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After seeing this report from the British Medical Association are there any other forum members who live with an illness, becoming as scared as me?
How the secretary of state for health proposes to abolish the NHS in England

Working alongside GP's and within the NHS, I can say there wont be a great deal of change with the forthcoming GP comission, the NHS will still continue to exist, and there is very little to worry about with regards patient healthcare.

The thing that will change, is the way the treatment and care is divided up and provided to patients, to try and reduce wastage and to help patients by offering more targetting the finances where it is needed most. And trust me, GP's will for certain, run the NHS far far more efficiently, and in the interest of patients, than some penpushing fat cat sat in London!

The NHS "cuts" as the papers like to report, are not truely happening, spenind on the NHS is NOT being cut... however, having worked in an admin role on occasion, dealing with some aspects of accounting, the amount of money that is wasted at present, the over-inflated prices for services that are paid just because its a government organisation (prices that private companies simply would never in a million years pay) is ludacris.

Generally though, there won't be a hugely visable change to the service patients actually recieve. The NHS is far too big (the biggest employer in the world??), and the budget/spending is out of control. In addition to this, the service need modernising, and a complete overhaul of every aspect cannot come soon enough!

I've not got an illness, but do work within the health and social environment.Just seeing how the government are cutting back on so many services is really scary for those people who do have needs.

my comment has gone!

@MattLFC

The BMA seems to view things differently.

Quote:Section 9 abolishes the duty on the health secretary to “provide [certain health services] throughout England, to such extent as he considers necessary to meet all reasonable requirements.

Does this mean that my Nan may not get here new hip because the local NHS doesn’t see elderly care as a necessary treatment.

@ Kirmit

What’s really scaring me are these two statements:

Freedom to create surpluses from care budget

The bill explicitly authorises the creation of surpluses from the patient care budget and their distribution to staff and shareholders as part of financial incentive or bonus schemes (section 23). Surpluses can be generated by selecting patients or services, denial of care, or reductions in staff terms and conditions, responsibility for which will be transferred to corporate bodies. The secretary of state cannot be held to account for diversion of NHS funds from patient care to staff or investors.

The end of the NHS?

The government proposes a commercial system in which the NHS is reduced to the role of government payer, equivalent to Medicare and Medicaid schemes in the US. However, government belief that cost efficiency, improved quality, and greater equity flow from competition in healthcare markets22 is not supported by evidence, the Office of Fair Trading, the government’s impact assessment, or its experience of independent treatment centres and private finance initiatives.

There's always going to be problems if the NHS starts being all about the money.

The scaremongering has started, huh. How surprising (not).

Silly me... thought the British Medical Journal was a serious publication.

Probably just my paranoia about dying prematurely.

So are you therefore saying that we should just present the NHS with an open paycheque and fight every illness, and every disease, with every treatment possible?

If thats the case, I assume you are happy for the standard rate of income tax to rise to a stupid level, say 40% or more? At present, the NHS is about money, they have a set budget, they have postcode lotteries, and they have x drugs are available and x drugs are too expensive etc...

However the current NHS and the way it allocates its spending (and the way it goes about deciding how to allocate spending), is out of control, and personally, id like to see us move more towards a US style of healthcare; maybe I would then no longer have to see upto 60% of patients missing appointments in each surgery, if they had to pay for the privaledge of them!! We already have to pay for our dental treatment, yet that is NHS, so why not other forms of healthcare? We have dental insurance to lessen/prevent the bills of dental treatment, so why not other forms of healthcare? We have charges for NHS prescriptions! Unfortunatly in the UK, everyone has an attitude that the state will pay for everything for them, from music lessons to the cost of babies/kids (in the form of benefits and tax credits) etc, so the charging of the healthcare will never happen.

As for those who think this is the end of the NHS... what exactly is wrong with that idea anyway? The NHS from top to bottom, is, and has been, for the mostpart, an inefficient, and unviable shambles, and any change which leads to better patient care has got to be embraced. Even things down the systems and procedures, are inefficient, and only 1 in 3 staff are actually medical staff, the rest are admins and the like, in jobs for life, with little/no concern about underperforming and generally lazy staff (something ive witness at first hand every day). There are not enough medical staff in the NHS, but there are far too many non-medical staff in the NHS, thats for sure.

You simply can't feasibly control an organisation as large as the NHS with a single set of rules and procedures, you can't manage staff from the top and expect them to remain efficient and working for their jobs, you can't generalise each patient condition and allocate x-money to x-problem without taking into account the local area's needs first. Government should not be responsible for running the NHS, it should be responsible for funding it and overseeing the regulation of it, ensuring there is a competitive enviroment, one in which both the patient gets an acceptable level of healthcare, and the taxpayer sees value for money (and by value, I don't mean the cheapest, I mean the best possible care for the money spent), and that is it.

See? "NHS Cuts". "Dying prematurely". "BMJ printed it so it must be gospel". What I said: Scare-mongering.

Anyone who believes that the Government is the best organization to run ANYTHING, will I'm sure, get the heathcare that they deserve. And yes, might well die prematurely - just like my elder brother did (in England).

If he had lived here in the USA and had available the same level of preventive medical care that I've had, provided by private sector companies that are actually allowed to make WICKED, EVIL profits (such a DIRTY word, how DARE they?) then I absolutely do believe that he would still be alive today. Am I biased? Hell yes.

(Apologies to Matt for seemingly stalking yet another of his posts...)

Early days, but not noticed anything at WUTH yet.

Since the introduction of Payment-by-Results (PbR) the emphasis for hospitals has been on speedier discharges, where medically safe, to maximise "bed days". For example, it is not unusual to see patients discharged after a day or so after having a mild stroke (i.e. virtually complete recovery). The short length of stay minimises stress on the patient but ultimately allows more patients to be treated. With the closure of intermediate services (e.g. Poulton House) patients may need to stay in longer or have a larger package of care on discharge.

For non-life threatening, elective treatment (e.g. joint replacement for osteoarthritis) we are at the mercy of the patient choosing to be referred to us. Patients have been allowed the option of choosing an out of area provider, private or even elsewhere in Europe in some cases for a while now - it's not something the current Government have introduced. PbR was partly introduced to level the playing field; for example the cost of a hip replacement at WUTH should be the same as one performed at Southport and Ormskirk.

As for emergency care, there are currently no private providers in the UK...
2004 figures put them third behind the Indian Railways (1.5m) and the Chinese Army (2.3m). Before anyone asks; managers account for 3% of the NHS work force (and no, I'm not one).

For those interested 70-75% of the NHS budget is spent on wages and 50% of that figure is nurses' wages.

I think I may have posted this comment in a previous post some months back, so sorry for repeating myself but it's something I feel strongly about. Perhaps if the NHS got rid of the managers,who manage managers who in turn manage managers and kept the front line staff there would be a lot more money to go into patient services. Incidentally some of the private providers offer a quicker waiting time to patients as well as a cheaper service to the GP's. Patient care won't be affected by the changes from the GP side of things. I work for a GP, and see it from the GP and patient point of view.