23 Oct 2014

Can a new plan ease fears over the struggling NHS?

There are those who believe, most passionately, that the NHS is being privatised by stealth and that its privatisation is part of a grand plan by the Tories, worked out in secret around various Notting Hill dinner tables.

Equally there are those who think private companies are being given too much access to the NHS and that, while patients will still not have to pay, the inevitable consequence of letting those companies in is that some services will fall by the way side.

Then, I suppose, there is a third group who believe that the NHS will struggle on regardless and that its status as the nearest thing to we have to religion will ensure the politicians do the best by it.

Today, the Chief Executive Simon Stevens (pictured below, right) laid out what he thinks is the way forward, and that includes asking for an extra £8bn by 2020 to implement a plan which includes switching funding from hospitals into other community-based services including GP surgeries.

Without the extra £8bn on top of planned increases in line with inflation, patients could suffer “severe” consequences.
The ideas have been largely welcomed, although the political parties haven’t quite said how they might pick up the obvious gauntlet thrown down.

The new chief executive of the NHS, Simon Stevens, has his blood pressure taken by practice nurse Lesley Dobson during a visit to Consett Medical Centre in Consett

Nobody is in any doubt that the NHS is struggling. The signs are everywhere, from GP surgeries to A&E departments. Sometimes the signs are not even as obvious as that. I was told recently of a service for people with neurological diseases to help them with bladder conditions, which has been chopped. It’s not a very sexy headline but, oh my goodness, those poor patients.

So a plan is good. And NHS England’s plan seems as good as any. But it will not assuage the fears of the first two groups about privatisation.

And on the Today programme Mr Stevens failed to truly answer the questions put to him on privatisation. Instead he said that “sometimes there will be a case” for a patient needing, for example, a hip operation to use a private provider paid by the NHS.

He said that it would ultimately be up to patients to decide who they wanted to provide that service.

Yet the issue that is never addressed from Whitehall is the lack of level playing field. When we, as journalists, ask to see the business case or know the profit margins or request financial details if the service should fail to deliver on its contract (as has happened numerous times), we are told that it is subject to commercial confidentiality.

There is currently little control, because of the way the system is set up, over whether a contract goes to a private company, a social enterprise or the NHS. Labour has said it wants preferred bidder status for the NHS, but it is not clear they can do that under current legislation.

All this will undoubtedly be hashed out in the run-up to the election. Although whether it will be resolved… I hate the phrase, but only time will tell.

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6 reader comments

  1. Martin says:

    My experience of management and non medical staff within the NHS, is it’s filled with incompetence and political correctness. For example a departmental manager who was supposed to act as a domain expert for a new system, didn’t know what the new system should be made to do, but no-one would deal with that lack of expertise. Second example – instead of salvaging a failed system, it was mocked and years of work were thrown away, although there was a lot to learn from the old system (threw the baby out with the bath water). For the avoidance of doubt, I had no association with the old system, just being an expert observer. Third example, (to use a medical analogy) senior management confusing a pharmacist, for a medical consultant. In reality the tech consultant didn’t even know how to debug code!!

    They need to face up to incompetence. Fear of failure/avoiding any blame for failure is also skewing the decision making process. Some parts of the public service put more effort into covering their backs than ensuring project success.

  2. Bob Watts says:

    It´s the same doctors working privately as in the NHS. They do their hours in the NHS then walk round the corner to their private clinic. It makes absolutely no sense to pay the five times what they earn in the NHS for doing the same job.

  3. Philip Edwards says:


    Of COURSE there is a plot to privatise the NHS. It’s what neocons do across the world. They would steal the bread from your mouth if it meant a penny more profit. They are a gang of disgusting, corrupt thieves without conscience. There can be no compromise with them.

    According to Kenneth Clarke in a BBC interview Thatcher wanted to adopt the Yank system outright. Even a grubby tory like Clarke realised that would invite disaster for the health of the country. Thatcher, of course, was nothing but a front woman for Yank profiteering companies who have always hated “socialised medicine.” So are her successors in all political parties.

    The tories opposed the introduction of the NHS from its very inception, just as they have opposed every single social advance this country has ever made.

    If this country is ever stupid enough to allow privatisation of the NHS it will deserve everything that will logically follow, the full horror of a disgusting Yankified system. If that ever happens you will see sick people being forced to sell their homes to cough up for profiteering hospitals and doctors and surgeons without conscience.

    The staff of our NHS are heroes to a man and woman. They operate against the most evil manipulation and hypocrisy even neocons can concoct, and they operate brilliantly.

    You would have to be blind not to see what is going on: deliberate reduction of funds at the required level, and continual bought-and-paid for media attacks on the symptoms of what is wrong but not on gradual privatisation intentions. The intention is to attack by attrition until such time as the bankers (you remember THEM, the gang who almost stole the wealth of the world – may yet do so) are called in “to rescue a failing system.” Hence blaming people for getting old and sick. In other words, always blame the victim a la the Daily Mail and the Sun. It is useless asking such scoundrels to be objective in their coverage. Many of them are just media neocon jobsworths without a scruple between them.

    Meanwhile, rich people receive tax breaks and corporations are not pursued for tax dues. No wonder the tories, New Labour and LibDems are hated and despised by anybody with a semblance of conscience.

    And if TTIP is eventually enshrined in capitalist law you can expect much, much worse on all fronts, never mind the NHS……..So why has British media decided to virtually ignore the biggest ripoff since the abolition of exchange controls?…….Answer on a postcard…..

  4. H Statton says:

    Taken from: Primary Care Talk (April 2004, No. 28)
    An old edition but I use it for the purposes of argument.

    Drug example:
    Premique, Low Dose (conjugated oestrogens 0.3mg and medroyprogesteroneacetate1.5mg) tablets in the treatment of oestrogen deficiency in post-menopausal women with an intact uterus (Cost: 3 x 28, £29.85).

    Some NHS money could be saved by one very simple process. Do not over-dispense drugs from the hospital pharmacy. When patients are referred via their GP to their local hospital for admission, they are asked to take their medication with them.

    If they have sufficient medication and it is seen to be well within its expiration date, then unless the patient requires more (e.g. if they are about to run out of medication when discharged or an increased dose is required), there is no need for the on-call medic to prescribe any more meds when the patient leaves.

    The maths is scary.

  5. H Statton says:

    Victoria MacDonald 24th October 2014
    Can a new plan ease fears over the struggling NHS?

    “This is the biggest single experiment in social service that the world has ever seen undertaken.”
    Aneurin Bevan (July 5th, 1948) -The introduction of the NHS.

    “…only time will tell.” I too dislike the expression but I’ve found myself using it all too often, apart from when I’m venting my spleen at some Tory MP on the telly.

    I can’t help but feel a little nervous when I hear the letters TTIP (Transatlantic Trade and Investment Partnership) and NHS in the same sentence; the proposed free trade agreement between the EU and US.

    According to Reuters Robin Emmott (Feb. 27th 2013), “EU trade chief hopes to clinch U.S. trade deal by late 2014”.

    This link provides an outline of the TTIP negotiations that preceded dialogue, 11th July 2014.

    With a policy in international marketing in which imports and exports are not tightly constrained by governments I cannot help but think the health of the healthcare system will be going down the tubes if we’re not careful.

    Big corps, big pharma, big shareholders….the bigger the better?! No thanks. I’d rather know who’s doing what, why and when and be alerted as to any potential seismic shift in the landscape rather than waking up to find all that I thought I’d voted for has simply been swept away during the night.

    I reckon I don’t have to mention the ‘Clegg Factor’: manifesto promises followed by titanic U-turns; the ‘others’ quietly applauding in the background. Maybe ‘Clegg Factor’ should make it into the dictionary alongside ‘Photobomb’.

    However, all parties know that any palpable threat by any of them to strangle services will come back and kick them in the polls. Thus, we fall into the murky realm of statistics, which as you know can paint whatever oily picture their constructor wants.

    The Royal College of Midwives on strike for the first time in their history (inception, 1881) the National Union of General and Municipal Workers (GMB) on strike, GPs in receipt of new contracts every two years. It is not a pretty sight, but I have the utmost respect and sympathy for these people. As per usual: taken for granted, overworked and underpaid.

    In public sector jobs such as these, the higher powers have many over a barrel. The workers first priority is caring for their patients, so it goes against all their professional instincts to abandon them. The government is taking the p*ss.

    An article reminding us that overseas investors and takeover bids are still a real threat to the NHS is summed up nicely by Sean Farrell in The Guardian (Friday 26 September 2014).

    It’s a pity we don’t have a levy on hot air in the House of Commons – it would solve a lot of problems.

  6. IAS2014 says:

    While the HEADLINE of “24hrs to Save the NHS” is one that the Labour party is tempted to reuse, and the media emphasise on this issue – though important – can do more to captivate those already ignorant and drawn into such headlines – is it not therefore fundamental that we, the public, step back and evaluate on balance the challenge and success of the NHS while also bringing into question HOW MUCH of the public are using A&E as a GP service and, thus, piling unnecessary pressure on nurses and the NHS overall?

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