Hundreds of contracts signed in 'biggest ever act of NHS privatisation' (England)

[Hibbyradge]

Even Thatcher wasn't mad or bad enough to flog off the NHS to the fat cats and shysters who want to make money out of sick people, but thanks to the useful idiots of Clegg's Liberal Party that's exactly what is happening under Dave's Tory government.

The Liberals in power have made a real difference; for the Tories to do what they ideologically wanted to do all along and that's to destroy vital frontline public services.

You can't trust the Tories with the NHS, but you can't trust the Liberals with anything.

http://www.guardian.co.uk/society/2012/oct/03/private-contracts-signed-nhs-privatisation?fb=native&CMP=FBCNETTXT9038

[Hibernia&Alba]

The NHS is one of the greatest institutions of Britain and should be fully publicly owned. Outsourcing has been going on since the 80s and sadly Labour in office continued the process. The PFI system used for the building of almost all new hospitals in the modern era will mean that taxpayers will end up paying the construction costs several times over.

If the NHS didn't exist today, would Labour have the courage and the vision to establish it, as in 1945? Sadly, I don't think so. They are still way out to the right on many issues, and no major party today is standing up for the interests of those beyond the stock exchange. Everything is geared towards being a consumer, and being a citizen who cares about the greater good has been jettisoned.

[Johnny0762]

They are also planning on swiping, from you, your employee rights.

Vote for UK government at your peril.

[ancienthibby]

They are also planning on swiping, from you, your employee rights.

Vote for UK government at your peril.

When I heard this, my first reaction was that my ears were deceiving me, but it's turned out to be true!

This is an utterly vile Tory plan - to encourage workers in companies to give up their statutory rights to redundancy pay, etc, in return for an unknown upside (albeit with no tax) is almost incomprehensible to me. I have been involved in a couple of companies where we tried to do both ie give people shares (via share options) but keep all their statutory rights in place.

Yesterday, Ruth Davidson had her Mutt Romney moment.

Today it's George Osbourne's turn.

Will Dave turn into Boris by the weekend??

[marinello59]

They are also planning on swiping, from you, your employee rights.

Vote for UK government at your peril.

I think you actually mean Vote Tory or LibDem at your peril.

[Phil D. Rolls]

We're still in this together. Yeah, they cut too deep and it hasn't worked out the way it was supposed to. But hey, we all assessed the damage wrongly, so we all have to carry the can for that wee wrong turning we took. So France, Germany and the USA took a different route, but so what? We're in it together, that's the bally old British attitude - we're sheet and we know we are.

Isn't Osborne the epitome of the school sneak by the way? Cads the lot of them.

[Johnny0762]

I think you actually mean Vote Tory or LibDem at your peril.

No, I was right first time. Vote UK government at your peril.

I could change my mind if you somehow convince me that the last Labour UK government didn't enter an illegal war, at our expense. Perhaps I am mistaken and that Blair, Brown & co aren't wealthier than their salary history? Perhaps the cabinet ministers of that said Labour party didn't oversee UK oil companies landing lucrative contracts in Iraq and Kuwait?

Perhaps you can tell me that my argument is completely wrong and that successive UK governments have not lined their own pockets at the expense of the ordinary tax payer whilst the rich are allowed their tax avoidance schemes?

Let me ask you a couple of questions...

Do you think we live in a fair and honest democracy (as touted by successive UK governments)?

Do you think politicians should become incredibly wealthy at the expense of tax payers?

[Hibernia&Alba]

I should have also commended Labour for at least scrapping the internal market of the Thatcher years which had hospitals competing against each other.

What we have is piecemeal privatisation. Slowly eroding the public ethos until there is nothing left.


Aye, and the latest Tory proposal to ask employees to sell off their employment rights for shares is disgusting. Everything can be bought and sold in their world and nothing is sacred. I really despise them.

[marinello59]

No, I was right first time. Vote UK government at your peril.

I could change my mind if you somehow convince me that the last Labour UK government didn't enter an illegal war, at our expense. Perhaps I am mistaken and that Blair, Brown & co aren't wealthier than their salary history? Perhaps the cabinet ministers of that said Labour party didn't oversee UK oil companies landing lucrative contracts in Iraq and Kuwait?

Perhaps you can tell me that my argument is completely wrong and that successive UK governments have not lined their own pockets at the expense of the ordinary tax payer whilst the rich are allowed their tax avoidance schemes?

Let me ask you a couple of questions...

Do you think we live in a fair and honest democracy (as touted by successive UK governments)?

Do you think politicians should become incredibly wealthy at the expense of tax payers?

What has that got to do with my comment? I distrust politicians regardless of party persuasion or nationality. You seem to be under the deluded impression that an independent Scotland will have saints in power.
Salmond was happy to claim ludicrously large meal allowances for Westminster whilst drawing two salaries. Throw in his toadying up to Trump and Murdoch and he doesn't look that different from the rest of them does he?
One thing I will give him enormous credit for is silencing many of the ''Scots good, English/UK bad bampots who made the Nationalist movement look ridiculous. Sadly there are still plenty of the Brigadoon Brigade about. When we get independence I will pledge my vote to any party willing to ship them offshore.
Anyway, enough of this diversion from the main sport..............Tory bashing.

[Johnny0762]

What has that got to do with my comment? I distrust politicians regardless of party persuasion or nationality. You seem to be under the deluded impression that an independent Scotland will have saints in power.
Salmond was happy to claim ludicrously large meal allowances for Westminster whilst drawing two salaries. Throw in his toadying up to Trump and Murdoch and he doesn't look that different from the rest of them does he?
One thing I will give him enormous credit for is silencing many of the ''Scots good, English/UK bad bampots who made the Nationalist movement look ridiculous. Sadly there are still plenty of the Brigadoon Brigade about. When we get independence i will pledge my vote to any party willing to ship them offshore.
Anyway, enough of this diversion from the main sport..............Tory bashing.

You seem to be under the deluded impression that independence stops at Alex Salmond. I wholeheartedly accept your comments about Trump and Murdoch but surely you can see that's the game that has to be played? Or do you think the Nats should vehemently defy some of the most powerful men in the world? Please don't tell me that you think the unelected Peerage system isn't every bit as loathesome as the characters you mentioned and their organisations? Yet we have to play the game with them too.

Perhaps independence could be an opportunity for a small nation like ours to change the face of politics? All you have to go on is what has gone before which is the very reason why Scots will consider the question in 2014.

I'd like to finish by saying that on one hand you denounce the mentality of some Scots then talk about a "sport - Tory bashing"! Not that I disagree with you, but those same Scots you denigrate with embarrassment are the same people highly likely to throw street parties when the Baroness finally goes to hell. IN other words... Tory bashers. :agree:

[marinello59]

You seem to be under the deluded impression that independence stops at Alex Salmond. Wrong. I support indepndence, not the SNP. Hopedfully they are disbanded after independence as being no longer relevant. I wholeheartedly accept your comments about Trump and Murdoch but surely you can see that's the game that has to be played? Or do you think the Nats should vehemently defy some of the most powerful men in the world? That's how they spun the decision to release Maghrehi, standing up for a principle no matter who was against it. Defiance. Please don't tell me that you think the unelected Peerage system isn't every bit as loathesome as the characters you mentioned and their organisations? Where did I defend the peerage system?....Labour should have totally reformed the House of Lords.Yet we have to play the game with them too.

Perhaps independence could be an opportunity for a small nation like ours to change the face of politics? All you have to go on is what has gone before which is the very reason why Scots will consider the question in 2014.

I'd like to finish by saying that on one hand you denounce the mentality of some Scots then talk about a "sport - Tory bashing"! Not that I disagree with you, but those same Scots you denigrate with embarrassment are the same people highly likely to throw street parties when the Baroness finally goes to hell. IN other words... Tory bashers. :agree:

I don't care who they bash. The Brigadoon Brigade deserve ridicule.

[Johnny0762]

I don't care who they bash. The Brigadoon Brigade deserve ridicule. I


I'll look in again when you've finished your post. :thumbsup:

[marinello59]

I'll look in again when you've finished your post. :thumbsup:

:greengrin.

[Beefster]

A couple of my family have had NHS treatment at Murrayfield Hospital, presumably in an attempt to bring the waiting lists down, and say that it was their best interaction with healthcare in decades. Significantly better infection rates, better outcomes and better facilities apparently.

[Phil D. Rolls]

A couple of my family have had NHS treatment at Murrayfield Hospital, presumably in an attempt to bring the waiting lists down, and say that it was their best interaction with healthcare in decades. Significantly better infection rates, better outcomes and better facilities apparently.

What do you mean by infection rates?

[steakbake]

I should have also commended Labour for at least scrapping the internal market of the Thatcher years which had hospitals competing against each other.

What we have is piecemeal privatisation. Slowly eroding the public ethos until there is nothing left.


Aye, and the latest Tory proposal to ask employees to sell off their employment rights for shares is disgusting. Everything can be bought and sold in their world and nothing is sacred. I really despise them.

The Tories know the game is up and that they are very unlikely to get back in at the next election. They need a 6% swing at least, something which has never happened. So, they are embarking on an ideologically driven wrecking spree in government for the last two years, so that they can get as much of their view of the world ingrained in government as possible. The next government will need years to unravel it and will need to do so at the peak of the need for deficit reduction.

This is what scorched earth government looks like.

[Phil D. Rolls]

The Tories know the game is up and that they are very unlikely to get back in at the next election. They need a 6% swing at least, something which has never happened. So, they are embarking on an ideologically driven wrecking spree in government for the last two years, so that they can get as much of their view of the world ingrained in government as possible. The next government will need years to unravel it and will need to do so at the peak of the need for deficit reduction.

This is what scorched earth government looks like.

Oh well, at least we've got a man with Clegg's integrity to stand up to them!

Anyone else feel this coalition is becoming more like an episode of Last of the Summer Wine everyday?


Clegg: Ayoop Foggy, wot's thee think thas doin with this economy then?
Cambo: I'm surprised you have to ask. Haven't you seen the new rocket powered bath tub I have developed to replace the Ambulance Service?
Vague: I were brought oop an a bath toob an it never did me any 'arm wotsoever, let's all dig in in an beat this ere Yoorp nonsense.

All: Ayoop!

[RyeSloan]

A couple of my family have had NHS treatment at Murrayfield Hospital, presumably in an attempt to bring the waiting lists down, and say that it was their best interaction with healthcare in decades. Significantly better infection rates, better outcomes and better facilities apparently.


I have first hand and second hand experience of botrh the NHS and Murrayfield.

To me the difference is stark. Murrayfield treats you as a customer, they thank you for attending and aim to provide you with a service. The NHS seems to see you as an irritation and merely want to process you through the system.

Don't get me wrong I have seen some excellent health care provision by the NHS but it does seem to be very much reliant on the individual you see rather than driven by the culture of the operation.

Running the NHS as a single in house entity stopped being possible a long time ago and the quicker people realise that the better. The principle of free universal healthcare at the point of use should never be quesitoned but the way that principle is met should surely be open to examination.

[Phil D. Rolls]

I have first hand and second hand experience of botrh the NHS and Murrayfield.

To me the difference is stark. Murrayfield treats you as a customer, they thank you for attending and aim to provide you with a service. The NHS seems to see you as an irritation and merely want to process you through the system.

Don't get me wrong I have seen some excellent health care provision by the NHS but it does seem to be very much reliant on the individual you see rather than driven by the culture of the operation.

Running the NHS as a single in house entity stopped being possible a long time ago and the quicker people realise that the better. The principle of free universal healthcare at the point of use should never be quesitoned but the way that principle is met should surely be open to examination.

Good points, I wouldn't disagree. To me one of the NHS's greatest challenges is that is providing so much more than it did when it was originally set up.

i

[Hibernia&Alba]

I have first hand and second hand experience of botrh the NHS and Murrayfield.

To me the difference is stark. Murrayfield treats you as a customer, they thank you for attending and aim to provide you with a service. The NHS seems to see you as an irritation and merely want to process you through the system.

Don't get me wrong I have seen some excellent health care provision by the NHS but it does seem to be very much reliant on the individual you see rather than driven by the culture of the operation.

Running the NHS as a single in house entity stopped being possible a long time ago and the quicker people realise that the better. The principle of free universal healthcare at the point of use should never be quesitoned but the way that principle is met should surely be open to examination.

I can't agree with this. First of all, we are patients not customers. The NHS isn't, and should never be, like going into a shop. What matters is having highly trained, highly motivated, highly respected professionals who treat patients with respect and compassion, and that we as patients are treated quickly and with the best resources available. I don't want a consultant who says "have a nice day" as I leave. It's a public service not a customer service.

And I don't agree the NHS sees patients as an irritation at all. The vast majority of the hundreds of thousands of NHS staff are dedicated and believe in public service, but they can't work miracles. In order to perform to their best they need the system properly funded and salaries for themselves that reflect te value of the work they do. They also need the stability which has been denied them for decades via countless reforms and Health Acts. Every few years there is root and branch re-structuring which, as soon as the staff have adapted to, is replaced with yet more upheaval.

Also, by definition the NHS has to be run as a single entity. It is a NATIONAL Health Service, there to ensure everyone gets access to the same care, wherever they live in the U.K. The disgrace of the postcode lottery in health care came about precisely because of Tory fragmentation of the system in the eighties. Break it up and the NHS will be finished. Stop the creeping privatisations and PFI schemes and once again allow it to concentrate on patients rather than budgets.

[Jack]

Can an admin please change the subject of this thread to NHS England.

The information provided in the OP will not happen in Scotland, at least in the foreseeable future.

[Phil D. Rolls]

I can't agree with this. First of all, we are patients not customers. The NHS isn't, and should never be, like going into a shop. What matters is having highly trained, highly motivated, highly respected professionals who treat patients with respect and compassion, and that we as patients are treated quickly and with the best resources available. I don't want a consultant who says "have a nice day" as I leave. It's a public service not a customer service.

And I don't agree the NHS sees patients as an irritation at all. The vast majority of the hundreds of thousands of NHS staff are dedicated and believe in public service, but they can't work miracles. In order to perform to their best they need the system properly funded and salaries for themselves that reflect te value of the work they do. They also need the stability which has been denied them for decades via countless reforms and Health Acts. Every few years there is root and branch re-structuring which, as soon as the staff have adapted to, is replaced with yet more upheaval.

Also, by definition the NHS has to be run as a single entity. It is a NATIONAL Health Service, there to ensure everyone gets access to the same care, wherever they live in the U.K. The disgrace of the postcode lottery in health care came about precisely because of Tory fragmentation of the system in the eighties. Break it up and the NHS will be finished. Stop the creeping privatisations and PFI schemes and once again allow it to concentrate on patients rather than budgets.

With respect, there is a certain amount of semantics that muddy the waters on this issue. "Clients" is another term that is often up for debate.

To me the medical profession, and some elements of the nursing and allied health professions like this model whereby the hospital acts to decide what is best for the person in need of care. Others would argue that the care should be driven by the needs of those accessing it.

It is nonsense to adapt a call centre type approach to people, and if people can't be civil and respectful in delivering care, they are in the wrong job. What I am saying is they need to differentiate between "have a nice day" and "how can we address your needs"? A great woman once called this "unconditional positive regard".

My feeling is - for whatever reason - too much care is task driven and not enough is person centred. The debate about whether private or public health funding can address this best is really a side issue. It's great to hear that BUPA can deliver such a good service, I wonder how much of that has to do with being able to cherry pick patients.

There are plenty of examples of shocking care in the private sector - Southern Cross, anyone? I guess it requires a population to take responsibility for some of their health care needs, work towards understanding them, and having the right, and the confidence to address what professionals deliver. At the moment, the medical model - an archaic, paternalistic system, holds too much sway in the field.

The other thing of course is that accountants can only see the costs of care, they can't see the benefits. There is a need for health care professionals to be more vocal in challenging some of the cost driven initiatives. To me, that is an area where they fall down - possibly because of the daunting process of working through such a behomoth as the NHS.

I love the NHS, I cherish it as this country's greatest achievements. Forget the Empire and the wars and the Industrial Revolution. For a society to mobilise itself to ensure that all its members have the best opportunity to remain well, was a noble and courageous thing to do.

Everyone in Britain should be proud of what we achieved. The game has moved on now, and we as a population have to work to maintain the high standards we have set ourselves. The NHS is Britain.

[Hibernia&Alba]

With respect, there is a certain amount of semantics that muddy the waters on this issue. "Clients" is another term that is often up for debate.

To me the medical profession, and some elements of the nursing and allied health professions like this model whereby the hospital acts to decide what is best for the person in need of care. Others would argue that the care should be driven by the needs of those accessing it.

It is nonsense to adapt a call centre type approach to people, and if people can't be civil and respectful in delivering care, they are in the wrong job. What I am saying is they need to differentiate between "have a nice day" and "how can we address your needs"? A great woman once called this "unconditional positive regard".

My feeling is - for whatever reason - too much care is task driven and not enough is person centred. The debate about whether private or public health funding can address this best is really a side issue. It's great to hear that BUPA can deliver such a good service, I wonder how much of that has to do with being able to cherry pick patients.

There are plenty of examples of shocking care in the private sector - Southern Cross, anyone? I guess it requires a population to take responsibility for some of their health care needs, work towards understanding them, and having the right, and the confidence to address what professionals deliver. At the moment, the medical model - an archaic, paternalistic system, holds too much sway in the field.

The other thing of course is that accountants can only see the costs of care, they can't see the benefits. There is a need for health care professionals to be more vocal in challenging some of the cost driven initiatives. To me, that is an area where they fall down - possibly because of the daunting process of working through such a behomoth as the NHS.

I love the NHS, I cherish it as this country's greatest achievements. Forget the Empire and the wars and the Industrial Revolution. For a society to mobilise itself to ensure that all its members have the best opportunity to remain well, was a noble and courageous thing to do.

Everyone in Britain should be proud of what we achieved. The game has moved on now, and we as a population have to work to maintain the high standards we have set ourselves. The NHS is Britain.

Whilst I agree with your admiration of the NHS, I would say the fact that you feel today's NHS is task driven rather than person driven is precisely because of the targets and market structures that are forcing health professionals into that position. It's because of the market ehos, not because of any flaw in the universal healthcare model. Health professionals are not, and never should be, number crunchers and salesmen. I don't agree that nurses, doctors, surgeons and consultants are archaic and paternalistic. If by paternalism you mean professionals who tell you what's best for you, then okay, but that's precisely because those doctors are highly trained and use their knowledge to describe the best course of action. If that's paternalism I'll bow to their their greater knowledge. I don't want 'empowerment', I want to live. There is nothing archaic abour that, rather it's the whole notion of being customer, which is ubiquitous now, that makes so many think they know it all. Being a customer in all arenas, including health, is a Thatcherite concept that everything is for sale and for profit, but, IMO we should listen to those professionals who have gone through years of training. There is nothing archaic about highly skilled people using their skills for the greater good.


As a democratic socialist I reject the idea that everybody is either a buyer or a seller, a provider or a customer. I believe there are values that go way beyond such a superficial relationship and that society needs values based upon humanitarian needs that money can't buy. The NHS as established by the Labour government of 1945 with Aneurin Bevan as Health Minister is the NHS I believe in. I don't want internal markets, outsourcing, BUPA and all the rest. I want the very best for evey man, woman and child in this country, regardless of background or income.

[Phil D. Rolls]

Whilst I agree with your admiration of the NHS, I would say the fact that you feel today's NHS is task driven rather than person driven is precisely because of the targets and market structures that are forcing health professionals into that position. It's because of the market ehos, not because of any flaw in the universal healthcare model. Health professionals are not, and never should be, number crunchers and salesmen. I don't agree that nurses, doctors, surgeons and consultants are archaic and paternalistic. If by paternalism you mean professionals who tell you what's best for you, then okay, but that's precisely because those doctors are highly trained and use their knowledge to describe the best course of action. If that's paternalism I'll bow to their their greater knowledge. I don't want 'empowerment', I want to live. There is nothing archaic abour that, rather it's the whole notion of being customer, which is ubiquitous now, that makes so many think they know it all. Being a customer in all arenas, including health, is a Thatcherite concept that everything is for sale and for profit, but, IMO we should listen to those professionals who have gone through years of training. There is nothing archaic about highly skilled people using their skills for the greater good.


As a democratic socialist I reject the idea that everybody is either a buyer or a seller, a provider or a customer. I believe there are values that go way beyond such a superficial relationship and that society needs values based upon humanitarian needs that money can't buy. The NHS as established by the Labour government of 1945 with Aneurin Bevan as Health Minister is the NHS I believe in. I don't want internal markets, outsourcing, BUPA and all the rest. I want the very best for evey man, woman and child in this country, regardless of background or income.

I hear what you are saying. I'd answer by saying "some times".

I don't know if you saw the story in the EEN yesterday where a guy was complaining that his mothers feeding tube had been withdrawn without his consent (I presume she was unable to give consent herself). Withot going into that story any further because, like all these things, the hospital is unable to give their side - I would say that if what the man says is true, it wouldn't be surprising.

There are fields of "medicine" - such as mental health, where there are many many examples of professionals imposing treatments on people, often to their detriment. My argument for empowerment is to put the control of an individuals life in the individual's hands. Of course, people should listen to the advice of professionals, but they should also take some responsibility for finding out as much as they can about drugs and interventions, diagnoses and alternative therapies as they can.

Doctors prescribed Thalidomide - they are not infallible. I don't think many of them would ever say they are. I agree it's not about consumerism when it's your life or well being that's at stake. As for care being task driven, I am afraid there are still too many hospitals that deliver care around factors like staff breaks and meal times. This results in the individual having to fit the system rather than the system fit the individual.

There is lots of evidence to support the view that, not only is this detrimental to people's recovery, but is not the best use of resources. I said before that the NHS is a great achievement, but we should never be complacent and work under the assumption that a) all those who work in it have the same level of concern for those who use it, and b) that it can't be improved.

[Hibernia&Alba]

These days doctors involve patients in the decision making process as much as possible. It used to be common practice for a terminally ill patient not to be told of their condition, something that just doesn't happen now. Patients, as far as I know and from the family experiences I have, are fully informed of their condition, their prognosis and the treatment options they have. Treating patients with compassion whilst being open about their condition is the standard approach.

The NHS can always be improved, it's a matter of how that should be achieved. IMO, outsourcing, cheap labour and running the service increasingly like a business is not the answer. Proper funding, motivated staff, and ending the constant revolutions that are imposed on the NHS by all new governments, are far more likely to produce a health system that provides social justice, better outcomes for patients and happier health professionals.

[Eyrie]

These days doctors involve patients in the decision making process as much as possible. It used to be common practice for a terminally ill patient not to be told of their condition, something that just doesn't happen now. Patients, as far as I know and from the family experiences I have, are fully informed of their condition, their prognosis and the treatment options they have. Treating patients with compassion whilst being open about their condition is the standard approach.

Doesn't always happen. I've had ongoing experience of the NHS for over a decade and here are some examples of the patient being secondary to the convenience of the NHS.

I got a letter at the end of March telling me that my outpatient appointment to see the consultant had been rearranged from early May to late October. That was all the letter said - no explanation was provided and I've had this happen before as well. I'm sure I could get an explanation if I asked, but why shouldn't this be provided at the time?

I've also had problems with getting a routine x-ray at the same hospital. When I asked why I was still waiting whilst people who arrived after me were being seen immediately I was informed by the receptionist that in-patients take priority. I ended up walking out, having warned the receptionist to no avail that I couldn't wait all day. This wasn't an A&E department so the in-patients were in no more need than I was.

Finally there was one medication which I had to collect every couple of months from the hospital which is on the other side of the city. Out of the blue I received a letter informing me that this could only be done during office hours in future. I had to complain to the consultant before anyone realised that these new hours were impossible for patients who work. Initially the hours were extended but this medication is now available from my chemist, which is much more convenient and thus patient-centred.

Don't get me wrong - I also have plenty of positive experiences of helpful and interested staff, but all three examples of poor patient care are worth mentioning.

[Phil D. Rolls]

These days doctors involve patients in the decision making process as much as possible. It used to be common practice for a terminally ill patient not to be told of their condition, something that just doesn't happen now. Patients, as far as I know and from the family experiences I have, are fully informed of their condition, their prognosis and the treatment options they have. Treating patients with compassion whilst being open about their condition is the standard approach.

The NHS can always be improved, it's a matter of how that should be achieved. IMO, outsourcing, cheap labour and running the service increasingly like a business is not the answer. Proper funding, motivated staff, and ending the constant revolutions that are imposed on the NHS by all new governments, are far more likely to produce a health system that provides social justice, better outcomes for patients and happier health professionals.

If it was the standard approach there wouldn't be initiatives to teach trained nurses how to care with compassion. If it was the standard approach elderly patients would be getting their nutritional needs met, instead of having a meal plonked in front of them - with no consideration about whether they are physically or mentally capable of actually feeding themselves. If it was the standard approach people asking for pain relied through the night wouldn't be fobbed off with paracetomol, instead of an opiate because there are not two trained nurses available to administer it.

If it was the standard approach - elderly people would not be getting DNR certificates written for them without consent.

It's far from a bed of roses. I agree that outsourcing doesn't always work best. That said, there are many not for profit or voluntary sector organisations that can work very well alongside the NHS, and often provide a standard of care that is not possible in the bureaucratic monster that our health service is.

Visit a psychiatric hospital - the Cinderella service of the NHS - and see where the health service is failing people. Visit the old crumbling hospital buildings where the elderly and infirm are cared for. Is that due to lack of funding or too many high salaries. It's for the people to decide, and take the time to become more informed about the options and choices they have.

[Hibernia&Alba]

I would still aruge that examples you highlight are a consequence of funding shortfalls and demotivated staff and not a result of a flaw in the system of universal health care free at the point of delivery. A privatised health service may provide a more pleasant experience for some, but many others wouldn't have access at all. What matters is that every individual has access to highly qualified staff and speedy access to diagnosis and the best available treatment. Ever more competition and outsourcing only gets in the way of ensuring that clinical need remains the top priority and also destroys morale, IMO, as the NHS workers themselves overwhelmingly say.

We should be making the fully publicly funded model work in the way it can, rather have governments undermining it and trying to destroy it. The Tories want the NHS to fail, they've never supported it but for the knowledge it is so popular with the electorate. Every initiative, particularly since Thatcher, has been designed to break it up and increase the role of the private sector. Their entire propaganda has been aimed at trying to introduce private sector values into what is a vital public service in an attempt to demonstrate that nothing in the public sector works. Well the NHS does work, and it works brilliantly for the population of the UK. Yes we should always be looking to make it better, but better within the principle of equal health care for everyone in the country. Improve it via the fully publicly funded model that has helped improve the nation's health immeasurably since 1945.

[Eyrie]

I would still aruge that examples you highlight are a consequence of funding shortfalls and demotivated staff and not a result of a flaw in the system of universal health care free at the point of delivery. A privatised health service may provide a more pleasant experience for some, but many others wouldn't have access at all. What matters is that every individual has access to highly qualified staff and speedy access to diagnosis and the best available treatment. Ever more competition and outsourcing only gets in the way of ensuring that clinical need remains the top priority and also destroys morale, IMO, as the NHS workers themselves overwhelmingly say. What part of not telling me why my appointment has been delayed for six months is due to cash or "demotivated staff"?What part of treating outpatients as second class citizens is due to cash or "demotivated staff"?What part of not thinking about the impact of changing when I can collect medication is due to cash or "demotivated staff"?Each is a simple case of something being done to suit the hospital with no regard for the impact on the patient. I'm in favour of a publicly funded health service, but one which puts the patient first. The NHS is like any other big organisation (whether public eg HMRC or private eg banks) in that it can at times forget why it is there.

[Jack]

What part of not telling me why my appointment has been delayed for six months is due to cash or "demotivated staff"?What part of treating outpatients as second class citizens is due to cash or "demotivated staff"?What part of not thinking about the impact of changing when I can collect medication is due to cash or "demotivated staff"?Each is a simple case of something being done to suit the hospital with no regard for the impact on the patient. I'm in favour of a publicly funded health service, but one which puts the patient first. The NHS is like any other big organisation (whether public eg HMRC or private eg banks) in that it can at times forget why it is there.

Where do you live?

[Phil D. Rolls]

I would still aruge that examples you highlight are a consequence of funding shortfalls and demotivated staff and not a result of a flaw in the system of universal health care free at the point of delivery. A privatised health service may provide a more pleasant experience for some, but many others wouldn't have access at all. What matters is that every individual has access to highly qualified staff and speedy access to diagnosis and the best available treatment. Ever more competition and outsourcing only gets in the way of ensuring that clinical need remains the top priority and also destroys morale, IMO, as the NHS workers themselves overwhelmingly say.

We should be making the fully publicly funded model work in the way it can, rather have governments undermining it and trying to destroy it. The Tories want the NHS to fail, they've never supported it but for the knowledge it is so popular with the electorate. Every initiative, particularly since Thatcher, has been designed to break it up and increase the role of the private sector. Their entire propaganda has been aimed at trying to introduce private sector values into what is a vital public service in an attempt to demonstrate that nothing in the public sector works. Well the NHS does work, and it works brilliantly for the population of the UK. Yes we should always be looking to make it better, but better within the principle of equal health care for everyone in the country. Improve it via the fully publicly funded model that has helped improve the nation's health immeasurably since 1945.

I'm not arguing for a privatised health service, I'm arguing for a better NHS. Possibly we're at cross purposes here. I'm arguing for the NHS to concentrate more on person centred care. It is failing on that front, and it ain't all down to funding.

You keep saying the NHS is successful, but I would come back to my original argument - "some times". You say that my examples are a result of funding shortfalls - what's your evidence base for that? How can a funding shortfall excuse a nurse from failing in the absolute basics of the job such as nutrition and hydration?

What does this story teach us about the NHS? Older People's Champion (http://www.scotsman.com/edinburgh-evening-news/health/eri-care-scandal-sparks-calls-for-older-people-s-champion-1-2576439)

[Eyrie]

Where do you live?

Edinburgh, so my experiences can't be blamed on privatisation. They can be blamed on the lack of person-centred care which is the point Filled Rolls is making.

My best experiences with consultants and nurses all have that in common - they make me feel like they're interested in my situation and are willing to talk with me rather than viewing me as another appointment to be seen that day.

[Hibernia&Alba]

I'm not arguing for a privatised health service, I'm arguing for a better NHS. Possibly we're at cross purposes here. I'm arguing for the NHS to concentrate more on person centred care. It is failing on that front, and it ain't all down to funding.

You keep saying the NHS is successful, but I would come back to my original argument - "some times". You say that my examples are a result of funding shortfalls - what's your evidence base for that? How can a funding shortfall excuse a nurse from failing in the absolute basics of the job such as nutrition and hydration?

What does this story teach us about the NHS? Older People's Champion (http://www.scotsman.com/edinburgh-evening-news/health/eri-care-scandal-sparks-calls-for-older-people-s-champion-1-2576439)

Training, removal of the cutbacks and the downsizing, enabling prefessional staff to feel valued, enough staff to look after the most vulnerable. It can be done. We need the democratic socialist principles the NHS was formed upon, so that every man, woman and child feels part of the system and that staff feel the same rather than thier being an economic unit. Consumerism must never apply to the NHS.

[Phil D. Rolls]

Training, removal of the cutbacks and the downsizing, enabling prefessional staff to feel valued, enough staff to look after the most vulnerable. It can be done. We need the democratic socialist principles the NHS was formed upon, so that every man, woman and child feels part of the system and that staff feel the same rather than thier being an economic unit. Consumerism must never apply to the NHS.

Whio is talking about consumerism, I'm talking about models of care. The resources are there right now to adapt them, some parts of the NHS are more successful than others.

You keep talking about ecomomic theories, I am talking about human beings. Can I suggest that is where any planning for future health care begins. Oh, and those involved in delivering their care are given more than lip service when implementing models of care? There is plenty going on in the NHS that no sane nurse or doctor would have agreed to.

[Hibernia&Alba]

Whio is talking about consumerism, I'm talking about models of care. The resources are there right now to adapt them, some parts of the NHS are more successful than others.

You keep talking about ecomomic theories, I am talking about human beings. Can I suggest that is where any planning for future health care begins. Oh, and those involved in delivering their care are given more than lip service when implementing models of care? There is plenty going on in the NHS that no sane nurse or doctor would have agreed to.


The model of care the NHS needs extends beyond any talk of market forces and any notion of patients as customers. It requires a fully publicly funded NHS, as was introduced in 1945, no talk of 'choice' and such nonsense which inevitably undermines the concept of equal and free care for all. I don't want a false 'choice', I want my nearest hospital to be as well equipped as any I can reach by helicopter. Every hospital can and should be as successful as every other within a national system. I'm not interested in making them compete against each other as if they are hotels. All should be funded to give exactly the same quality of care as each other regardless of where anybody lives, and anything that makes hospitals compete and compare is to me a betrayal of the values upon which the NHS was founded. Total equality of access and care is the only equitable outcome in my opinion. It doesn't matter whether you are in Lands End or John O'Groats, you get the the same care. All are equal, none are entitled to a superior NHS. Total equalty, based upon public funding and which is non-negotiable. One model for every man, woman and child who pays their National Insurance!

The concept of equal access to a free NHS that provides total care for all is fundamenatally sound and must be defended to the last. It's those attempts to move away from that system, particularly since Thatcher, that have produced injustice and ineffiency. We need to return to the era before market bull****.

The concept of an NHS free to all and which provides equal access to every citizen is fundamentally sound, and it's the attermpts to move away from that system that have created unfairness and huge waiting lists. Everybody receiving the same care will provide the best for every human being. We don't need to be duped by false notions of choice and differntiation.

[Phil D. Rolls]

The model of care the NHS needs extends beyond any talk of market forces and any notion of patients as customers. It requires a fully publicly funded NHS, as was introduced in 1945, no talk of 'choice' and such nonsense which inevitably undermines the concept of equal and free care for all. I don't want a false 'choice', I want my nearest hospital to be as well equipped as any I can reach by helicopter. Every hospital can and should be as successful as every other within a national system. I'm not interested in making them compete against each other as if they are hotels. All should be funded to give exactly the same quality of care as each other regardless of where anybody lives, and anything that makes hospitals compete and compare is to me a betrayal of the values upon which the NHS was founded. Total equality of access and care is the only equitable outcome in my opinion. It doesn't matter whether you are in Lands End or John O'Groats, you get the the same care. All are equal, none are entitled to a superior NHS. Total equalty, based upon public funding and which is non-negotiable. One model for every man, woman and child who pays their National Insurance!

The concept of equal access to a free NHS that provides total care for all is fundamenatally sound and must be defended to the last. It's those attempts to move away from that system, particularly since Thatcher, that have produced injustice and ineffiency. We need to return to the era before market bull****.

The concept of an NHS free to all and which provides equal access to every citizen is fundamentally sound, and it's the attermpts to move away from that system that have created unfairness and huge waiting lists. Everybody receiving the same care will provide the best for every human being. We don't need to be duped by false notions of choice and differntiation.

When I talk about models of care, I am not talking about the resources received, but how those resources are applied. You can provide person centred care at the same cost as you can provide task driven care.

Do you not think that the people who work in the NHS have had some part to play in the betrayal of the ideals? It gets a bit tiresome, this constant sterotyping of nurses as "hard working angels" for example. What did the nurses, and their union do to stand up for the NHS when it was under threat?

I don't want to get heavy on this, but you are making a lot of assertions like - "The concept of an NHS free to all and which provides equal access to every citizen is fundamentally sound, and it's the attermpts to move away from that system that have created unfairness and huge waiting lists." What evidence do you have to support that?

The way that I have understood it is that the NHS is attempting to treat many more people for longer periods of time, than it did when it was established. It is its very success in raising life expectancy that sees a growth in things like hip replacements, and dementia care.

[Jack]

Hey you two.

Can I please ask you to specify which NHS system you are discussing as each of the home nations has a different model and have been pretty much independent from each other since day 1.

Just a simple point Hibernia&Alba. Hospitals are built for different reasons. It is totally unfeasable to build an ERI everywhere. It would be impossible to staff never mind build. Specialist surgeons just wouldn't get the numbers to stay competent. Lots of reasons.

The good news on that though is that Scotland is recognized as being a world leader in the world of telehealth and telecare. This is leading to expert consultants becoming available in remote and rural areas without travelling huge distances.

[Phil D. Rolls]

Hey you two.

Can I please ask you to specify which NHS system you are discussing as each of the home nations has a different model and have been pretty much independent from each other since day 1.

Just a simple point Hibernia&Alba. Hospitals are built for different reasons. It is totally unfeasable to build an ERI everywhere. It would be impossible to staff never mind build. Specialist surgeons just wouldn't get the numbers to stay competent. Lots of reasons.

The good news on that though is that Scotland is recognized as being a world leader in the world of telehealth and telecare. This is leading to expert consultants becoming available in remote and rural areas without travelling huge distances.

I am talking about care in Scotland, primarily in hospital based settings. My own subject of interest is the care of mentally ill people, there are many that could argue that taking people to a hospital far from their community is not the best way to aid recovery. Surely it can't cost that much more to have nurse led, community hospitals where people could get well in the environment in which they will return to?

That is the sort of thing I am driving at - budgets could be used more effectively if those spending the money looked at the best way to help service users. It is a win/win situation, improved care means longer periods between admissions.

[IWasThere2016]

Having worked in the NHS for several years in the late 90s/early 00s, my opinion is it is very wasteful and inefficient.

The most recent experience confirmed this as my wife was asked repeatedly about allergies by 2/3 nurses and 2/3 doctors in the space of a few hours. We then had a 5 hour wait on a prescription from the hospital pharmacy. Both ludicrous IMHO.

[Hibernia&Alba]

When I talk about models of care, I am not talking about the resources received, but how those resources are applied. You can provide person centred care at the same cost as you can provide task driven care.

Do you not think that the people who work in the NHS have had some part to play in the betrayal of the ideals? It gets a bit tiresome, this constant sterotyping of nurses as "hard working angels" for example. What did the nurses, and their union do to stand up for the NHS when it was under threat?

I don't want to get heavy on this, but you are making a lot of assertions like - "The concept of an NHS free to all and which provides equal access to every citizen is fundamentally sound, and it's the attermpts to move away from that system that have created unfairness and huge waiting lists." What evidence do you have to support that?

The way that I have understood it is that the NHS is attempting to treat many more people for longer periods of time, than it did when it was established. It is its very success in raising life expectancy that sees a growth in things like hip replacements, and dementia care.

Look at the the rates of factors life expectancy, infant mortality and chronic illnesses such as whooping cough asnd TB before and after the introduction of free health care for all, then compare it to rates from the 1950s onwards. Look at the effects upon waiting lists and the state of the buildings themselves in the 1980s when the internal market and outsourcing was introduced in the 1980s.

A month ago my best friend's sister had a liver transplant in Edinburgh Royal. A young mother with a lifelong condition who no doubt would have found it very hard to obtain private insurance in a privatised system due the costs of such a procedure and the fact she had a pre-existing condition, not to mention the fact she mightn't have been able to afford such premiums. The NHS model saved her life and is second to none in the world in terms of outcomes and social justice. It is one of the things that makes me proud of this country. We have the best health care model in the world and should always be looking to improve it rather than change its fundamentals. Fully publicly owned, fully accessible to all, fully equal. I can't praise it enough. The Labour government 1945 and Aneurin Bevan in particular are forever heroes.

[Phil D. Rolls]

Look at the the rates of factors life expectancy, infant mortality and chronic illnesses such as whooping cough asnd TB before and after the introduction of free health care for all, then compare it to rates from the 1950s onwards. Look at the effects upon waiting lists and the state of the buildings themselves in the 1980s when the internal market and outsourcing was introduced in the 1980s.

A month ago my best friend's sister had a liver transplant in Edinburgh Royal. A young mother with a lifelong condition who no doubt would have found it very hard to obtain private insurance in a privatised system due the costs of such a procedure and the fact she had a pre-existing condition, not to mention the fact she mightn't have been able to afford such premiums. The NHS model saved her life and is second to none in the world in terms of outcomes and social justice. It is one of the things that makes me proud of this country. We have the best health care model in the world and should always be looking to improve it rather than change its fundamentals. Fully publicly owned, fully accessible to all, fully equal. I can't praise it enough. The Labour government 1945 and Aneurin Bevan in particular are forever heroes.

Yes, but when you have situations like a nursing assistant refusing to take a lady to the toilet, because it is "protected meal time", then the system is overriding the needs of the individual. When old people are dragged out of their beds at 7.30 so that breakfast can be served at 8.30, and the domestics can get in to clean the ward, it is the same thing.

I fully support the NHS, it is something for us all to be proud of. I just think that there is room for improvement. My arguments are not about how the individual pays for the care, but about the way it is delivered.

Delivering a universal system of care is not compatible with the needs of the individual. People complain about the post code lottery, but the alternative is that every hospital or GP has to spend their budget the same way.

A GPs surgery in Muirhouse is going to have different priorities than one in the Grange. The system has to be flexible enough to address people's needs, whilst recognising that there is not an infinite amount of money to spend.

When you think about it, the best health care would be delivered in people's homes, not in hospitals. We accept that there are not enough people to deliver that - right away we have made a compromise.

[Hibernia&Alba]

Yes, but when you have situations like a nursing assistant refusing to take a lady to the toilet, because it is "protected meal time", then the system is overriding the needs of the individual. When old people are dragged out of their beds at 7.30 so that breakfast can be served at 8.30, and the domestics can get in to clean the ward, it is the same thing.

I fully support the NHS, it is something for us all to be proud of. I just think that there is room for improvement. My arguments are not about how the individual pays for the care, but about the way it is delivered.

Delivering a universal system of care is not compatible with the needs of the individual. People complain about the post code lottery, but the alternative is that every hospital or GP has to spend their budget the same way.

A GPs surgery in Muirhouse is going to have different priorities than one in the Grange. The system has to be flexible enough to address people's needs, whilst recognising that there is not an infinite amount of money to spend.

When you think about it, the best health care would be delivered in people's homes, not in hospitals. We accept that there are not enough people to deliver that - right away we have made a compromise.

I totally disagree with that. I see no contradiction between a service that is free to all at the point of use and managing the needs of the patients in the system. What changes would you make, if you think a universal system is incompatible with the needs of the individual ? More private sector involvement? We already have PFI for building hospitals ( massively expensive to taxpayers ) and tenders for all kinds of things like food, cleaning, maintenence. Would you weaken trade union rights for staff in the name of 'flexibility'? Would you introduce private health insurance to treatment itself, so that patients become 'customers'? Any terrible examples of lack of care e.g. a nurse refusing to take a patient of the toilet, doesn't require root and branch reform of the NHS system. It requires that nurse to be disciplined for their conduct and staff rotas organised to ensure there is cover at all times. The system is already top heavy with managers who should be able to organise staffing levels.
The fact that there are Health Acts introduced by governments at an average of every three years, Acts which produce huge upheavals each time, undermines the ability of the NHS to establish a method of consistent practice. Politicians are keeping the system in a state of permanent revolution, preventing practitioners from working effectively. Constant upheaval is no way to get the best out of anything. These are the kind of issues I would be concentrating upon to gain the best from a fantastic system.

To go back the OP, the incremental attempts to privatise the NHS, as explified by the latest huge privatisation programme in England is totally wrong, IMO, both in terms of health outcomes and social justice. The direction of ever more privatisation needs stopping and reversing.

[Phil D. Rolls]

I totally disagree with that. I see no contradiction between a service that is free to all at the point of use and managing the needs of the patients in the system. What changes would you make, if you think a universal system is incompatible with the needs of the individual ? More private sector involvement? We already have PFI for building hospitals ( massively expensive to taxpayers ) and tenders for all kinds of things like food, cleaning, maintenence. Would you weaken trade union rights for staff in the name of 'flexibility'? Would you introduce private health insurance to treatment itself, so that patients become 'customers'? Any terrible examples of lack of care e.g. a nurse refusing to take a patient of the toilet, doesn't require root and branch reform of the NHS system. It requires that nurse to be disciplined for their conduct and staff rotas organised to ensure there is cover at all times. The system is already top heavy with managers who should be able to organise staffing levels.
The fact that there are Health Acts introduced by governments at an average of every three years, Acts which produce huge upheavals each time, undermines the ability of the NHS to establish a method of consistent practice. Politicians are keeping the system in a state of permanent revolution, preventing practitioners from working effectively. Constant upheaval is no way to get the best out of anything. These are the kind of issues I would be concentrating upon to gain the best from a fantastic system.

To go back the OP, the incremental attempts to privatise the NHS, as explified by the latest huge privatisation programme in England is totally wrong, IMO, both in terms of health outcomes and social justice. The direction of ever more privatisation needs stopping and reversing.

Yeah, but that's not what I was talking about. I am talking about the attitudes of those in the NHS and how they can be changed, and also about how the demands of every individual in society can never be met by a one size fits all approach.

It would be nice if the machine could be adapted to the needs of the patient rather than the needs of the hospital. Some of the things nurses do wrong is because they are asked to make a decision about what is best for the patient, and what is best for the system.