For Nurses for Reform this is wonderful news, as regular readers of this blog will know, this is something that we have campaigned since our inception.

Mr Cameron has the future of the NHS in his hands and I urge him strongly not to drop the ball this time.  These reforms really are the only way to improve healthcare for NHS funded patients.

This story, that NHS waiting times will increase due to the government’s healthcare reforms, is blatant scaremongering by NHS managers.

Although it is true that NHS hospitals cannot cope with the demands placed upon them.  Since 2000, thanks to the historic concordat signed by Tony Blair and Alan Milburn, the NHS has been able to use the spare capacity of the UK’s independent healthcare sector to ensure that waiting times do not increase and availability of treatments is not compromised for NHS funded patients.

The time has really now come for many politicians, NHS managers, and clinicians to wake up to the fact the the NHS hospitals, in their current form, will never cope with demand.  It is expensive and does not provide the high standards of care that can be achieved elsewhere with better cost efficiency.

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.

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.