Primary Care Trusts (PCT) are apparently asking NHS hospitals to delay seeing patients for many weeks to ration healthcare, enable the fiddling of the balance sheet and lower expectations of the service.

I think that is it fair to say that most people now have pretty low expectations of the NHS, especially when we see stories of NHS failure such as this and rationing such as this!

NFR has long argued that the government’s Health Bill does not go far enough. So long as trust hospitals remain in the public sector and are not privatized there cannot by definition be sufficient independence or genuine market driven competition. That is why NFR believes in universal independent provision and wants full-blown hospital privatisation.

If only the trade unions were right. If only H5 would openly campaign for more privatisation!

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.

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.

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.

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.

NFR believes that we are at a turning point with the way that healthcare is delivered in the UK.  If the coalition government do not have the will to abolish such time and money wasting quangos as the Health Protection Agency what hope is there that they will have the courage to push through the much needed market-oriented reforms that will take the NHS from being a failing service to a more customer focused system.

This should also make very interesting reading for the government. There has been a lot of spin around the health care reform that they are planning.  This report demonstrates that they will need to be determined and focused if they are to deliver on their promises to develop a health care system that is fit for the 21st Century.

For many years there has been a dialogue of the deaf between the UK and the US.  While we believe that they have a totally private system that will leave people dying in street if they do not have private insurance, they believe that we have this wonderful state system that gives everyone everything they want. Nothing could be further from the truth.

Both systems are badly flawed and in dire need of more market oriented reform.