Tag Archives: NHS

Teacher workload – a concern north and south of the border

Yesterday, Nick Clegg gave a speech to public sector workers. His specific focus was on teacher workload. Everyone thinks that teachers work short hours and have long holidays. Yet everyone who has a child actually at school will know how much effort goes in to preparing lessons. And everyone who knows a teacher knows that they spend a lot of their supposed “off-duty” time thinking of interesting lessons or, more likely these days, filling in interminable paperwork. We know that children need to be kept safe and their progress checked, but I get the feeling that the bureaucracy is overbearing and unnecessary. Let’s just give you a small example from my own experience. Every time my child sets foot outside the school we have to fill in a consent form. It’s A4. It has all sorts of medical info on it. It even asks how far they can swim unaided, a skill which is unlikely to be needed when representing the school in a maths competition or reading stories to 6 year olds in the local primary school. We can be filling in one of these forms twice a month. If it’s a mild inconvenience for us as parents, what’s it like for teachers who have maybe 30 of them to collect for each class? Why can parents not fill in a standing consent with all the info which covers the whole year?

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Opinion: A radical, Liberal and localist alternative to NHS commissioning

nhs sign lrgLast week at Liberal Democrat Conference in Glasgow the party amicably and democratically settled one of its longest-running disagreements, about the way in which NHS services should be commissioned.

This is a subject Liberal Democrats need no introduction to. It has been a thorn in our side ever since Andrew Lansley first published his White Paper, “Equity and Excellence: Liberating the NHS” (2010), and culminated in Conference’s refusal to endorse the policy in Gateshead in 2012, instead neutering the so-called “Shirley Williams amendment”.

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Norman Lamb writes… Extra funding for the NHS is a Lib Dem priority right now

nhs sign lrgAs a society we are judged by the way that we care for the vulnerable, the elderly, and those suffering from illness. Britain can be proud that in 1948 we led the world in laying the foundations for a universal health service, available to all regardless of wealth.

And we continue to lead the world today. Earlier this year the Commonwealth Fund rated the UK NHS best in the world overall, as well as in a number of specific categories.

In this Government, Liberal Democrats have protected health spending, …

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Well, that rather blows a hole in the Yes campaign’s NHS claims, doesn’t it?

I don’t often use the word “lies” in politics. I save it for the most egregious examples of political dishonesty. One which has made me incredibly angry recently has been the Yes campaign’s utterly dishonest campaign on the NHS. They argued that a Yes vote was the only way to protect the NHS, saying that privatisation in England meant that there would be less in funding through the Barnett Formula. Preying on the fears of some of the most vulnerable people in our society is completely unacceptable.

The Institute of Fiscal Studies has just, to put it mildly, proved the Yes campaign wrong. This is what they have to say:

Independence would give the Scottish government more freedom to set spending and tax policies. It would also, in principle, have more freedom to borrow. That freedom would be constrained by the size of the debt it would likely inherit and the willingness of markets to lend. On most plausible scenarios it is hard to see how an independent Scotland could “end austerity” in the short run. In work published this summer we showed how, on the basis of the independent OBR’s oil forecasts, an independent Scotland would likely still have a deficit of 2.9% of GDP (borrowing of about £800 per person in today’s terms) by 2018-19 even if it followed current UK government tax and spending plans – plans that are forecast to lead to the UK as a whole actually having a small budget surplus by the same year. In this case an independent Scotland would need to implement bigger spending cuts (or more tax rises) than the UK as a whole or try to borrow more. This means it would likely be harder rather than easier to protect the NHS.

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Opinion: If an NHS Tax is a step too far, let taxpayers make an optional “NHS Donation”

nhs sign lrgLiberal Democrats have committed to protecting the NHS Budget in the next Parliament. But over the next 6 years, we will need to fill a £30 billion deficit to maintain the level of quality we expect from our NHS. Social care faces a £7 billion shortfall.

There have been recent reports that senior party figures are looking at a hypothecated “NHS Tax”.

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LibLink: Norman Lamb – Supporting general practice

Norman LambThe GP magazine has run a piece by Lib Dem health minister Norman Lamb on the party’s plans to support general practice.

Here’s an excerpt:

The Liberal Democrats are proud to have ringfenced health spending over the course of this Parliament. With an ageing population, and emerging medical challenges, such as the growth in long-term conditions, facing our health service it may be a given that protecting health spending is a sensible thing to do.

That was not, however, the case in 2010. The coalition has made sure that we have protected the health budget, but the Labour party said that this was irresponsible, and in Wales have cut the health budget by 8%. Sadly, on this crucial area there is simply not consensus.

When faced with these emerging challenges what is needed is to look at how we approach providing health care. We need big shifts in care: from repair to prevention, from fragmentation to integration, from impersonal to personal. That is why we are committed to providing better care, closer to home, and combining health and social care budgets. We also want to see more joined up care – hospitals working with GPs, district nurses and social care workers. There is also an opportunity to better utilise technology in our health service, but at the heart of any changes will be GPs.

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Let Kirsty Williams know your views on nursing levels in Wales

Kirsty Williams and Peter Black visit nursesWelsh Liberal Democrat leader Kirsty Williams has been on a mission for some time to ensure minimum nursing levels in Welsh hospitals. She explained on this site why this was important in a post in March this year.

Evidence is increasing from across the world on the positive impact that nurse staffing levels have on patient care and the recruitment and retention of staff. Nurses who have fewer patients to tend are able to spend a greater amount of time with each patient and as a result can provide better care. If they are more easily able to identify potential problems with a patient’s care, then they are able to play a preventative, rather than a simply reactive, role and consequently reduce the level of treatment needed and the cost of this care to the NHS. It also means better support for staff which leads to more manageable workloads, increased job satisfaction and reduced levels of stress or burnout.

Kirsty’s attempts to put staffing levels on a statutory footing has now reached the next stage. She has published a draft Bill and is currently running a consultation on it. You can access the Bill and the Consultation Document here.

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Opinion: What Andy Burnham didn’t tell you about NHS privatisation

nhs sign lrgAndy Burnham’s recent set-piece speech on the NHS, the latest instalment of Labour’s “summer offensive”, opened with a neat bit of scene-setting. By briefly championing a group of Darlington mothers who are presently marching 300 miles in protest at the use of private providers in the NHS, he conjured a mood of protest while subtly co-opting their campaign. Thereafter he sought only to reduce the 2015 general election to a “binary choice” between “a part-privatised, two-tier health market under David Cameron” and “a public, integrated national health and care service under Labour.”

In terms of how he defined that choice, though, Burnham could hardly have done worse than to frame his argument with an example from Cambridgeshire, singling out for particular criticism its attempt to integrate care services for older people.

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Rennie on the SNP’s “dishonest, desperate and disgraceful” NHS scaremongering

nhs sign lrgScottish Lib Dem Leader Willie Rennie delivered a passionate speech yesterday setting out his positive arguments for Scotland remaining in the United Kingdom.

A link to the whole speech is below, but he spent a bit of time rebutting some recent scaremongering by the SNP on the issue of the NHS:

And across the UK, few things unite people like our belief in the NHS.

Founded on the principles that it should meet the needs of everyone, that it should be free at the point of delivery, and that it should be based on clinical need not the ability to pay, it remains a source of pride in which each and every one of us has a stake.

These principles are unique and they are enduring.

For the Nationalists to claim that they are under threat is dishonest, desperate and disgraceful.

It is also factually wrong.

Despite the financial pressure of the global financial crisis, the NHS budget has been protected and NHS funding in England is now £12.7 billion higher than it was in 2010.

Private sector involvement in England’s NHS is paid for with public money, meaning that the cash equivalent is protected for Scotland – and the Scottish Government can spend it however they see fit.

The publicly-funded NHS was this year ranked best healthcare system across the 11 richest countries in the world – and we are determined to keep it that way.

But five weeks out from the independence referendum, and the SNP has suddenly started to pretend that funding is in doubt.

Standing on street corners, dripping poison about the NHS into the ears of passers bye is a sign of just how desperate they are becoming.

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Paul Burstow MP writes… Making the pursuit of happiness as important as GDP

cf reportOver the past 12 months I have been working with mental health experts and the think-tank CentreForum, grappling with the challenge of how we can improve mental health care.

Today sees the publication of our final report, The pursuit of happiness: a new ambition for our mental health. It reflects the expertise of many, makes a number of recommendations to transform not just health services, but the mental health of the nation, and it has one overarching call – that the pursuit of happiness should be a priority …

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NHS under pressure across whole UK – how do we fund the health service we need?

StethoscopeA clinical commissioning group in South Warwickshire was heavily criticised last week for suggesting that it might charge patients for use of mobility aids like crutches, walking sticks and neck braces.  A rather hyperbolic Guardian column screamed that this was the “first painful step towards the dismantling of the NHS” which seems a bit strange given that they’ve been telling us for the past two years that the NHS had been all but privatised anyway.

The furore over this idea made me think, though. While you don’t and never should …

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Norman Lamb: “As a Lib Dem, I want to eradicate gay conversion therapy”

Norman Lamb, Minister for Consumer AffairsNorman Lamb has told the Guardian that he will do all he can to eradicate referral to gay conversion therapy in NHS England:

Gay conversion therapy is abhorrent and has no place in a modern society, according to the health minister Norman Lamb, who has asked for assurances from NHS England that GPs do not make any referrals for such treatment.

photo by: bisgovuk
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Norman Lamb MP writes… Improving patient safety in the NHS

Nurse jokes with patientBack in 2012, an independent study of NHS case notes from hospitals concluded that in about 2.3% of hospital deaths there was strong evidence that death could have been prevented. In practice, this equates to around 6,300 preventable deaths in hospitals every year.

This is a shocking statistic. As Liberal Democrats, we should never fall into the trap of talking down the NHS – our health and care services do fantastic work day after day savings lives and providing excellent care.  But we must also be willing to confront …

photo by: NHSE
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Paul Burstow MP writes…Government makes concessions on Care Bill

nhs sign lrgOver the last week I have been working with 38 degrees who ran a strong campaign raising concerns about a key clause in the Care Bill that made changes to the way in which a hospital in serious financial or clinical trouble would be handled in the NHS.

Trust special administration (TSA) as it is known, was introduced by Labour in 2009.  It is a blunt process that should only ever be used in exceptional circumstances of financial or clinical failure.

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Kirsty Williams AM writes… An important step towards minimum nurse staffing levels in Wales

Today, the National Assembly for Wales voted to give me permission to bring forward a Private Members Bill to set minimum nurse staffing levels in law.

I believe this is necessary in Wales because we currently have the highest number of patients per nurse in the UK, which means that all too often our nurses are unable to give the time to perform their role to their highest caring ability.

Evidence is increasing from across the world on the positive impact that nurse staffing levels have on patient care and the recruitment and retention of staff. Nurses who have fewer patients to …

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Opinion: Let individuals control who uses their health information

Alongside pizza flyers and estate agent adverts, you may have received a leaflet on Care.data.

This April, GP surgeries were going to upload data from GP records onto a national HSCIC database – unless you opted-out. The leaflet had no opt-out form or Freepost return address.

If you don’t opt-out, medical data, including prescriptions and your conditions, will leave the surgery and go to HSCIC. HSCIC then centrally pseudo-anonymise it – removing your name. Your birthdate and postcode stays.

HSCIC’s own risk assessment warns patients could be identified if the pseudo-anonymised data was joined up with other easily-available data. And centrally …

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Norman Lamb writes… Working together for better mental health crisis care

When someone is experiencing a mental health crisis, it essential that they feel able to access the help they need – and quickly. They will probably be in a state of extreme distress and confusion. Without help, people may be at risk of causing harm to themselves and those around them (cases of injury to others are actually very rare). They often end up in police cells – completely inappropriately. They may even commit suicide – and all too often, I hear tragic cases of suicide after someone has repeatedly been unable to access mental …

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The Independent View: Clause 118 of the Social Care Bill must be defeated

nhs sign lrgIn the post-Lansley NHS the Secretary of State for Health no longer has the duty to provide a comprehensive health service. Such responsibility as remains has been handed to the Clinical Commissioning Groups (CCGs). CCGs do not have a responsibility for everyone in the neighbourhood – there is no universal state responsibility to provide us with healthcare any more – but they do at least have the responsibility for commissioning the care needed by their own registered patients.

The Clinical Commissioning Groups are about to be undermined.

When Jeremy Hunt, the current Secretary …

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Opinion: Managing the NHS

nhs sign lrgI agree with Norman Tebbit. There, I’ve said it. The antique rottweiler was writing in the Telegraph in response to a number of intemperate comments made on another column about the service received from staff at the NHS. He said, among other things, “when things go wrong, as they have often done in the NHS, I believe it is right to blame the officers, especially the more senior ones, rather than the troops”. I agree with him whole heartedly on that point, though not on …

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The Independent View: Could Ireland’s emerging healthcare reforms test David Laws’ NHIS vision?

Nearly a decade ago now, David Laws MP raised the idea of evolving the NHS into a continental-style universal ‘National Health Insurance Scheme’ (NHIS), where healthcare would be progressively funded from dedicated income contributions, individuals could choose insurers and everyone would be entitled to a comprehensive package of set treatments within a decentralised but heavily regulated system. It was a bold and interesting proposal, which for better or worse helped define the 2004 Orange Book in eyes of many, though it has perhaps also been misunderstood and straw-manned to a degree.

However, besides substantive criticisms and the understandable sensitivities that talk …

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Norman Lamb writes… How Liberal Democrats are promoting safety and openness in the NHS

nhs sign lrgAs a Liberal Democrat, my priority for the NHS is simple. I want patients to have the best possible care. When people are ill and vulnerable, they deserve safe and compassionate care provided by doctors and nurses with the best possible training and medical expertise. And people need to know that, when mistakes are made, doctors will be open with them – and that lessons will be learnt.

What happened at Mid Staffs Hospital was a shocking scandal. The stories of neglect sent shock waves across the country. This Government …

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Norman Lamb writes … The start of a revolution in joined-up care

Back in May, I wrote on Lib Dem Voice, about the launch of a programme of “Integration Pioneers” to drive forward the revolution in joined-up care that is desperately needed across the NHS and social care.

On Friday, I announced the final outcome of a rigorous process to select the very best leaders in integrated care. A panel of experts, including some of the global leaders in integrated care, scrutinised the bids. Now, 14 Pioneers spread across England covering rural and urban areas will lead a movement of change joining up a horribly fragmented system which too often let’s …

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Opinion: Clinical Commissioning Groups – don’t hold your breath

nhs sign lrgWe are now 6 months into the much touted reorganisation of the health service, with the advent in April this year of Clinical Commissioning Groups to replace Primary Care Trusts, the only real difference being that GPs run the Clinical Commissioning Groups.

The reorganisation did ensure a reduction in cost by the simple expedient of setting Clinical Commissioning Group administrative budgets one third below historic  Primary Care Trust administrative cost, yielding a Clinical Commissioning Group admin cost of £25/head of population. There are 211 Clinical Commissioning Groups. The adjusted population figure is 53.8m, and so total Clinical Commissioning Group admin spend is £1.345bn. Clinical Commissioning Groups are administering a total health budget of £60bn, averaging £284m per Group. Clinical Commissioning Group admin costs are therefore 2.24% of total health service expenditure.

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Norman Lamb writes: A huge leap forwards in delivering personal health budgets

nhs sign lrgAt the heart of the Liberal vision of a fairer society is the belief that people should be in control of their lives – the belief that the state does not always know best.  For decades in the NHS and the social care sector, we have had a situation where the government will spend tens of thousands of pounds a year providing care for an individual, but giving that individual little or no control over the design and commissioning of their package of care.  We need to achieve a …

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Norman Lamb MP writes…The Better Care promise – driving up standards of care across our NHS

It is clear that no single institution has done more to improve people’s lives than the NHS, and its generosity and expertise is something of which we are rightly proud. Yet events which have come to light, such as the abuse of people with learning disabilities at Winterbourne View or the grave neglect of patients at Stafford Hospital, have highlighted serious problems within our health service.

This week in particular we have seen the publication of two key independent reviews on NHS care, both of which highlight areas in need of urgent improvement. The outcome of the review by Baroness Neuberger …

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Norman Lamb MP writes…Tackling Mental Health stigma and discrimination: the NHS 65 years on

65 years ago today, the foundations of our modern National Health Service were laid based on the recommendations of a Liberal, William Beveridge. The founding principle that our NHS should always be free at the point of use endures today. The NHS now treats around a million people every 36 hours, with 300 million GP appointments each year. It is a national institution of which we are rightly proud.

However, the National Health Service is far from perfect. Significant changes are needed to cope with the challenges faced by the fact that people are living longer, and are living with an …

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Norman Lamb MP writes: Ensuring transparency and accountability in the Health Service

In recent months we have seen some shocking examples of failures of care within the health service. Tragic events such as those which occurred at the Mid-Staffordshire Hospital and the Winterbourne View Hospital have demonstrated a desperate need to ensure that people are held to account when awful things happen across the NHS and care services.

It is clear that we need to restore trust in health and care services. When a serious failing occurs it is simply unacceptable for patients and their families to be left in the dark or to feel that those responsible have not had to face …

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Opinion: Should we offer to pay university fees for doctors who commit to NHS?

The dire need in the NHS for qualified high level medical staff could be given a much needed boost by offering medical students free university fees if they commit themselves to working solely for the NHS for a number of years after qualifying as a junior doctor.

Even as they progress through the NHS as junior doctors they are still being taught and trained in NHS hospitals by senior doctors, surgeons, anaesthetists and registrars. Some then go on to be the elite in the world of medicine, being in demand to do heart and liver transplants, neuro-surgery, plastic surgery etc – …

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Farron on alleged CQC Morecambe Bay NHS Trust cover-up: “Justice must now take its course”

Tim FarronHere’s the question Tim Farron — in whose Cumbrian constituency Morecambe Bay NHS Trust falls — asked of Health secretary Jeremy Hunt yesterday, after it was reported that senior staff at the NHS regulator, the Care Quality Commission (CQC), sought to cover-up a critical review of their conduct following a series of baby deaths at Furness General Hospital:

Tim Farron (Westmorland and Lonsdale) (LD): My constituents can be forgiven for wondering whether, when the watchdog chooses to muzzle itself, it is time to put it to sleep. The report shows that

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Opinion: Some thoughts on the NHS from a recent patient

I’ve just spent 3 weeks on a trauma ward in a northern hospital after a nasty accident, and coming from an industrial background, here are some thoughts on the NHS and a Lib Dem approach.

First and most importantly, hospitals are large, high tech and high skill businesses. They are continually investing in equipment, and the best hospitals will have motivated doctors, nurses and managers who take ownership of their jobs and are part of the process to continually improve the clinical excellence and effectiveness of the hospital. Hospitals share many of the challenges of excellence with manufacturing businesses.

What are the …

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