The Liberal Democrats And The Scottish Parliament

[Blackpool Jags]

2. The NHS changes are being completely overblown. All that's happening is PCTs' responsibilities are being transferred to GP consortia. It's not privatisation beyond the independent involvement that already exists and spending on the NHS is being protected. Massive ideology, huh?

 

You really need to get your head out of some the dross tracts you obviously read that masquerade as newspapaers or professional journals.

 

In the unlikely event that you've cast a glance over the White Paper, you'll maybe notice the semantic turn from 'The NHS as preferred provider' to 'Any willing provider'. This means that GPs, who should be flippin well turning up to work to see patients and not becoming bureaucratic functionaries, will be politically under intense pressure to allocate health services to any of the gamut of private providers that the legislation will beget, and for which it has, in itself, been enacted. This range of 'willing providers' can include anybody from Bupa to Asda Healthcare to Jaconelli's. This is a one-way ticket to the American model which is the shame of the developed world.

 

Not ideological my big fat sweaty arse.

[Woodstock Jag]

Total and utter pish. You know nothing.

 

The only cuts that have been made to date, which you could legitimately attribute to the Coalition government, would be the £6 billion of efficiency savings in the last fiscal year. Most of that was in scrapping the ID cards database, among other things. There were no front-line cuts imposed for the last financial year by the Coalition. Anything that was cut at a lower level was done so by councils and would have done so anyway under Labour.

 

Fair comment, Allan. My point was in response to our resident anarcho-free marketeer who, by his own analysis, is slumberingly unaware of the devastation caused, hitherto, in Local Govt., Education, Social Services and the NHS where we are experiencing the impact of the first and second waves of £20billion worth of cuts.

 

The cuts this year are within £2billion of those Labour planned to implement. If you really think that that final £2billion is "devastating" when public spending is STILL going up and will only just get back to 2007 levels by the next election, then you're using the incorrect definition of devastation.

[Woodstock Jag]

You really need to get your head out of some the dross tracts you obviously read that masquerade as newspapaers or professional journals.

 

In the unlikely event that you've cast a glance over the White Paper, you'll maybe notice the semantic turn from 'The NHS as preferred provider' to 'Any willing provider'. This means that GPs, who should be flippin well turning up to work to see patients and not becoming bureaucratic functionaries, will be politically under intense pressure to allocate health services to any of the gamut of private providers that the legislation will beget, and for which it has, in itself, been enacted. This range of 'willing providers' can include anybody from Bupa to Asda Healthcare to Jaconelli's. This is a one-way ticket to the American model which is the shame of the developed world.

 

Not ideological my big fat sweaty arse.

 

I have read the White Paper. Thanks for patronising me again, though.

 

Having the NHS as preferred provider is fundamentally unfair. If other providers can do it better and or more cheaply, they damned well should have the opportunity to do so. If you really don't want the most efficient operation doing things, and you think that to want that is ideological, more fool you.

 

This is nowhere near the US system. The US system is horrifically set-up and sees subsidised drugs companies and vested interests sewn throughout private insurers. The legitimate comparisons are with the German system, where private companies co-ordinate healthcare but the state is ultimately the macro-observer and provider of funding. It works absolutely fine over there and it will work absolutely fine over here.

[jaggybunnet]

I have read the White Paper. Thanks for patronising me again, though.

 

Having the NHS as preferred provider is fundamentally unfair. If other providers can do it better and or more cheaply, they damned well should have the opportunity to do so. If you really don't want the most efficient operation doing things, and you think that to want that is ideological, more fool you.

 

This is nowhere near the US system. The US system is horrifically set-up and sees subsidised drugs companies and vested interests sewn throughout private insurers. The legitimate comparisons are with the German system, where private companies co-ordinate healthcare but the state is ultimately the macro-observer and provider of funding. It works absolutely fine over there and it will work absolutely fine over here.

 

it is actualy a damnd site better and cleaner and thats not a dig at the nurses who shouldnt be cleaning wards anyway.

[Blackpool Jags]

It works absolutely fine over there and it will work absolutely fine over here.

 

The BRITISH system works perfectly fine here when it isn't being mauled and torn apart by rabid right wing politicians who are constantly champing at the bit to give even more public money to their fat cat mates in the private sector.

[Woodstock Jag]

The BRITISH system works perfectly fine here when it isn't being mauled and torn apart by rabid right wing politicians who are constantly champing at the bit to give even more public money to their fat cat mates in the private sector.

 

Except it's not being "mauled" or "torn apart" and the only people doing anything to it aren't "rabid" or "right wing". They are not "constantly champing at the bit to give even more public money to their fat cat mates in the private sector"

 

In fact, the only accusation that holds water in this post is that they're politicians.

[jaggybunnet]

The BRITISH system works perfectly fine here when it isn't being mauled and torn apart by rabid right wing politicians who are constantly champing at the bit to give even more public money to their fat cat mates in the private sector.

 

 

oh dear

[Allan Heron]

The other thing about the NHS reforms is the downgrading of the obligations of the Secretary Of State. That would suggest that the role of the government/state as macro-observer (?!?!?) would be pretty toothless.

 

I don't have a problem with the NHS using private companies to provide services - the question is making sure that the tail and the dog are not confused.

[Woodstock Jag]

The other thing about the NHS reforms is the downgrading of the obligations of the Secretary Of State. That would suggest that the role of the government/state as macro-observer (?!?!?) would be pretty toothless.

 

I don't have a problem with the NHS using private companies to provide services - the question is making sure that the tail and the dog are not confused.

 

No, it would downgrade the role of government/state from autocratic rule to oversight.

[alx]

It's interesting that in Glasgow Kelvin, labour won by a 1000 votes last time. But there were 3000-ish LD votes. Where will these votes go this time? Hmmmmm.

[alx]

I don't have a problem with the NHS using private companies to provide services - the question is making sure that the tail and the dog are not confused.

 

I do have a problem with this. A lot of these companies profiteer by paying staff peanuts on rubbish contracts. It's particularly offensive when they are employing immmigrants living in bunk houses and what you. Also, I really object to small businessmen floating about in top of the range cars (even Aston Martins and Maseratis sometimes) that are paid for by exploiting the wages of staff.

[Allan Heron]

No, it would downgrade the role of government/state from autocratic rule to oversight.

 

Indeed, and that is the nub of the problem. It would remove the Health Service from the ambit of government to become someone else's problem.

 

It would mean that the guarantees being liberally (sic) given out about what would and wouldn't happen as a result of the reformsm aren't worth the paper they're not written on because ultimately the government would no longer have control, only the influence that writing another cheque could buy them.

[Woodstock Jag]

Indeed, and that is the nub of the problem. It would remove the Health Service from the ambit of government to become someone else's problem.

 

It would mean that the guarantees being liberally (sic) given out about what would and wouldn't happen as a result of the reformsm aren't worth the paper they're not written on because ultimately the government would no longer have control, only the influence that writing another cheque could buy them.

 

How does having a duty of oversight amount to it "being removed from the ambit of government to become someone else's problem"?

 

It's not for government to give national guarantees on the provision of any service. The whole point of these reforms is that local providers determine local services. That's liberalism in a nutshell.

[Allan Heron]

How does having a duty of oversight amount to it "being removed from the ambit of government to become someone else's problem"?

 

It's not for government to give national guarantees on the provision of any service. The whole point of these reforms is that local providers determine local services. That's liberalism in a nutshell.

 

Oversight is a very weak term - I'd regard that term as effectively being powerless to intervene in any substantial.

 

And the idea that local providers determine local services fills me with absolute horror. Shouldn't that be the local community?

Edited March 30, 2011 by Allan Heron

[Woodstock Jag]

Oversight is a very weak term - I'd regard that term as effectively being powerless to intervene in any substantial.

 

And the idea that local providers determine local services fills me with absolute horror. Shouldn't that be the local community?

 

But local providers are accountable to the local community. If the service is inadequate people will look to use other providers who can do a better job. These proposals don't create regional monopolies.

[Allan Heron]

But local providers are accountable to the local community. If the service is inadequate people will look to use other providers who can do a better job. These proposals don't create regional monopolies.

 

How are they accountable? And will the providers be local? Not very likely.

 

End result is that you are describing a health service that is open to the free market. Which is what you claimed it wasn't at the outset.

[Woodstock Jag]

How are they accountable? And will the providers be local? Not very likely.

 

End result is that you are describing a health service that is open to the free market. Which is what you claimed it wasn't at the outset.

 

They are accountable in that they won't be allowed to provide services with government funding unless they meet the criteria set. They are accountable in that if people choose not to use their services, but to choose those of another, the consortia will fold, the contracts withdrawn and the connected funding re-assigned to better providers.

 

GP consortia would surely be more local than PCTs...

 

The end result is not a free market, because the government is the source of finance and right of tender of universal healthcare. The free market would dissociate completely tax revenue from the funding, and restrict the regulatory and tender role of government to negligible. This is NOT free market healthcare the like of which you see in the USA.

[Blackpool Jags]

I do have a problem with this. A lot of these companies profiteer by paying staff peanuts on rubbish contracts. It's particularly offensive when they are employing immmigrants living in bunk houses and what you. Also, I really object to small businessmen floating about in top of the range cars (even Aston Martins and Maseratis sometimes) that are paid for by exploiting the wages of staff.

 

100% in agreement with this.

 

"Private companies believe the shake-up of the NHS will lead to a big expansion of their currently small role, as many GPs will need their help to carry out their new role as commissioners of healthcare.

 

Firms which already have small-scale involvement with family doctors are preparing to exploit the chance to gain an unprecedented foothold in the NHS once GPs start spending £80bn of NHS funds."

 

 

http://www.guardian.co.uk/society/2010/jul/12/nhs-private-companies-gps-funds

 

Companies like Serco, Capita are in dialogue with many Health Trusts who are presently in the invidious position of having to find a combined figure of £20billion of 'cost improvements' to stay afloat. For the comprehensionally impaired that's twenty thousand million pounds. These parasitic companies are agreeing to make reductions in their existing contract prices with the quid pro quo of being handed bigger slices of the contract cake: ie additional contracts with resultant reduction in the quality of service delivery, all in an environment where cost trumps quality on virtually every count.

 

Serco, Capita, G47 and a lengthening array of leech outfits are posting record profits in these recession stricken times, with public service contract revenue accounting for upwards of 60% of these companies' income streams. Result - as alx explains above. This ideological obscenity must end but, thanks to the ConDems' dogma, GP commissioning will see an unprecedented boom for private companies at taxpayers' expense, with the inevitable downward trajectory in the quality of service delivery.

[Allan Heron]

They are accountable in that they won't be allowed to provide services with government funding unless they meet the criteria set. They are accountable in that if people choose not to use their services, but to choose those of another, the consortia will fold, the contracts withdrawn and the connected funding re-assigned to better providers.

 

GP consortia would surely be more local than PCTs...

 

The end result is not a free market, because the government is the source of finance and right of tender of universal healthcare. The free market would dissociate completely tax revenue from the funding, and restrict the regulatory and tender role of government to negligible. This is NOT free market healthcare the like of which you see in the USA.

 

But in the real world, the relationship betweeen people and their GP's is usually a pretty personal one. I know that in Health Centres, you can get appointments with any of the doctors in the practice people do prefer to keep continuity with the doctors they know and trust.

 

In this brave new world, people aren't going to have the information available to them to make any judgements about the backup services (rather as they don't just now). How are they going to know whether the people providing the services to Consortia A in their are any better/worse than used by Consortia B. And, indeed, will they be any different at all.

 

To be effective, I'm not convinced that there wouldn't be a pressure for these consortia to be bigger rather than smaller. And this would probably escalate over the passage of time. If the consortia remained small, the likliehood would also be that the services they are looking to procure may well become monopoly providers within their area.

 

This may not be a free market as you have described, but it is seeking to create a market in health for customers who won't have the information, knowledge or understanding of the information to make differential judgements to inform the choices they are being given.

 

But at present, if people don't like their GP's they have the ability to register with another one. In the future, that's still likely to be how things are judged by people. They are not going to become experts in the different levels of service offered by the providers used by the consortia.

 

I don't know how the Trust work down south, but up here there is a close relationship between elected officials and the health boards. There are also close linkages between social work and the NHS. Again, I don't know how this works down south but if there is a similar scenario (and I'd imagine there has to be) it's hard to see how that necessary coordination can take place.

 

Of course, this is all against a backdrop of the Secretary of State essentially lying about perceptions of service within the NHS. Satisfaction levels remain at a high level despite his declarations about the NHS being "broken". My own experiences with the NHS have been nothing but positive - I was unwell for about a month in December/January and my treatment involved my GP, the local hospital plus both the practice and district nurses (both visits to my house and to emergency services). It all went without a hitch so I didn't see anything that was broken.

[Blackpool Jags]

GP consortia would surely be more local than PCTs...

 

 

GP consortia will not be more local than PCTs; they will exist as 'clusters', an example of which, in this neck of the woods, will be the 'Lancashire' cluster. This will replace upwards of half a dozen local PCTs within the current Lancashire footprint.

[B.C.G. JAG]

I'd have thought you'd have more sympathy for anyone going into coalition to soften the devastating impact of an out of touch and unpopular administration.

[B.C.G. JAG]

Woody, when you're to the right of Norman Tebbit, it's time reconsider your position, or go all the way with a nice new faux military wardrobe:

 

click

[Woodstock Jag]

Woody, when you're to the right of Norman Tebbit, it's time reconsider your position, or go all the way with a nice new faux military wardrobe:

 

click

 

Norman Tebbit isn't very right-wing at all. He's an authoritarian centre-right politician.

[B.C.G. JAG]

Norman Tebbit isn't very right-wing at all.

[Woodstock Jag]

 

If you read an interview with him in the Torygraph today, he actually says he admires Clegg more than he does Cameron.