National Health Service (NHS)

NHS bill passed.

I'm not sure if it's not just the latest iteration of the centralise control / localise control cycle of the NHS that has been going on for years.

I guess it's the margins and the marginalised that will bare the brunt of the changes though.

Would anyone complain if a new thread was started to discuss the NHS bill?
I can't believe there isn't one already.

As long as large multi-national companies were invited to tender for moderating duties on that thread.

Moderating duties should first be imposed on a group that is unwilling and ill-equipped to perform that job, and at which they are destined to fail.

Let the discussion begin continue.

Set to be made law by Easter

http://www.bbc.co.uk/news/uk-politics-17447992

It's a massive topic though and so many different elements of it. NHS reforms, commissioning, LINKs / HealthWatch, personalised planning,

Had a brief chuckle at the Andrew Lansley description by flesh bag Charlie Brooker this week:

"... Yet no matter how many people are bellowing at him, Lansley perpetually wears the nonchalant expression of a man killing time by humming cheerfully in a lift. Presumably he has now become so accustomed to the sound of loudly heckled abuse, he doesn't even hear it any more.

I guess to him it's like a noise made by some weird machine in his workplace, a background soundtrack he tunes out subconsciously. The protesters' plaintive ape wails of despair simply bounce off him like rice grains flicked at a rock.

For a man who recently conducted a high-profile "listening exercise", he's got a shitty set of ears."

Fucking toads. One key change as a result of legislation is that Secretary of Health is no longer legally responsible for provision of the NHS. Does this mean that, as he no longer has any resposibility, Andrew Lansley will no longer collect a wage for his now non-job?

In 5 years time the Tories will be encouraging us to castigate GPs for destroying the NHS. Creative Destruction - It's their next favourite hobby after nepotism, self-service, gay-bashing and closeted homosexual sado-masochism.

Edit: forgot to say: very good diagram Tiswas - I'll be nicking that.

Please don't tarnish gay SM with the Tory brush.

Here's an anecdote. My best mate is a GP in Tower Hamlets. A few years back (under Labour) one of the neighboring surgeries had been very badly run and had to taken over. His surgery bid for it as did a private company. It was obvious throughout that the process was rigged and, sure enough, the private company got the contract. However my friend's surgery was entitled to ask the man who made this decision to come in and explain it. Which he did, with an advisor in tow. At one point they asked him if, nationally, when there had been tenders from NHS practices and private companies if an NHS tender had ever won. The bloke turned to his advisor and asked if he had to answer the question. He was told he did. The answer, of course, was no.
What does this show? That privatisation has been going on for a while, that it is rigged. Oh and that it is a scam; the practice that was taken over by the private company has now failed again because the bid was so low that, surprise surprise, they found they could not run it on that money.
And if anyone thinks the money goes on salaries; my mate works at least 50 hours a week (though he is nominally 3 1/2 days a week) in the poorest catchment area in England and earns a lot less than any moderately experienced graphic designer or IT specialist on the forum.

we will get treated if we are ill, albeit in slightly dirtier beds / wards

And having waited longer. People don't just get 'ill' though. Fine if you have an an ulcer, easy and profitable to treat. But if you have multiple physical and mental problems then there is no money to be made from you. Your treatment is subsidised by the simpler, profitable illnesses. No private business has any interest at all in that model.

And if anyone thinks the money goes on salaries; my mate works at least 50 hours a week (though he is nominally 3 1/2 days a week) in the poorest catchment area in England and earns a lot less than any moderately experienced graphic designer or IT specialist on the forum.

Which is why the low wages only attract doctors from poorer countries with little or no English language skills, and the places where they qualified as nurses and GPs are left desperately short of qualified medical staff, and are loathe to invest money in more training because they just come to the UK after they've qualified...

Actually that is not true; pious as it sounds his practice attracts doctors who want to work with the most disadvantaged people and have a strong feeling of empathy and social responsibility. Though at interviews they have had people laugh out loud when they have been told what the pay is.

Actually that is not true; pious as it sounds his practice attracts doctors who want to work with the most disadvantaged people and have a strong feeling of empathy and social responsibility. Though at interviews they have had people laugh out loud when they have been told what the pay is.

If I can't blame the forruns I don't want to play.

Aren't they the same thing (to the extent that LLPs are the "same" as Ltd companies? Surgeries are almost de facto franchises of the NHS, owned and run by various types of organisations, but ultimately wearing the same uniform, locked into purchasing and provisioning agreements and having their wages set by state / trust.

I am no expert on the detail but it was essentially a local GP partnership vs a large international company - any qualified provider or whatever it is being called nowadays. His practice is a partnership so they are essentially self-employed whereas most GPs now are taken on as salaried staff - better pay, less admin and so on. It's a complicated situation but the reality of 'competition' is not.

Actually Will, I ve been that man at meetings . I suspect I know who he was. The truth is that GP practices do and did win some of those tenders. Thats not to say that some PCTs would not have preferred another provider to come in. Some, eg in Barking have made a big difference to primary care in the area and actually made people healthier. Some thing not all of the old style GP practices did or do.

The Bill, however, is a mess.

I was careful to label it as anecdote. The number of anecdotes he has of a similar nature do tend to start to seem like evidence though.

Well Cameron and his mob are anecdotally politicians, so the comparison holds.

And if anyone thinks the money goes on salaries; my mate works at least 50 hours a week (though he is nominally 3 1/2 days a week) in the poorest catchment area in England and earns a lot less than any moderately experienced graphic designer or IT specialist on the forum.

Where would we be without graphic designers, though?

GPs who are partners, especially in a PMS practice with a high QOF score are probably doing better than OK. Especially as the NHS pays for the rent and rates on their premises. Some one over 50 will also have a very decent pension. They still believe they are hard done by. One of the things I don't like about my job is talking about money with GPs. They have the same motivation as super model for getting out of bed and the BMA is the NUM in pinstripes.

They could also benefit significantly from taking over the commissioning budget.

At the other end it's getting harder, the salaries are about £70k and the chance of a partnersip or owing a practice and becoming one of the above is diminishing .

Detailed report on this topic Thursday 8pm radio 4

Where would we be without graphic designers, though?

In Comic San Serife.

http://you.38degrees.org.uk/petitions/petition-to-stop-new-nhs-competition-regulations-si257-being-passed

http://www.independent.co.uk/life-style/health-and-families/health-news/your-life-in-their-hands-is-the-caredata-nhs-database-a-healthy-step-or-a-gross-invasion-of-patient-privacy-9042564.html

http://www.care-data.info/

Thanks VB for pointing this out in the Wellness thread.

http://www.theguardian.com/society/2014/mar/03/nhs-england-patient-data-google-servers

NHS staff striking over pay this morning - 1st time in 30 years. Independent pay review body recommended 1%, after 4 years of no pay increase, but government says no (after granting ministers 11%). So, we're all in it together then.

Open consultation:
Setting the mandate to NHS England for 2016 to 2017
https://www.gov.uk/government/consultations/setting-the-mandate-to-nhs-england-for-2016-to-2017
Closes 23rd November - 3 days left.

Some more info here: https://www.opendemocracy.net/ournhs/caroline-molloy/dont-want-government-to-let-nhs-die-one-crucial-thing-you-can-do-now

Kings Fund says there's not really any extra money for actual services. DoH says there is. NHS england sits awkwardly on the fence. http://gu.com/p/4fb2d?CMP=Share_iOSApp_Other

Wondering what magic efficiencies the DoH thinks will cover the funding shortfall over the next 5 years? Well here's an idea... I recently heard a senior service manager in a London MH trust talking about schizophrenics needing to be "more robust"... a big dose of HTFU everyone and it'll all be fine.