Saturday, 3 November 2012

Broxtowe Save The NHS - Public Meeting

The newly formed “Broxtowe - Save Our NHS” group had a public meeting recently regarding the effects of the 2012 Health and Social Care Bill, which many believe will result in a two tier heath service, based on ability to pay and will see much the NHS fall into private ownership.

BFTF has a deep affection for the NHS and regards it as one of the UK’s crown jewels, so attended the meeting to see what was said.

There were three main speakers, and some of their points are outlined below.

Nick Palmer (former Labour MP for Broxtowe)
Nick began his talk by pointing out that when Labour entered office in 1997 the average waiting time for a hip replacement was 2yrs, and that patients were routinely told that they could instead have the same operation, by the same surgeon (!!!) privately within 2 months.

During Labours time in office, waiting times dropped dramatically. And the result of this was that fewer patients went private and the private healthcare companies lost a lot of business.

Nick went on to describe the three types of privatisation that he felt were now underway.

Privatisation of Provision - the fees that the government pays for each specific medical provision (from a hip operation to open heart surgery) are loaded in favour of the easier procedures that private companies prefer to undertake. In contrast, the fees for complex surgery do not cover costs. Traditionally, NHS hospitals could use the surplus from the easy operations to cover the losses in the complex ones - but with the easy operations being stripped out and handed to private companies this will no longer be possible. And as a result, NHS trusts will find themselves at much greater risk of going bust.

Privatisation of Patients - the amount of private work the NHS is allowed to perform was increased in theSocial Care Bill from the previous limit of around 5% to 49%. Supporters of the Bill claim that this money will go straight back into the NHS but Nick was concerned that NHS managers- under intense financial pressure - would use the money not for general care but to build more money-making private facilities - sending us back to the situation that existed in 1997.

Privatisation of Preventative Care - Unbelievably, the new Clinical Commissioning Groups (CCG’s) do not have any responsibility for preventative health care, so this is being landed on councils, who do not have the funding or the expertise to undertake this work. To call this shortsighted seems something of an understatement. Nick pointed out that the Nye Bevin, the architect of the NHS, said at its inception that it was about prevention as well as cure.

So what is to be done? Nick felt that it was not necessarily wise to simply dismantle the whole Bill, should Labour be elected at the next election, and that there were two specific areas that, if addressed, would alleviate most of the damage that the Bill was doing. Firstly, that the financial pressure on hospital managers should stop and secondly the existing NHS provision should be given priority in any tendering competition.

Dr Arun Chopra (Consultant Psychiatrist at QMC)
Dr Chopra began by pointing out that the public’s satisfaction with the NHS was at an all-time high at the time of the 2010 election, and has already dropped since then. (Incidentally, you can download the data here, and BFTF has plotted the relevant chart below)
Public Satisfaction with the NHS


He continued by saying that doctors were being asked to make some £20billion of savings, an unprecedented amount, in the midst of a huge re-organisation of the NHS and that this was causing doctors to take their eyes off the ball in terms of their clinical roles. Morale was also being affected by concern about job losses and the impact of pay freezes (effectively pay cuts due to the effects of inflation)

Dr Chopra expressed anger at seeing senior Conservative politicians saying that there services were being protected , saying “that’s absolute crap - it’s a lie”.

The doctor said that some of the objectives that Landsley stated for the Bill (such as clinicians input into service provision) were things that doctors were happy to do for free - it did not need legisalation. What needed legislation were the elements of the Bill that enabled privatisation.

Dr Chopra felt that this profit motive was having adverse effects for the NHS, saying that GP practices run by private companies sometimes had only one permanent doctor, with the rest being made up of locums. This saved money but provided a poorer quality of service for the patient. Another example given was that of the report into Winterbourne View Hospital, were patients were ill treated, with Dr Chopra stating that the investigation into the abuse there identified the profit motive as being a factor (BFTF has found a link to the report (see here) and it states that “Castlebeck Ltd appears to have made decisions about profitability, including shareholder returns, over and above decisions about the effective and humane delivery of assessment, treatment andrehabilitation “)

Dr Chopra also said that suicides were increasing, partly due to the recession, partly due to cuts in services and partly due to the effect of ATOS, who are reviewing the cases of everyone who receives disability benefit.

He also raised the issue of training, pointing out that private companies would not have any incentive to train our next generation of doctors, leaving this job (and its associated costs) with the NHS - further reducing the NHS’s ability to compete for contracts. In addition, if the easy medical care is siphoned off by private companies, the NHS will no longer be able to train future doctors using these routine cases.

Dr Chopra pointed out that Labour did not get it all right, admitting that the PFI programme was now a millstone around the necks of NHS Trusts.

And he closed out by saying that his perception was that people did not want lots of “choice”, they wanted to know that they would receive good quality care in a timely fashion. Adding that he hoped that the next time the UK hosted the Olympic Games, the opening ceremony would also feature the NHS logo prominently.

And finally, reminded the audience of the Conservatives pre-election promise to “cut the deficit, not the NHS”

Sharon Vasselin (Unison Notts Healthcare)
Sharon reviewed much of the history of the NHS Health and Social Care Bill, listing a number of useful resources and reports. Unfortunately, she rattled through her talk so fast that BFTF had no chance of accurately writing anything down. My bad, but I’m only human.

Question and Answer Session
Perhaps worth noting a few points from the Q&A Session:

ATOS won a contract for performing “Benefit Tests” and then promptly subcontracted the work back to the Lanarkshire NHS - presumably after taking a profit.

Nick Palmer pointed out that his (Conservative) opponent at the last election had been much better funded than he had and that the private funding of political parties was “a cancer in out system”

One or two of the questions came from people who described the problems they had faced in accessing mental health care, and Dr Chopra commented that it was good to hear people talking about mental health in the same way they did about physical ailments. Dr Chopra also cautioned against accepting the Conservative view that the NHS was overfunded, pointing out that it was only after several years of Labour funding increases that the amount the UK spent on health care matched that of our European neighbours - around 9.6% of GDP

Dr Chopra also suggested that making Health and Wellbeing boards more powerful would allow then to champion the interests of the patient more effectively.

Nick Palmer wondered why ATOS appeals took so long (about a year) and pointed out that this was a hugely stressful burden on the people concerned - people who, by definition, are not in the best of health.

The deadline (apparently) for amending CCG constitutions, for example as suggested by 38degrees, is April 2013 (see here for more info about this - its important!)

What the British Public thinhs the Government should be spending money on


A Few Personal Comments
Whilst BFTF cares deeply about the NHS, this is not from any particular political point of view. Indeed, the last election left BFTF with the choice of the Conservative Party, who increasingly seemed to favour dog-eat-dog social policies and Labour, who had spent a great many years forcing the NHS to take disastrous PFI contracts whilst adopting a foreign policy that appeared to be largely about helping the US bomb brown people. Some choice!

And issues such as Trident and PFI seemed to be off every party's radar at election time.

So, BFTF was not particularly keen on hearing the chair state that he had "a seething hatred for the conservative party", nor on members of the public being addressed as "comrade" (Mr Chairman, you can be sure that BFTF isn't your comrade, sunshine) because this kind of, frankly, tribalism, isn't good for democracy and is exactly what puts ordinary people off engaging in the political process in the first place.

Dear Politicians, for goodness sake, there must be many things that Labour and the Conservatives agree on - why don't you ever talk about those? Why is is always about conflict and disagreement?

Q&A with Dawn Smith from Notts CCG
A public meeting organised by 38 Degrees at the Mechanics Institute, 3 North Sherwood Street, Noots NG1 4EZ on Mon 26th Nov at 7.30pm

Other Links
Anna Soubry (Broxtowe Conservative MP) response to Nottingham Save the NHS Campaign
Anna Soubry NHS "Mythbusters"
Kings Fund NHS Reform "Mythbusters"
Interview with Prof Ian Shaw (Health Policy Prof at UoN)
Challenging the BBC on their coverage of the NHS Bill
Post on the NHS Bill

Lastly, in the spirit of being fair and giving everyone a chance to state their view, BFTF asked the Nottingham Conservatives what they thought of this article and whether there were any counter points they wished to raise.

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