The Independent View: Do us all a favour and drop the NHS Bill

About 2 weeks ago, Shirley Williams rightly claimed that the whole competition chapter of the Bill would need to be removed before it could be passed. However, the amendments that Nick Clegg has proposed, as indicated in his letter of 28th February, just do not match up to her reasonable demand. The competition chapter contains clauses 70 to 81. The Clegg amendments only affect clauses 78, 79 and 80. So, clauses 70 to 77 remain unchanged. Hence, a lot of the Lansley ‘nasties’ remain and if the Bill is passed, these ‘nasties’ will become law of our land.

For example, the Secretary of State will have the power to make regulations relating to competition (Clause 73), and to investigations into anti-competitive behaviour by the NHS Commissioning Board and clinical commissioning groups (Clause 74); and the general merger control regime for enterprises in the UK must be applied to NHS foundation trusts (Clause 77). The framework for regulating competition that is specific to the health sector therefore remains in place, and so considerations of competition law, rather than, say, evidence-based medicine or health outcomes, would have primacy when making decisions about the commissioning of health services. In short, the newly amended Bill would still be a mess. Competition based on price rather than quality could thrive. Disruptions to services resulting from short term financial reengineering of corporate bodies will continue—remember Southern Cross.

Also, none of the Clegg’s new proposals have been agreed with Cameron. And so, Clegg’s promised land may not materialize.

Just as you Lib Dem delegates played a key role in ‘forcing’ the Coalition to embark on a listening exercise at your last Spring Conference in Sheffield, you can still play a constructive and meaningful role at this week’s conference.

The frustrating and slow deliberations with the Tories over the past year should have convinced you that they are hell bent on ‘marketising’ our NHS. Privatisation will then follow. No sensible Lib Dem member wants that. What you want is further democratization of the NHS. You do not need this Bill in its current complicated format, to achieve democratization.

Further discussions on additional amendments will be futile and complicated. As it is, the Bill is already damaged and dangerous.The only sensible path you can take is to vote for dropping of the whole Bill. After that, a sensible option could be to pass the whole issue to the Parliament’s Health Select Committee and ask it to come up with an agreed, considered way forward. Do not forget that this Bill, as drafted, is not part of the Coalition Agreement.

The majority of the professionals in the NHS are against the Bill. Ans as the full implications become apparent, most of the public is against it.If the Lib-Dems collude with the Tories and the Bill becomes law, the electoral revulsion will be unimaginable.

Please help drop the Bill. You will do your Party and the country a great favour.

The Independent View‘ is a slot on Lib Dem Voice which allows those from beyond the party to contribute to debates we believe are of interest to LDV’s readers. Please email [email protected] if you are interested in contributing.

* Suresh Chauhan is a former Liberal Party member from Leicester, who has been campaigning against the NHS Bill since July 2010.

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40 Comments

  • Well said, and in addition these are the main issues at this moment in time:
    HOSPITALS
    – Each NHS hospital will be permitted to generate 49% of its income from private health companies.
    There is to be no additional investment to expand NHS hospitals to cope with the extra private patients. The result is that there will be less capacity for NHS patients.
    – NHS hospitals are generally regarded as cheaper to run than private hospitals. As a result of NHS hospitals being allowed to generate 49% of their income from private healthcare companies, some private hospitals may close and instead use NHS hospitals.
    – As more NHS services may be provided by private companies, NHS hospitals may suffer a reduction in income and so may have to make cuts to the services they provide.
    – The Govt. has said that they won’t save NHS hospitals that fall into financial difficulties. They will have to be given to private companies or close.
    COMMISSIONING NHS SERVICES
    Local NHS PCTs (who currently do the commissioning of healthcare) are to close by April 2013 with the loss of approximately 23,500 NHS jobs. The cost of redundancies was estimated at a billion pounds. However, the true cost is turning out to be a lot higher. Latest figures show that an extra £617m will need to be spent on unforeseen redundancy costs. The cost of closing NHS PCTs is now upwards of £2 billion pounds.
    Clinical Commissioning Groups (groups of GP Practices) are to replace the local NHS PCTs. The cost of setting them up (and rehiring those made redundant from NHS PCTs) is estimated at more than 2 billion pounds.
    There are to be several times more Clinical Commissioning Groups (CCGs) than there are/were NHS PCTs. As a result, there will be an increase in bureaucracy due to a massive duplication of admin work.

    The Govt. say that GPs will be doing the commissioning, but GPs will have to put it into the hands of others to do it for them as they don’t have the skills nor time to actually do it themselves.

    Despite the political rhetoric, nowhere in the Bill does it actually state that GPs are required to do the commissioning or purchasing of services in the new market. Hence why the new Clinical Commissioning Groups (CCGs) will be doing the commissioning for them (some GPs may become Board members). US health companies are already bidding to advise them.

    The Bill allows Clinical Commissioning Groups (CCGs) to contract out commissioning functions to private accountancy, health insurance and management consultant firms, which will be able to decide what care is provided free at the point of use through the NHS and what is not.

    As the Govt. is forcing NHS PCTs to redirect money from healthcare to paying off their debts, it is thought that the Govt may have to provide an emergency cash bailout (which hasn’t been costed for in the Health Bill).

    – More than 3.5 billion pounds of taxpayers money could be saved by simply keeping Local NHS PCTs and putting some more health professionals on the boards. In addition, billions of pounds of taxpayers money could be saved and better healthcare provided if local NHS PCTs were not being forced to pay off their debts and close.

    – The Govt. also plans to introduce a number of additional layers of bureaucracy. The result will be far more bureaucracy in the NHS not less.

    – Private health companies and the NHS will be bidding against each other for contracts to treat NHS patients. This means that the NHS will have to spend a fortune on marketing, presentations, advertising, consultants etc. (which means less money to spend on actual healthcare). Again, there is no provision for this additional cost in the Health Bill.

    – Private healthcare companies used by the NHS won’t require indemnity insurance should things go wrong with your treatment.

    – GPs will be rationing healthcare. Can you be confident that you will be receiving impartial advice, receiving the necessary treatment that you actually need, not receiving treatment that you need, or whether the GP is receiving perks for sending you to a particular healthcare provider of which they might even own shares?

    – On the Boards of every Clinical Commissioning Group (CCG) will be local councillors and they are to be paid £80 per hour.

    PATIENTS

    – GP practice boundaries are to be abolished. This means that some GP surgeries may merge and people may have to travel further to see a GP.

    – Patients may not have such a wide choice of where to have treatment. Instead you will be limited to the health companies that your GP practice and CCG has contracts with. If you want to go to a different hospital, then you may need to change your GP to one in another practice that has a contract with the hospital you want to use.

    – The trust between a patient and GP may suffer as the patient may wonder whether the GP is profiting from the treatment being suggested, or rationing treatment due to budget constraints.

    – Some services, including screening, immunisation and vaccination will be handed to local authorities with the discretion to decide what will be provided, and to whom. This means that some services that were formerly free on the NHS may become chargeable.

    – There is currently no statutory law requirement for candour (transparency) ‘throughout’ the NHS. The European Court of Human Rights made it clear that at present there is,

    “no duty to give the parents of a child who died as a result of their negligence a truthful account of the circumstances of the death, nor even to refrain from deliberately falsifying records”

    – Freedom of information requests by taxpayers and patients may be refused on the grounds of ‘commercial confidentiality’ when those NHS services are provided by private healthcare companies.

    – It will be back to the postcode health lottery with different health priorities in different areas.

  • Andrew Suffield 6th Mar '12 - 5:26pm

    Perhaps if you could explain why regulating competition, investigating anti-competitive behaviour, and controlling mergers are a bad thing? Or even a pro-market thing?

    In the unlikely event that there was legitimate medical evidence in favour of monopoly abuse and corruption, I would still be inclined to say we should think twice before letting those things happen.

  • John Carlisle 6th Mar '12 - 5:31pm

    He is quite right. Drop the Bill – now.
    This verbatim from a physio who had just seen a senior member of the Cabinet:
    “He does need a full understanding of what is going on in real life and how its affecting people. That we were in competition with other providers 18 months ago did make our service change an improve but its a change we were wanting to make for ages but the PCT would not allow the time/funding. Once competition came in we were allowed to make the changes. In some way competition was good (because of bad leadership), but on the other hand it was bad as it broke down communication and stopped allowing us to share best practice.

    The best way – as you know – is to ask the staff on the ground what they think needs to happen, then management can facilitate any changes. We are currently doing this with our staff, getting them to give ideas and those who have good ideas take on little projects and in turn ask other staff to feed into it. This is a model we could all use. It also empowers the staff and makes them feel valued. A valued staff member will work harder/smarter for the organisation as a result, and will be less likely to leave. Its not nice for staff to be forced by competition! this just lowers morale massively – this happened during the commissioning process for our service, some good staff left and went to work in private practice.”
    Kill the Bill, keep the structures that are working and FIRE some of the supine leaders in the PCTs who are working for their jobs and not for their staff or patients.

  • Andrew Suffield 6th Mar '12 - 5:38pm

    keep the structures that are working and FIRE some of the supine leaders in the PCTs who are working for their jobs and not for their staff or patients

    You are labouring under the misapprehension that these two things are unconnected. In fact, it is those very structures that reliably generate this behaviour from PCTs. The structures you describe as “working” are giving no reward for success, severe penalties for failed projects, and no penalties whatsoever for sitting on a big pile of money and refusing to authorise projects. Why are you surprised that the PCTs work to the rules set and are unwilling to lose their jobs by doing things that benefit staff or patients?

  • Brilliant. But who is listening?

  • Tony Dawson 6th Mar '12 - 6:51pm

    If this Bill did any of the things which Andrew Suffield is suggesting that it does, it might be worth considering. But it does not. it is infantile in construction and a shambles in action. The central tenet – that GPs want to do purchasing is a total lie. GPs want to influence purchasing, not to actually do it themselves. And thank heavens for that. It is a very hard job for GPs to do what they are meant to do properly at the moment. Any spare time they have, they’d rather mostly spend on their hobbies. The GP purchasing consortia will end up being actually run (whoever is notionally in charge) by a mix of overpaid management consultant wallahs and PCT refugees.

  • John Carlisle 6th Mar '12 - 7:33pm

    Andrew
    Define failed projects and rewards for what success. My experience is that these are related to targets and compliance.
    Is that your understanding as well?

  • Andrew Thomas 6th Mar '12 - 7:51pm

    I am one who has stayed and will continue to battle for the soul of this party. Bad mistakes have been made, namely with tuition fees and the Academies Bill in Education. We now need to stand firm and at the very least defeat all the parts of the health bill to do with competition and I would support rolling back from the Labour reforms which allowed competition in the first place.

  • “If you had stayed a member of the Liberal Democrats you could have gone to conference and voted.”

    That might be a stronger argument if the party leadership hadn’t completely ignored conference votes on other subjects …

  • Richard Dean 6th Mar '12 - 9:15pm

    DO US ALL A FAVOUR – STOP THIS DAMAGING ANTI-BILL CAMPAIGN!

    “ the Secretary of State will have the power to make regulations relating to competition (Clause 73), and to investigations into anti-competitive behaviour by the NHS Commissioning Board and clinical commissioning groups (Clause 74)”

    GOOD! OR ARE YOU SAYING THAT COMPETITION SHOULD BE TOTALLY UN-REGULATED AND UN-POLICED?

    “The general merger control regime for enterprises in the UK must be applied to NHS foundation trusts (Clause 77)”

    GOOD! – DO YOU WANT PRIVATE MONOPOLIES TO DEVELOP AND THEN CHARGE THE UK TAXPAYER THROUGH THE NOSE FOR HEALTHCARE? – I WON’T SUPPORT YOU IF THAT’S WHAT YOU WANT!

    “The framework for regulating competition that is specific to the health sector therefore remains in place,”

    GOOD! OR DO YOU WANT QUALITY TO FALL AND COSTS TO GO THROUGH THE ROOF?

    ” and so considerations of competition law, rather than, say, evidence-based medicine or health outcomes, would have primacy when making decisions about the commissioning of health services.”

    WRONG! IT WOULD BE PERFECTLY POSSIBLE TO APPLY THE EVIDENCE-BASED APPROACH IN COMBINATION WITH COMPETITION LAW. ESSENTIALLY YOU MAKE JUDGMENTS IN THE FOLLOWING ORDER:

    1. WHICH BIDS SATISFY HEALTH OBJECTIVES? – REJECT THOSE THAT DON’T
    2. WHICH OF THE ONES THAT DO ARE BETTER VALUE FOR MONEY?

    THIS IS VERY WELL-ESTABLISHED APPROACH THAT IS CONSISTENT WITH COMPETITION LAW. STEP 1 ACHIEVES THE HEALTH OBJECTIVES AND STEP 2 THEN ACHIEVES THE FINANCIAL ONES.

    “In short, the newly amended Bill would still be a mess.”

    THAT WOULD BE YOUR FAULT!

    “ Competition based on price rather than quality could thrive.”

    WRONG! SEE STEPS 1 AND 2 ABOVE

    “ Disruptions to services resulting from short term financial reengineering of corporate bodies will continue—remember Southern Cross”.

    NO! STOP TRYING TO FRIGHTEN PEOPLE WITH FANCY WORDS. PEOPLE HAVE LEARNT FROM SOUTHERN CROSS.

  • Richard Dean 6th Mar '12 - 9:35pm

    @John Carlisle

    “Its not nice for staff to be forced by competition! this just lowers morale massively – this happened during the commissioning process for our service, some good staff left and went to work in private practice”

    Wasn’t this jumping from the frying pan into the fire? Or was there something more complicated going on here that we don’t know about?

  • I don’t know what you where professor of Richard Dean but it obviously wasn’t internet etiquette. Capitalisation is considered as shouting…

    I’m interested to know what you learned from Southern Cross. I have to say its not immediately obvious. I learned that even with a burgeoning elderly population, private equity is perfectly capable of setting up businesses under a new and remarkably unsustainable business model (overly leveraged with property assets hived off) and then walking away when they don’t quite make as much money as they’d hoped, leaving the taxpayer to pick up the pieces. This is also what happens with individual patients when private operations “go wrong” – patients are dumped back onto the NHS into High Dependency Units. Its also what happens when private clinics install faulty implants but fail to get insurance.

    Would you board a jet plane if they were still making 1000 changes to it as you climbed aboard? Some people have the temerity to think that the NHS is important and its worth taking time to get reform right, and if stakeholders can’t be persuaded, taking a fresh look and starting again. Ultimately Lansley has been working on this since 2003 and Cameron is not a details kind of a guy, noone is persuaded that we should go forward for this for any reason other than “it would be rather embarrassing to do a U turn now”.

  • Firstly to the poster above, It really is not necessary to type in caps and shout on the board, it does nothing constructive in getting your opinions across and is very discourteous.

    Everybody is entitled to form an opinion on the facts as they understand it.

    You seem to be very learned on these reforms and highly opinionated, may I ask you how you have formed these opinions, what evidence you have seen to support these opinions and share them with the board.

    It is my opinion and my understanding from talking to my own GP that these reforms are bad for the NHS and those most reliant on them.
    My GP confirmed to me that these reforms will see NHS waiting lists sky rocket. As he said, at present time Consultants and Surgeons are only allowed to “hire” facilities i.e operating theatres for a limited amount of time for private patients and that NHS patients “must” come first and take priority, However, these reforms will allow NHS hospitals to “let” out their facilities to Consultants/ Surgeons, for up to 49% for private paying patients and Private medical care providers.

    On that basis alone it is my opinion that this bill is totally wrong, it will destroy the NHS and put many peoples health at risk.
    I trust my G.P who is the senior partner of my local surgery and has been my doctor for 20 years. He has always been supportive and I can always trust him to tell me straight how something is.

  • Richard Dean 6th Mar '12 - 10:00pm

    Sorry about the capitals – wasn’t meaning to shout. – basically it was my attempt at differentiation – needed some way to separate my reactions to what I was reacting to – and no, I’m not a prof. But then again,the title and tone of the original piece that we are discussing does seem to verge on the smear in places, rather than the clinically logical argument. Maybe my subconscious was screaming against it. Perhaps a psychologist could help here?! 🙂

    I understand your point about the 1000 faults. At some time the anti-bill people will have done so much damage that the whole thing has to be re-done, yes, which will mean that the present system will remain in place. Was this the very system that allowed Southern Cross to happen? I’m old and can’t remember. If so, these anti-bill people are really creating the groundwork for huge future problems, wouldn’t you agree?

  • Richard Dean 6th Mar '12 - 10:14pm

    @Matt, thanks, no, and sorry, it wasn’t intended to be shouting. This medium doesn’t allow much in the way of formatting, and I had forgotten about the convention. I hope people were still able to think even with the unintended noise!

    Thank you for agreeing that I am entitled to an opinion. I am a member of this LibDem party and have been totally honest when signing up to this website. I believe I therefore have the right to express my opinion here. DO tell me if not! If the anti-bill people need to sink so low as to silence me, well, it goes to show how poorly their arguments stack up!

    I am also happy that you have your own opinion. I have no idea at all about your GP. I ask you to read the history of Bevan’s fight to get the NHS set up in the first place, and would remind you that GPs and consultants are very highly paid individuals and it is certainly in their personal interests to keep as much control of events as they can.

  • @Richard Dean

    of course you have a right to express your opinion as i stated in my previous comment, everyone has a voice and is entitled to be heard 😉

    May I ask who and what you are referring to when you say anti-bill people? As we have already established everybody is entitled to form an opinion on the facts as they have understood them, just because those understanding and opinions differ to those of your own does not make them wrong or anti-reformists.

    I do not need to read Bevan’s history of the NHS, The NHS was formed 65 years ago, I do not think anyone would say that the NHS does not need reforms. Just not these reforms.

    We should not be allowing private health care companies to take over our hospitals and services/facilities to treat their private patients which would have a detrimental effect on the NHS patients who are reliant on the services and already faced with shocking waiting lists which are getting worse and worse by the day.

    I agree also, my G.P is paid an “enormous” amount of money. Personally I do not think it is right that anyone should be earning these obscene salaries. However in the case of my own surgery they provide many out of hours clinics and even open on a Saturday’s, of course this is more money in the pockets of the partnership, But I would rather see the money going their to people who are “actually” providing the real service to their patients, rather than some “private American Healthcare Provider who will screw the system and the tax payers”

  • Richard Dean 6th Mar '12 - 10:54pm

    @Matt, Thanks for your forgiveness. I am not an expert on anything medical. There seem to be plenty of people on LDV who are anti the bill – some even include the phrase “Kill the bill” in their contributions. The Author of the article we are discussing is recommending that the bill be dropped. I just watched the BBC News where LibDems seemed to be portrayed as irritating spoilers to a bill that is now “almost certain to be passed”. The News also showed Landsley being respected, looking responsible and dignified, and not running from a doctor. I disagree with the sentiment that this bill will do our party no good. I think damage will be done to the party if Gateshead comes out against the bill – the BBC report identified that possibility as a danger, rather than as something that the country would be grateful for, and ITV are also not too sympathetic

  • I am also concerned that whenever the government contracts out “public sector” work to “private” contractors, we repeatedly see fraud, corruption, spiralling costs with no proof of quality and no transparency to us the tax payers.

    Cases in Point

    A) G.P’s no longer carrying out assessments on their own patients for eligibility for Disability Benefits. It was GP’s who first kicked up the fuss about assessing claimants because, The government and the DWP where wanting them to meet targets for removing entitlements and the amount of claimants. This was something GP’s were not prepared to do as they have taken an oath to always put their patients needs first and this would contradict that oath.
    So instead the government contracts out the medical “assessments” to ATOS who employ “health care professionals” who are constrained by no such oath as you are not their “patient” and seen upon instead as a “customer”
    As we are all well aware, the huge failings of ATOS to get medical decisions right, by the colossal amount of “successful” appeals, which is of course clogging up the tribunals and a huge added cost to the tax payer from the department of DWP and the Department of Justices Bill.
    When a Doctor fills out a “sick note” for a patient, this is a legal document that the DWP has to treat and accept as such, there are also long term sick notes a doctor can provide but I forget what these are called.
    When the DWP sends you a form to fill in for ESA or DLA this is also regarded as a legal document and should be treated as so, however, neither the DWP or ATOS seem to take the slightest piece of notice most of the time, hence again by the amount of appeals currently logged in the system.

    A4e and “work fare” we are all hearing about the high level of corruption within this publicly funded private company to the tunes of millions of pounds, Paying for 100 staff to go on “champagne” holidays “seminars” to places in spain and Monaco in celebrating winning “more” government contracts.

    Whenever the government tries to shrink the size of the state, we always get these problems, corruption is rife and results are paid by extremely questionable practices rather than by results.

    Do we really want to allow that into our NHS that so many people are reliant on. I don’t think so

  • Andrew Suffield 6th Mar '12 - 11:38pm

    However, these reforms will allow NHS hospitals to “let” out their facilities to Consultants/ Surgeons, for up to 49% for private paying patients and Private medical care providers.

    Not really. NHS hospitals are already permitted to let out up to 49% of at least most of their facilities to private patients. This was a Labour reform in the previous government, not something new in this one.

    Define failed projects and rewards for what success. My experience is that these are related to targets and compliance.
    Is that your understanding as well?

    Sort of – and that has the same perverse effect – but worse, if a PCT does a project which is not directly related to an existing target (trying to solve a real-world problem that the targets did not envisage) then there is no reward for success (because all rewards are based on targets), and any failure of such a project will be treated politically as a waste of money, lambasted in the media, and the leaders will be sacrificially fired to quell public outrage. This leads to them being immensely conservative. Anybody who was working in the same environment, where you lose your job if you fail but keep it if you do nothing, would behave in the same manner.

    The systems of the NHS are broken. The most regrettable thing about this whole affair is that it has been impossible to have any real debate on this subject and come up with any solutions, because the debate is all political tribalism and mostly based on lies about privatisation. It seems likely that reform has become politically impossible, and we’re going to be stuck with exactly the same system of bureaucratic inaction for some years to come.

    The future of the NHS doesn’t look very good.

  • John Carlisle 7th Mar '12 - 5:57am

    Andrew, What damaged performance in the NHS was not the structures but the reward system. The system of regulation drove far too many policies and decisions on the ground, where the regulators became the customer and not the patients.
    Now they will be doing it again with commissioning etc. A vast bureaucracy will be built up AGAIN which we will have to pay for (and which by the way the private sector does not have to pay for so their overheads are much lower) that will add no value at all to the service.
    What we should have and could have done was transform the NHS with the help of the medical staff starting with the patients’ real needs. And it does not begin with patient choice, It begins with good care pathways that take you from being ill at home all the way back to being better at home, i.e. health and social care. A hospital may not even be a part of it most of the time.
    But no, politicians, in their earnest desire to be seen to be DOING something, begin with re-organisation. That is the where it all goes wrong.

  • out of curiosity, how many people posting on these NHS threads who are in favour of the reforms have private medical Insurance. Please be honest now 🙂

  • Andrew Suffield, where is your source and evidence for claiming that the last Labour Government allowed up to 49% usage of NHS facilities for private patients ?

  • @Richard Dean. You are obviously very supportive of ‘the Bill’. That is your perfect right. But why should anyone “STOP THIS DAMAGING ANTI-BILL CAMPAIGN!” because of your personal opinion. The contents of this Bill were never put before the British (or English) electorate by ANY political party for approval prior to the last General Election. You must know that both the LibDems and the Conservatives denied any intention of “top-down reorganisation” of the NHS. The Coalition has absolutely no democratic mandate for the Bill (nor would Labour have, if it was in power). Therefore those people opposed the Bill (of any political persuasion or none) have democracy on their side. As a consequence, I believe that Labour will be gifted a golden opportunity to be ‘holier than thou’. In future elections we can expect Labour to promise to repeal the BIll lock stock and barrel, along with threats of no compensation for any private company that invests money in NHS services. I fully expect Tony Blair to get involved – along the lines of “yes we introduced some reforms into the Health Service but they were for the benefit of patients, the Bill is for the benefit of Tory business friends”. I fear that for the LibDems especially this has the makings of a real electoral catastrophe – vey much bigger than ‘fees’.

  • http://www.sourcewire.com/releases/rel_display.php?relid=67657

    “More than seven NHS trusts across England have already revealed plans to increase their private facilities in preparation for the new Bill.

    In the East, Cambridge University Hospitals NHS Foundation Trust plans to start construction work on a new complex containing a private hospital in 2012. Papworth Hospital NHS Foundation Trust has also recently commenced a project with private provider Spire Healthcare.

    In the Midlands, Milton Keynes Hospital NHS Foundation Trust plans to establish a new private patient’s facility. In the South, Basingstoke and North Hampshire NHS Foundation Trust looks to invest £2.5million in a private ward of single rooms.

    In London, Royal Marsden NHS Foundation Trust plans to increase its number of private care beds by 30% by 2012. Additionally, King’s College Hospital NHS Foundation Trust plans to refurbish its private patient wing.

    There are many benefits to staying in a private unit. A patient with health insurance will avoid the long NHS queues and be treated at a time of their choice, with a consultant of their choice. Patients with health insurance will also be treated in an en-suite private room, with use of a personal telephone and television.

    In addition, a private unit situated in an NHS hospital will benefit from the comprehensive services of a large hospital, including access to cutting edge clinical research.”

    Seems quite clear to me really. Allowing NHS trusts to get 49% of their income from Private Patients will have a huge detrimental effect on NHS patients and resources and will increase waiting times for clinic and surgeries for NHS patients.

    I do not understand how anyone can possibly think otherwise when it’s in black and white

  • Dave Eastham 7th Mar '12 - 11:54am

    As far as the current 2006 NHS act goes, (if somewhat undermined by the implementation of the HSCB before it passes into legislation), regarding allowing NHS facilities to be used to generate private patient income, the “caps” were based on historically what they were actually doing at that time. Thus institutions such as Great Ormond St Children’s Hospital, which for historical reasons and international reputation, were treating a higher level of private patients than say, the average District General Hospital or Foundation Trust (Great Ormond Street also derives a large amount of funding from charitable giving which is something else it is sometimes forgotten). It certainly “did for” at the time, the somewhat grandiose plans over some DGH/Trusts to build private patient wings, including the Trust which was local to where I was living then (under the aspiration to bring in revenue”for the NHS”). Can we drop this item of discussion please?. It is a proverbial red herring. Unless there is going to be a vast increase in capacity/facilities for Private Patients, then the only place “up to 49%” resources are going to come from “to generate all this wonderful new income stream for the NHS” is those facilities currently devoted to treating NHS cases. Quarts and pint pots come to mind. Can’t be done.

    There have been many articles on LDV over the last few weeks on this subject. A lot of the contributions have been based on anecdote to “prove” that there is something terminally wrong with a collaborative NHS as a method of delivering qualitative, equitable and cost effective Health Care. (As a proportion of GDP) Suggestions of mixed State Insurance based models, such as that of France have been regularly advocated. Trouble all of these systems cost several orders of magnitude more in terms of GDP without consequent several orders of magnitude of better health outcomes. Let alone Patient (or is that “customer” now?) satisfaction, which according to the health bit of the British Social Survey (2010) is the highest it’s ever been and way above comparable surveys in other European Countries. (the lowest was 1997)

    Others, have accused anyone of any contrary opinion to the HSC Bill as being a “vested interest”, especially if, as I have, spent your working life in Health Care or are, consequently a member of a Professional Association. Personally speaking, I would not be a Lib Dem if I was not capable of objective analysis. Such accusations are frankly silly and no argument at all. Anyway, conversely is it being suggested that the supporters of this bill have no vested interests?. A quick examination of the “interests” of some of those behind this Bill who have so far and will no doubt be voting in support in Parliament. Would frankly, be excluded from doing so if they were in local government, by the conflict of interest regulations. (See LGA handbook for local councillors)

    Suresh is right in his analysis of the effects of the recent amendments to Part 3 of the Bill. It does not do what Nick and Shirley claimed it would.

    Evan Harris yesterday published a detailed analysis of what has been “delivered” from the Lib Dems conference motion last year on his Guardian blog column http://www.guardian.co.uk/society/blog/2012/mar/07/nhs-reforms-live-blog-thousands-to-attend-westminster-protest-rally?intcmp=239. If you have not already done so, I suggest you all read it.

    It is also worth remembering, that the original motion on the 2011 spring conference was essentially a hagiography in praise of the HSC Bill as it then was. It had 12 signatures sponsoring it. The amendment to the motion, which was supported by over 200 signatures, turned it into a series of demands to correct the faults in the Bill. That motion is and remains constitutionally Lib Dem Policy.

    The HSC Bill as it now stands does not fulfil the demands of that motion. It is about neither Health or Social Care but seeks to introduce a full Market based Health Service. The Lib Dems should withdraw their support from the Bill.

  • Dave Eastham 7th Mar '12 - 11:58am
  • Geoffrey Payne – “However you can be a member of the party and not necessarily vote for it.”
    Indeed; some have even campaigned for rival candidates.

  • I just think it is important to have the facts right, Mr Eastham.I notice that Mr Suffield has not been back with anything to back up his claim that Labour were allowing up to 49%usage of NHS facilities.That is all.

  • @ Margaret

    I agree entirely. It is extremely frustrating when those who support this bill flood these threads with claims and opinions and yet fail to provide a shred of evidence to back up these claims.

    When serious valid questions are presented to them against this bill which they can not answer “truthfully” they either chose to ignore it, or run to another thread where they promote their support for this bill.

  • Thanks, Matt. I do not hold out much hope now that this bill will not go through.

  • George Roussopoulos 8th Mar '12 - 4:37pm

    @Margaret
    It will take a miracle to stop this bill now, I fear, yes, but there is still a hope.

    However if the LD leadership perseveres with it against the wishes of the great majority of LD members, of the health professionals and of the country as a whole, its fate after passage may be the same as that of the Poll Tax as and when an effective grassroots opposition is organised.

  • As a Lib Dem Member who has stayed [albeit reluctantly] in the hope of fighting all the wrong decision-making by the Leadership, I would feel much more confident if the Leadership and those who are pushing forward too much, too far and too quickly, would actually listen to their Membership!!!! At the moment, the views of grass roots Members are being ignored totally – what ever we decide at Conferences is, by and large, not acted upon. The leadership and members of the Cabinet are doing exactly what they want to do and not acting upon what the Membership wants them to do.

    The mantra which our Party frequently trumpets about “It’s the Members who make the Policies” is clearly no longer the case. Many of us are in total despair at the too common practice of our views and opinions being stamped on and ignored.

    We have haemorrhaged many Members since the Coalition was formed – if we continue as we are doing, the Party will sink without trace, probably never to rise again, certainly not in my lifetime. Having been a Liberal and Lib Dem voter since 1964, the Party for which I have voted over the years is no longer recognisable!

  • Jayne Mansfield 9th Mar '12 - 11:59am

    @ Dave Eastham, Thank you for articulating what people like myself have diffficulty in articulating in a succinct manner.

    If NHS hospitals are going to take up to 49% of private patients when the demand from NHS patients remains or even increases, where are the extra staff and facilities such as available operating theatres going to come from to ensure that NHS patients don’t lose out or feel compelled by illness ‘to go private’?

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